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Learn about implementation science theories, models and frameworks and their application to primary health care and immunization
Comprehensive reference guide for using implementation science theories, models and frameworks in primary health care and immunization

Reference Guide

Templates and Job Aids

Copy any card into a WhatsApp group, a workplan or a supervision checklist. Most cards use one framework from the inventory.

Diagnosis Cards

CFIR Five-Domain Scan

  1. Innovation (the thing we implement, here vaccination): Is it simple, affordable and clearly better than what we did before?
  2. Outer setting: What outside our team helps or blocks us (funds, policy, partners, insecurity, community attitudes)?
  3. Inner setting: Do we have the staff, equipment, priority and communication to deliver it?
  4. Individuals: Does each key person have the need, capability, opportunity and motivation to play their part?
  5. Implementation process: Did we plan, engage the right people, review progress and adapt?

COM-B Behaviour Diagnosis

  1. Name the behaviour: who does what, when, where?
  2. Psychological capability: do they know how and when?
  3. Physical capability: are they physically able?
  4. Physical opportunity: do time, money, stock and place allow it?
  5. Social opportunity: do family, peers and leaders support it?
  6. Reflective motivation: do they believe it is worth it?
  7. Automatic motivation: do habits or feelings pull them away?

BeSD Four Questions for Caregivers

  1. Thinking and feeling: How worried are you about this disease? How safe do you think the vaccine is?
  2. Social processes: What do your family, leaders and health worker say about it?
  3. Motivation: Do you plan to get your child vaccinated?
  4. Practical issues: What makes it easy or hard to get the vaccine here?

For formal surveys, use WHO's BeSD priority questions with their exact wording.

Design Worksheets

Barrier-to-Strategy Matrix

  1. Barrier (one line, with evidence source):
  2. Framework and construct (e.g. CFIR inner setting, available resources):
  3. COM-B component or BeSD domain:
  4. Intervention function:
  5. ERIC strategy:
  6. Implementation outcome to track:

One row per priority barrier. Every barrier needs at least one strategy. Every strategy needs at least one outcome.

Strategy Specification

  1. Strategy name (ERIC):
  2. Actor:
  3. Action:
  4. Action target:
  5. Temporality:
  6. Dose:
  7. Implementation outcome affected:
  8. Justification:

Framework Selection Record

  1. Problem and setting (domain, level):
  2. Research or programme purpose (from Part D):
  3. Framework chosen and functional category (from Part A):
  4. Why this framework fits the question:
  5. How it will shape data collection and analysis:
  6. Known limitations for this setting:

Measurement Cards

Proctor's Eight Outcomes Checklist

  • Acceptability: Do people find it agreeable?
  • Adoption: Did facilities and staff start using it?
  • Appropriateness: Does it fit this setting and problem?
  • Feasibility: Is it doable with what we have?
  • Fidelity: Are we delivering it as planned?
  • Implementation cost: What does delivery cost?
  • Penetration: How far has it spread in our setting?
  • Sustainability: Will it continue as routine?

RE-AIM Five Questions

  1. Reach: What share of eligible people received it, and whom did we miss?
  2. Effectiveness: What improved, and were there harms?
  3. Adoption: Which facilities and staff took it up?
  4. Implementation: Did we deliver it as intended, at what cost, with what changes?
  5. Maintenance: Do results and delivery continue over time?

Outcome Measurement Plan

  1. Outcome (Proctor or RE-AIM):
  2. Indicator and definition, with numerator and denominator:
  3. Data source (register, tally sheet, DHIS2, supervision checklist, survey):
  4. Frequency:
  5. Owner:
  6. Review forum (e.g. monthly LGA review):