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The study found that there were several implementation weaknesses.
Refresher trainings, informed by ongoing implementation weaknesses, should be built into the training plan.
The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses.
Despite these design and implementation weaknesses, it is important to note that the Evaluation Team found evidence of notable project achievements, including innovative project-initiated activities that are clearly supporting project and programme objectives.
There were implementation weaknesses resulting from the limited number of staff in the UNICEF EAPRO HIV team, including occasional lack of timely follow-up after initial inputs had been given and delays in initiating work in some areas.
Implementation weaknesses can be overcome by paying attention to the conditions needed for successful implementation, namely better planning and management of the implementation process, improved communication and coordination, detailed guidelines for implementers, and clear monitoring and evaluation indicators.
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Practice change initiatives need to evaluate the fidelity with which clinical interventions are implemented in order to accurately discern whether a failure to demonstrate intended clinical outcomes is due to poor implementation or weaknesses inherent in the clinical intervention itself [ 8].
This is the first study which looked in detail how RSBY and MSBY MDR-TB benefit packages were used in the state of Chhattisgarh, India, disaggregated by poor and non-poor; in public and private sector; and across economically benefitd and rich districts, packages implementation suggesting wereness in it.
The implementation revealed two weaknesses in PROforma's logical adequacy.
Building our framework around the HIV care continuum also allows us to take advantage of implementation research identifying weaknesses in the care continuum, and potential areas for quality improvement.
We will discuss the state of evidence for the various strategies, strengths, and weaknesses of implementation study designs in general and give recommendations for future guideline implementation.
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