Table 1

Use of RE-AIM for EPHS evaluation in general and for evaluation of the intervention ‘safe delivery’ (as a maternal health services tracer) in particular

ConstructApplication to EPHS in generalApplication to specific service, safe delivery
Reach% of population covered* by facilities that use EPHS% of population in need* receiving safe delivery services
EffectivenessChange in service delivery (qual†)+out-of-pocket costs (quant)Change in mortality and out-of-pocket costs for facility delivery (quant)
Adoption% of units‡ adopting EPHS% of units‡ adopting safe delivery service
ImplementationLevel of fidelity to EPHS overall (eg, % of services provided)Level of fidelity (quality) of core components of safe delivery
MaintenanceSustainment of adoption/implementation over timeSustainment of adoption/implementation over time
  • *Calculation of coverage would be a population-weighted average based on utilisation data and measures of adoption.

  • †Since an EPHS reform might continue some interventions from a previous EPHS and add or remove others, ‘effectiveness’ would need to be a holistic, qualitative assessment of how effective the EPHS reform was in actually changing clinical practice.

  • ‡‘Units’ can refer to districts, facilities or individual providers depending on the needs of the particular application.

  • EPHS, essential packages of health services; qual, qualitative; quant, quantitative; RE-AIM, Reach, Effectiveness, Adoption, Implementation and Maintenance.