ArticleGlobal health action2015
Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region.
Article in Global health action, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Utilizing a mixed-methods approach to assess implementation fidelity of a group antenatal care trial in Rwanda.PloS one · 2023Trial
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- Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviours.International health · 2025Article
- Stakeholders' perspectives on funding malaria, HIV/AIDS and tuberculosis services in Tanzania through domestic resources mobilisation: a qualitative study.BMJ public health · 2025Article
- From pilot to national roll-out of the improved Community Health Fund (iCHF) in Tanzania: lessons learnt and way forward.Cost effectiveness and resource allocation : C/E · 2024Article
- Article
- Does mobile renewal make health insurance more responsive to clients? A case study of the National Health Insurance Scheme in Ghana.BMJ global health · 2023Article
- Whether or not to enroll, and stay enrolled? A Tanzanian cross-sectional study on voluntary health insurance.Health policy OPEN · 2023Article
- The role of risk preferences: voluntary health insurance in rural Tanzania.Health economics review · 2023Article
- Linking the Community Health Fund with Accredited Drug Dispensing Outlets in Tanzania: exploring potentials, pitfalls, and modalities.Journal of pharmaceutical policy and practice · 2022Article
- Savings Groups for Social Health Protection: A Social Resilience Study in Rural Tanzania.Diseases (Basel, Switzerland) · 2022Article
- Sustaining capacity building and evidence-based NCD intervention implementation: Perspectives from the GRIT consortium.Frontiers in health services · 2022Article
- Article
- Do household perceptions influence enrolment decisions into community-based health insurance schemes in Tanzania?BMC health services research · 2021Article
- Factors influencing variation in implementation outcomes of the redesigned community health fund in the Dodoma region of Tanzania: a mixed-methods study.BMC public health · 2021Review
- Looking at the bigger picture: how the wider health financing context affects the implementation of the Tanzanian Community Health Funds.Health policy and planning · 2019Article
- Understanding the implementation of Direct Health Facility Financing and its effect on health system performance in Tanzania: a non-controlled before and after mixed method study protocol.Health research policy and systems · 2019Article
- Jazia prime vendor system- a public-private partnership to improve medicine availability in Tanzania: from pilot to scale.Journal of pharmaceutical policy and practice · 2019Article
- Exploration of dynamics in a complex person-centred intervention process based on health professionals' perspectives.BMC health services research · 2018Article
- Evaluating complex health financing interventions: using mixed methods to inform further implementation of a novel PBI intervention in rural Malawi.BMC health services research · 2016Article
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Authors and funding
5 authors.
Funding
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Abstract
backgroundDespite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI) schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. 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.
objectiveIn this paper, we describe a process evaluation protocol aimed at opening the 'black box' to evaluate the implementation processes of the Redesigned Community Health Fund (CHF) program in the Dodoma region of Tanzania.
designThe study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review), and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. DISCUSSION: This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes.
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