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
| Construct | Application to EPHS in general | Application to specific service, safe delivery |
| Reach | % of population covered* by facilities that use EPHS | % of population in need* receiving safe delivery services |
| Effectiveness | Change 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 |
| Implementation | Level of fidelity to EPHS overall (eg, % of services provided) | Level of fidelity (quality) of core components of safe delivery |
| Maintenance | Sustainment of adoption/implementation over time | Sustainment 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.