Date: 18 October 2023

Dataset Title: Data for a process evaluation of a randomized controlled trial of group antenatal care in Ghana
Dataset Creators: Zielinski, Ruth E; Kukula, Vida; Apetorgbor, Veronica;  Awini, Elizabeth;  Moyer, Cheryl;  Badu-Gyan, Georgina; Williams, John; Lockhart, Nancy  Lori, Jody R

Dataset Contact: Ruth Zielinski  ruthcnm@med.umich.edu

Key Points: 
This is a process evaluation of the RCT, Group Antenatal Care and Delivery project (GRAND) to identify and document patient, provider, and system barriers and facilitators to program implementation. 

Using both quantitative and qualitative methods, potential and actual influences on the quality and conduct of the program's operations, implementation, and service delivery were identified. 
Only the seven (7) sites randomized to the Group ANC (G-ANC) intervention were included for collection of process evaluation data since the evaluation was of G-ANC implementation. 
Data were collected from August 2019 to November 2020 and included both quantitative and qualitative data sources.  


Research Overview:
The process evaluation included both quantitative and qualitative data sources. Midwives at the intervention sites completed tracking logs to measure feasibility of the intervention. 
Research team members traveled to intervention sites where they conducted structured observations and completed fidelity and learning methods checklisst to determine adherence to the model of group antenatal care delivery (ANC). 
In addition, midwives facilitating group antenatal care meetings were interviewed and focus groups were conducted with women participating in group antenatal care.  


Methodology:
This study used mixed methods design that included qualitative data in the form of focus group discussions (FGDs), and individual interviews (II), quantitative data collected via observation during one of the later (5, 6 or 7) group ANC meetings and GANC attendance records. 
Research team members traveled to intervention sites where they interviewed midwives facilitating group antenatal care meetings and conducted FGDs with women participating in group antenatal care.

In addition, a sample of Group Antenatal Care (G-ANC) meetings were observed to determine adherence to the model of group antenatal care delivery. 
Observations included whether content was delivered as intended, whether women were encouraged to actively participate in group discussions and activities, whether picture cards were used as written in the Facilitators Guide, and whether feedback was provided to participants during demonstrations. 

During these observations the research team members completed both the Fidelity Checklist Scale and the Learning Methods Checklist. Attendance records were collected by the midwife facilitators for each group antenatal care meeting.  
A face-to-face semi-structured interview was completed with a midwife facilitator from each intervention site following the structured observation of the group ANC meeting.
For each intervention site at least one focus group discussion was held with pregnant women participating in group ANC.  

Informed consent was obtained from the midwife facilitators for the II and from pregnant women for the FGDs. Participation was voluntary for II and FGDs.

The interviews were conducted in the local language, Twi, audio recorded and then translated and transcribed verbatim by research assistants who are fluent in both English and Twi.
Quantitative data (Fidelity Checklist, Learning Methods Checklist) collected by research team members during the observation of the group ANC then entered into an Excel spreadsheet. Participant attendance was recorded at each meeting. 

Data were analyzed descriptively to assess whether certain items, midwives, or intervention sites were performing less well when compared to others. 

To analyze the qualitative data from the focus groups and interviews, a qualitative comparison approach was used. 

Identifiers such as individual names, dates, and health facility names were removed to de-identify data. 

We did not conduct focus groups with women in the control arm, conduct observations or interviews with providers in the control arm as the intent of the focus group is to glean information about women’s experience in G-ANC.

De-identified data enclosed


Citation to related publication: 
Zielinski R, Kukula V, Apetorgbor V, Awini E, Moyer C, Badu-Gyan G, et al. (2023) “With group antenatal care, pregnant women know they are not alone”: The process evaluation of a group antenatal care intervention in Ghana. PLoS ONE 18(11): e0291855. https://doi.org/10.1371/journal.pone.0291855


Dataset citation: 
Zielinski, R. E., Kukula, V., Apetorgbor, V., Awini, E., Moyer, C., Badu-Gyan, G., Williams, J., Lockhart, N., Lori, J. R. Data for a process evaluation of a randomized controlled trial of group antenatal care in Ghana [Data set], University of Michigan - Deep Blue Data. https://doi.org/10.7302/y9qf-az09


Files included as follows:
Informed Consent_Focus Groups.pdf
Informed Consent_Providers.pdf
GRAND Process Evaluation readme.txt
Fidelity Checklist data codebook.pdf
Fidelity Checklist data.csv
Learning Methods codebook.pdf
Learning Methods data.csv
Focus Group Discussion questions.pdf
Transcriptions_FGD with women.pdf
Individual Interview questions.pdf
Transcriptions_Interviews with Providers of GANC.pdf
GANC Attendance_deidentified.csv
GANC Attendance codebook.csv