Maina M, Molyneux S, Were F, Oluoch D, Mutua E, Gathara D, English M, Imam A, Ngaiza G, Rababeh A, Grewal G, Nasir N, Waithira C, Odinga N, Kagonya V, Onyango O, Karumba K, Jones C, Mwangi P, Kinyua L, Thuranira L, Njoroge V, Mwangi N, Mwangi L, Musyoka P, Kioni Z, Fuller SS
Glob Health Action. 2025;18
Understanding how to best implement healthcare innovations in resource-poor settings requires complex interventions and evaluations, often straining existing healthcare systems. We aimed to address this challenge in our Kenyan neonatal intervention research by deeply integrating stakeholder engagement, applying layered methodologies, and leveraging our research team's diverse expertise. This paper reports on the design and implementation of a research programme examining the impact of new staff introductions on care quality, staff, and family experiences within an existing neonatal technology programme in Kenya. Collaborating with stakeholders, our multidisciplinary programme of research included the analysis of routine health data before and after staff introductions, co-creation of novel quantitative data collection tools, and embedded qualitative research. Continuous feedback from participants, stakeholders, and researchers facilitated an adaptive approach, with timelines and methods adjusted to minimise participant burden. This iterative process allowed for robust data collection to inform health system improvements. Our findings provide insights into implementation and evaluation research for healthcare innovations in resource-constrained settings and emphasise ethical, context-sensitive research practices for sustainable health system strengthening. Key findings: The paper reports the use of layered mixed methodologies to conduct implementation research of a complex intervention in Kenyan neonatal hospitalsAdded knowledge: This paper provides a detailed approach to designing and implementing a complex health intervention in settings that are under resourced. Sustained stakeholder engagement throughout the conceptualisation, design, and implementation of research is essential for both intervention success and knowledge generation.Global health impact for policy and action: This study highlights the need for researchers to engage policy makers and stakeholders to support research on complex interventions and evaluations and ethical research practices. eng
