Logic model for proposed intervention mechanisms/ theory of change (adapted from Bonell and colleagues 2015)38
| Inputs | Processes and actions | Intended changes (Theoretical domains framework)21 | Intended outputs | Intended health outcomes | |
|---|---|---|---|---|---|
Intervention | Formative research: interviews with providers, mothers, and key stakeholders Consultation with experts to develop technical materials: • Training protocols and manuals • Counselling flipbook • Community advocate leaflets Training of private GPs and clinic assistants: theoretical and practical training | Quarterly counselling sessions for mothers (child development, child nutrition, maternal mental health) Quarterly child growth monitoring Text message/SMS reminders to mothers for quarterly follow-up appointments Assessment and treatment of chid developmental delay (may include referral) Assessment and treatment of maternal depression (may include) | Mother Social influences Knowledge Beliefs about consequences Environmental context and resources Reinforcement Private GP and clinic assistant Social influences Knowledge Skills Environmental context and resources Social and professional role and identity | Mother Mother–child health services are accessible and desirable to mother Increased capability and confidence to support child nutrition and development in the home environment Increased capability and confidence to protect own mental health in the home environment Private GP and clinic assistant Motivated and skilled to provide mother–child health services | Reduced developmental delay at 12 months of age (primary outcome) Improved childhood nutrition Reduced maternal depression |
| Both intervention and control arms | DGHS endorsement of intervention and control clinics Identification and orientation of community advocates Growth Monitoring Cards to intervention and control clinics Standard calibrated equipment to intervention and control clinics Supervision of data entry on Growth Monitoring Card by clinic assistant (Field research officer) | Recruitment of mothers by community advocates Vitamin A supplement | Adequate participant recruitment High quality data |