Facilitators and Barriers to Successfully Implementing Study on Integrated District Evidence-to-Action Program to Reduce Under-5 Mortality in 4 Districts, Mozambique

CFIR DomainsFacilitatorsBarriers
Advantage of core intervention components (audit and feedback meetings, supervision and mentoring, and financial support) compared to routine and similar MCH interventions (relative advantage)Limited flexibility of intervention design, and decision making about data collection tools and use of intervention small grants (adaptability)
Outer settingPositive pressure district managers and NGO staff exerted over health facility staff (external policy and incentives)---
Inner settingHistorically established professional networks and communications among NGO and government staff and managers at provincial and subprovincial levels (networks and communication)
Relative priority given to MCH at national and subnational levels of Mozambique’s health system (implementation climate)Intervention did not adequately address nurse shortages and training needs, health facility infrastructure, and district transportation needs—compatibility (implementation climate)
Access to knowledge and information about the intervention (readiness for implementation)
ProcessApproach to implementing intervention components as originally planned (executing)---
  • Abbreviations: MCH, maternal and child health; NGO, nongovernmental organization.