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Table 1 Examples of research questions for each evaluation type

From: Protocol for the process evaluation of interventions combining performance-based financing with health equity in Burkina Faso

Types of evaluation Examples of research questions
Emergence - How was the problem of accessibility and performance recognized?
- What were the debates surrounding the potential solutions?
- What motivated the choice to select these intervention arms instead of others?
- What were the positions of the different actors involved in the adoption of these intervention arms?
Performance - Did the performance change in the different levels of health facilities? If so, why?
- Were the performance objectives met since the beginning of the intervention arms?
- Did the utilization rate of healthcare services change for the general population or vulnerable groups?
- Did the quality of healthcare services change for the general population or vulnerable groups?
- Did the level of motivation of health professionals change?
Fidelity - Were the activities regarding the training of health professionals, the contracts, the monitoring, the payments, the user fee exemptions, and the CBHI implemented as initially planned?
- Were any of these activities added, modified, or omitted?
Processes - How do stakeholders perceive the implementation of the intervention arms?
- Which factors facilitated or hindered the implementation of the intervention arms?
- What are the unintended processes and effects caused by the intervention arms?
- How did the intervention arms influence governance, management, monitoring, and leadership within the healthcare system?
- How did the intervention arms influence interpersonal relations, communication, and collaboration between stakeholders?
- How did the intervention arms influence the practices, behavior, and motivation of healthcare providers?
- How did the intervention arms influence the available resources, medical supply, and the infrastructure?
- How do the different components of the intervention arms interact?
Ethical considerations - What are the ethical considerations related to the intervention arms?
- How was the community involved in the implementation of the intervention arms?
- How do stakeholders perceive the process of identification of the poorest that is conducted by the community?
Sustainability - Which human, material, and financial resources necessary for the intervention arms' activities were integrated in the district's budget?
- Were the intervention arms adequately adapted to the context? Are they compatible with local practice?
- Is the implementation of the intervention arms in line with the priorities of the health authorities?
- Is there a cultural relation between the intervention and the stakeholders (e.g., rituals, symbols)?
- Did the interventions influence the healthcare system?
- How were the rules and procedures institutionalized?
Scale-up - How were the stakeholders that can contribute to a scale-up of the intervention arms implicated? Are they favorable and committed to a scale-up?
- Do the intervention arms respond to a recurrent and persistent problem?
- Do the contexts in which the intervention arms were tested reflect the rest of the country?
- Could the human, material, and financial resources be mobilized to scale-up the intervention arms?