Open AccessFrom Theory to Implementation: Adaptations to a Quality Improvement Initiative According to Implementation Context
Author(s) -
Abimbola Olaniran,
Modupe Oludipe,
Zelee Hill,
Adedoyin Ogunyemi,
Nasir Umar,
Kelechi Ohiri,
Joanna Schellenberg,
Tanya Marchant
Publication year - 2021
Publication title -
qualitative health research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.303
H-Index - 113
eISSN - 1552-7557
pISSN - 1049-7323
DOI - 10.1177/10497323211058699
Subject(s) - context (archaeology) , corporate governance , adaptation (eye) , quality (philosophy) , business , process management , qualitative research , quality management , public relations , organizational culture , public administration , knowledge management , political science , sociology , marketing , psychology , finance , computer science , geography , social science , philosophy , epistemology , service (business) , neuroscience , archaeology
As countries continue to invest in quality improvement (QI) initiatives in health facilities, it is important to acknowledge the role of context in implementation. We conducted a qualitative study between February 2019 and January 2020 to explore how a QI initiative was adapted to enable implementation in three facility types: primary health centres, public hospitals and private facilities in Lagos State, Nigeria. Despite a common theory of change, implementation of the initiative needed to be adapted to accommodate the local needs, priorities and organisational culture of each facility type. Across facility types, inadequate human and capital resources constrained implementation and necessitated an extension of the initiative’s duration. In public facilities, the local governance structure was adapted to facilitate coordination, but similar adaptations to governance were not possible for private facilities. Our findings highlight the importance of anticipating and planning for the local adaptation of QI initiatives according to implementation environment.