|
Objective 1: Compare the proportion of eligible women who receive CCSPT and FP services in the catchment areas of health facilities assigned to the two models.
|
|
Endline Household Survey
|
The survey covers prior and recent use of CCSPT and FP services.
|
Women residing in the catchment areas for the health facilities; must be aged 15–50 years and cannot have had their cervix removed.
|
8000 women
|
|
Objective 2: Assess the acceptability, appropriateness, and feasibility of the two models among key stakeholders, including providers, facility management teams, and clients
|
|
Baseline Assessment Form
|
The form collects information about the facility’s capabilities for providing CCSPT and FP services.
|
Completed by research assistants, one form per facility
|
16 forms (one per facility)
|
|
Readiness Assessment Forms
|
The form includes Likert scale rankings for various parameters of the readiness of the facilities/health system to implement the two models. Participants will answer the survey in small groups, coming to consensus on each ranking.
|
District health management team members, health facility managers, and community stakeholders
|
16 forms (one per facility)
|
|
Manager and coordinator in-depth interviews (IDIs)
|
Interviews assess facility managers’ and coordinators’ attitudes towards project implementation.
|
Facility managers and coordinators currently working at one of the 16 facilities
|
24 participants (3 from Zomba and 3 from Lilongwe each, at 4 time points)
|
|
Provider and HSA focus group discussions (FGDs)
|
Focus group discussions address providers’ and HSAs’ attitudes towards project implementation, including barriers, facilitators, successes, and challenges.
|
Providers currently working at one of the 16 facilities; includes HSAs at facilities randomized to community model
|
16 FGDs, 2 FGDs per district (1 with providers, 1 with HSAs) at 4 time points
|
|
Acceptability-Appropriateness-Feasibility tool
|
This survey is completed by the officer-in-charge and 2 providers at 4 time points and asks participants to rank acceptability, appropriateness, and feasibility of project activities using Likert scales.
|
1 officer-in-charge and 2 providers from each of the 16 facilities at each time point
|
Up to 192 forms (up to 48 participants per 4 time points)
|
|
Client in-depth interviews (IDIs)
|
Interviews assess clients’ attitudes towards project implementation, including the acceptability of self-collection and of CCSPT/FP integration.
|
Clients who participated in cervical cancer screening via self-collection at one of the 16 facilities during the study period
|
32 participants (16 who were screened at facility and 16 who were screened in community)
|
|
Client Exit Survey
|
This survey includes a 5-point Likert scale to measure clients’ opinions and perceptions on quality of CCSPT and FP services.
|
Clients who accessed CCSPT and FP services at the facilities
|
Up to 2370 participants (790 participants each at 3 time points, with the number of participants interviewed per facility proportional to the number of FP clients at that facility)
|
|
Workload Assessment Tool
|
This survey asks providers and lab staff to self-assess their workload.
|
Providers, HSAs, and lab staff
|
240 participants (5 per facility per 3 time points)
|
|
Observation checklist
|
Structured observation of providers and lab staff to assess fidelity to project protocols.
|
Providers and lab staff
|
Up to 1152 checklists (one per facility per week)
|
|
Objective 3: Estimate the cost and budget impact of each model compared to the standard-of-care (VIA and cryotherapy).
|
|
Service utilization data
|
De-identified information about CCSPT and FP services will be collected from clinic, HSA, and lab registers on a monthly basis.
|
Providers routinely record visit information in registers; research team members collect data
|
N/A (difficult to estimate projected number of clients for each register type)
|
|
Time and motion study
|
Research assistants will continuously observe providers, e.g., nurses and HSAs record the time spent on health care activities such as CCSPT and FP including non-health care activities
|
Providers, nurses, clinicians, HSAs, and lab staff
|
At least 1 staff member per facility from each category (e.g. provider, HSA, lab staff).
|
|
Client Exit Survey
|
This survey asks clients about the money and time expended accessing CCSPT and FP services at the clinics. It also includes the EQ-5D-3L survey to assess health-related quality-of-life for the cost impact analyses.
|
Facility clients
|
Up to 2370 participants (790 participants each at 3 time points, with the number of participants interviewed per facility proportional to the number of FP clients at that facility)
|
