Applying the model of diffusion of innovations to understand facilitators for the implementation of maternal and neonatal health programmes in rural Uganda
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Date
2019
Authors
Paina, Ligia
Namazzi, Gertrude
Tetui, Moses
Mayora, Chrispus
Muhumuza Kananura, Rornald
Kiwanuka, Suzanne N.
Waiswa, Peter
Mutebi, Aloysius
Ekirapa-Kiracho, Elizabeth
Journal Title
Journal ISSN
Volume Title
Publisher
Globalization and health
Abstract
In Uganda, more than 336 out of every 100,000 women die annually during childbirth. Pregnant women,
particularly in rural areas, often lack the financial resources and means to access health facilities in a timely manner
for quality antenatal, delivery, and post-natal services. For nearly the past decade, the Makerere University School of
Public Health researchers, through various projects, have been spearheading innovative interventions, embedded in
implementation research, to reduce barriers to access to care. In this paper, we describe two of projects that were
initially conceived to tackle the financial barriers to access to care – through a voucher program in the community
- on the demand side - and a series of health systems strengthening activities at the district and facility level - on
the supply side. Over time, the projects diverged in the content of the intervention and the modality in which they
were implemented, providing an opportunity for reflection on innovation and scaling up. In this short report, we
used an adaptation of Greenhalgh’s Model of Diffusion to reflect on these projects’ approaches to implementing
innovative interventions, with the ultimate goal of reducing maternal and neonatal mortality in rural Uganda. We
found that the adapted model of diffusion of innovations facilitated the emergence of insights on barriers and
facilitators to the implementation of health systems interventions. Health systems research projects would benefit
from analyses beyond the implementation period, in order to better understand how adoption and diffusion
happen, or not, over time, after the external catalyst departs.
Description
Keywords
Uganda, Innovation, Maternal health, Health systems research, Vouchers, Diffusion
Citation
Paina, L., Namazzi, G., Tetui, M., Mayora, C., Kananura, R. M., Kiwanuka, S. N., ... & Ekirapa-Kiracho, E. (2019). Applying the model of diffusion of innovations to understand facilitators for the implementation of maternal and neonatal health programmes in rural Uganda. Globalization and health, 15(1), 1-11. https://doi.org/10.1186/s12992-019-0483-9