Group Care in the first 1000 days: implementation and process evaluation of contextually adapted antenatal and postnatal group care targeting diverse vulnerable populations in high and low resource settings

Abstract Background Group Care (GC) improves the quality of maternity care, stimulates women’s participation and facilitates growth of women’s social support network. There is an urgent need to identify and disseminate the best mechanisms for implementing GC in ways that are feasible, context appropriate and sustainable. This protocol presents the aims and methods of an innovative implementation research project entitled Group Care in the first 1000 days (GC_1000), which addressed this need. Aims The aim of GC_1000 is to co-create and disseminate evidence-based implementation strategies and tools to support successful implementation and scale-up of GC in the first 1000 days in health systems throughout the world, with particular attention to the needs of ‘vulnerable’ populations. Methods In five inter-related work packages with specific tasks, objectives and deliverables we will systematically study the implementation and scale up of antenatal and postnatal GC in seven different countries. GC_1000 project will be based theoretically on the consolidated framework for implementation research (CFIR), while the process evaluation will be guided by ‘Realistic Evaluation’ principles. Data are gathered across all research phases and analysis at each stage is synthesized to develop Context-Intervention-Mechanism-Outcome configurations. Discussion While the GC_1000 study design comprises of several strengths, it also contains some limitations which we aim to counter in various ways. This four-year project will generate evidence-based knowledge about the integration of complex interventions in diverse health care systems and it will pave the way for sustained implementation of GC targeting vulnerable groups.