Table 1 Summary of included studies

Barac [10]

Chile, India, Pakistan, Bangladesh, Thailand, Vietnam, South Africa, and Nigeria

Typhoid

To identify typhoid-relevant interventions implemented between 1990 and 2015 and explore contextual factors perceived to be associated with their implementation

Mixed-methods

Organizations involved in implementation; Health policy and health system leaders at national or subnational levels

Post-implementation

Used to guide data collection; used to guide data analysis

Bardosh [11]

Canada, Kenya

HIV (Kenya)

To evaluate how a two-way SMS communication system to increase patient adherence to medication and engagement in care was perceived, diffused, and adopted in ongoing project sites

Qualitative design

Health providers in facilities involved in implementation

Mid-implementation

Used to guide data collection

Chu [12]

China

Hepatitis C virus (HCV)

To explore social and structural factors affecting HCV treatment access at an HIV treatment facility and methadone maintenance treatment centers to inform strategies for expanding access

Qualitative design

Patients benefiting from intervention

Post-implementation

Used to guide data analysis; used to interpret/contextualize findings

Cole [13]

Mozambique

Maternal health

To explore the contextual factors that may have contributed to observed increases in institutional deliveries from 2009-2014 in Nampula province.

Mixed-methods

Health providers in facilities involved in implementation; Patients benefiting from intervention

Post-implementation

Used to guide data collection; used to guide data analysis

Cooke [14]

Tanzania

Opioid treatment and HIV

To understand the contextual factors that influence the effectiveness of integrated methadone and anti-retroviral therapy implementation

Qualitative design

Patients benefiting from intervention; Health providers in facilities involved in implementation

Post-implementation

Used to guide data analysis

Dansereau [15]

Chad, Cameroon

Immunizations

To retrospectively evaluate the implementation of Gavi’s health system strengthening support and identify drivers of and barriers to implementation

Mixed-methods

Organizations involved in implementation

Post-implementation

Used to interpret/contextualize findings

Dogar [16]

Nepal, Pakistan

Tuberculosis (TB)

To describe challenges and lessons learned of implementing tobacco cessation in routine TB care

Qualitative design

Patients benefiting from intervention; health providers in facilities involved in implementation

Post-implementation

Used to interpret/contextualize findings

English [17]

Kenya

Pediatric inpatient care

To explore why a facility-based intervention to introduce care based on best-practice guidelines varied in effect across place and time

Mixed-methods

Organizations involved in implementation

Post-implementation

Used to interpret/contextualize findings

English [18]

Kenya

Pediatric inpatient care

To develop a system-oriented intervention to improve services for children in district hospitals

Qualitative design

Organizations involved in implementation

Pre-implementation

Used to frame/design the intervention

Gimbel [19]

Mozambique, Kenya, Cote d'Ivoire

HIV

To define the core and adaptable components of a facility-based intervention to address implementation challenges in prevention of mother to child transmission (PMTCT), and identify contextual influences that explain implementation heterogeneity

Qualitative design

Organizations involved in implementation

Post-implementation

Used to guide data collection; used to guide data analysis; used to interpret/contextualize findings

Gimbel [20]

Mozambique, Rwanda, and Zambia

Primary health care

To describes and categorize data quality assessment and improvement activities of a multi-country initiative and identify core intervention components and implementation strategy adaptations to improve data quality

Mixed-methods

Organizations involved in implementation

Post-implementation

Used to guide data collection, used to guide data analysis, used to interpret/contextualize findings

Gutierrez-Alba [21]

Mexico

Clinical practice guidelines generally

To identify and prioritize barriers and facilitators facing the implementation of Clinical Practice Guidelines in hospitals.

Qualitative design

Organizations involved in implementation

Mid-implementation

Used to guide data collection; used to guide data analysis; used to interpret/contextualize findings

Hosey [22]

US Associated Pacific Islands

Chronic disease

To describe the implementation and evaluation of a non-communicable disease (NCD) pilot project to systematically strengthen NCD health care quality and outcomes across five health systems

Mixed-methods

Organizations involved in implementation

Mid-implementation

Used to guide data analysis; used to interpret/contextualize findings

Huang [23]

Uganda

Pediatric mental health

To assess the feasibility and effectiveness of implementing professional development programs for early childhood teachers and determine if children with teachers exposed to professional development programs have better mental health outcomes

Mixed-methods

Health providers in facilities involved in implementation

Mid-implementation

Used to guide data collection

Jones [24]

Zambia

HIV

To identify predictors of a voluntary male medical circumcision program’s success or failure to create an “early warning” system that enables remedial action during implementation

Mixed-methods

Health providers in facilities involved in implementation

Mid-implementation

Used to guide data collection; used to guide data analysis’ used to interpret/contextualize findings

Landis-Lewis [25]

Malawi

HIV

To identify and describe barriers to using electronic medical record data for individualized audit and feedback for healthcare providers in Malawi and to consider how to design technology to overcome these barriers

Qualitative design

Health providers in facilities involved in implementation

Mid-implementation

Used to guide data collection

Malham [26]

Morocco

Maternal health

To identify the factors hindering full implementation of a national action plan to strengthen the professional role of midwives in two regions and to identify recommendations that could increase the effectiveness of the action plan

Qualitative design

Health providers in facilities involved in implementation

Mid-implementation

Used to guide data analysis; used to interpret/contextualize findings

Malham [27]

Morocco

Maternal health

To assess the extent to which a national action plan to strengthen the professional role of midwives was delivered in two regions, and the barriers and facilitators influencing implementation

Qualitative design

Health providers in facilities involved in implementation

Mid-implementation

Used to guide data analysis; used to interpret/contextualize findings

McRobie [28]

Uganda

HIV

To assess implementation of national HIV policies regarding testing, treatment, and retention at health facilities serving two health and demographic surveillance sites

Mixed-methods

Health providers in facilities involved in implementation

Pre-implementation

Used to frame/design the intervention

Myburgh [29]

South Africa

HIV

To identify barriers and facilitators in the implementation of an antiretrovirals electronic register at facility, sub-district, and district levels

Mixed-methods

Health providers in facilities involved in implementation

Post-implementation

Used to interpret/contextualize findings

Naidoo [30]

South Africa

HIV

To explore barriers and facilitators to implementation of community-based HIV programs in order to produce actionable findings to improve them

Qualitative design

Patients benefiting from intervention; health providers in facilities and in communities involved in implementation

Post-implementation

Used to interpret/contextualize findings

Nathavitharana [31]

Bangladesh

TB

To present operational data and discuss the challenges of implementing FAST (Find cases Actively, Separate safely and Treat effectively) as a TB transmission control strategy in health facilities

Qualitative design

Health providers in facilities involved in implementation

Post-implementation

Used to guide data analysis

Naude [32]

South Africa, Cameroon

Evidence based health policy generally

To describe the different contexts in which health policies are formulated and identify the facilitators and barriers to incorporating research evidence

Qualitative design

Health policy and health system leaders at national or subnational levels

Post-implementation

Used to interpret/contextualize findings

Petersen Williams [33]

South Africa

Maternal health

To investigate health care providers’ perceptionsof the acceptability and feasibility of providing screening, brief intervention, and referral to treatment to address substance use among pregnant women attending antenatal care

Qualitative design

Health providers in facilities involved in implementation

Pre-implementation

Used to frame/design the intervention; used to guide data collection

Phulkerd [34]

Thailand

Obesity

To identify barriers and potential facilitators to implementing regulations to restrict unhealthy radio and television food advertising to children and policies to promote healthier products

Qualitative design

Organizations involved in implementation

Pre-implementation

Used to guide data collection

Rodriguez [35]

South Africa

HIV

To identify barriers and facilitators in the implementation, uptake, and sustainability of PMTCT protocols in a rural areas

Qualitative design

Health providers in facilities involved in implementation; health policy and health system leaders at national or subnational levels; patients benefiting from intervention

Post-implementation

Used to guide data analysis; Used to interpret/contextualize findings

Rwabukwisi [36]

Ghana, Mozambique, Rwanda, Tanzania, and Zambia

Primary healthcare

To retrospectively evaluate a multi-country consortium aiming to implement and evaluate district-level health system strengthening interventions

Qualitative design

Organizations involved in implementation

Post-implementation

Used to guide data analysis

Saluja [37]

N/A

Surgery

To discuss key factors influencing implementation of national surgical planning in LMICs

Qualitative design

Organizations involved in implementation

Post-implementation

Used to guide data analysis; used to interpret/contextualize findings

Sax [38]

Pakistan

Primary healthcare (healthcare accreditation)

To identify perceived factors influencing introduction and adaptation of international healthcare accreditation to improve healthcare quality

Qualitative design

Organizations involved in implementation

Post-implementation

Used to guide data analysis

Shi [39]

China

Evidence-based public health generally

To assess implementation of evidence based public health and identify barriers to evidence based public health in the public sector

Qualitative design

Health providers in facilities involved in implementation; health policy and health system leaders at national or subnational levels

Pre-implementation

Used to frame/design the intervention; used to guide data collection; used to guide data analysis

Soi [40]

Mozambique

Human papillomavirus (HPV) vaccination

To identify implementation barriers and facilitators affecting the scale-up of HPV vaccination in Mozambique

Qualitative design

Health providers and educators in facilities and schools involved in implementation; health and education policy and health system leaders at national or subnational levels

Post-implementation

Used to guide data collection; used to guide data analysis

VanDevanter [41]

Vietnam

Tobacco cessation

To identify potential barriers and facilitators to implementing system changes to increase adoption of tobacco use treatment guidelines

Qualitative design

Health providers in facilities involved in implementation

Pre-implementation

Used to guide data collection; used to guide data analysis

Warren [42]

Kenya

Maternal health

To describe the complex processes, strengths, and challenges of an intervention aiming to address mistreatment during childbirth and promote respectful maternity care

Qualitative design

Patients benefiting from intervention; health providers in facilities involved in implementation

Post-implementation

Used to guide data analysis

White [43]

Benin

Surgical safety

To measure the sustainability of surgical safety checklist use and to evaluate the acceptability, adoption, appropriateness, feasibility and fidelity of nationwide checklist implementation, including penetration of the checklist into operating room culture

Mixed-methods

Health providers in facilities involved in implementation

Mid-implementation

Used to interpret/contextualize findings