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      Strengthening Interpersonal Relationships in Maternal and Child Health Care in Rural Tanzania: Protocol for a Human-Centered Design Intervention

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          Abstract

          Background

          Evidence indicates that clients’ dissatisfaction with providers’ competencies within maternal and child health (MCH) continues to impact trust in formal health care systems, service uptake, continuity with care, and MCH outcomes. A major problem with existing interventions is the failure to address all the complexities of provider-client relationships necessitating targeted, contextualized, innovative solutions that place providers and clients at the forefront as agents of change in optimizing intervention design and implementation. To improve the provider-client relationship, the Aga Khan University is piloting a human-centered design (HCD) intervention where MCH nurses and clients are invited to partner with researchers in the intervention design and evaluation process.

          Objective

          The objective of this research is to co-design an intervention package (prototype) for improving nurse-client relationships in the rural Shinyanga region of Tanzania using a series of iterative HCD steps, involving key stakeholders to tailor solutions for complex problems impacting provider-client interactions in MCH care.

          Methods

          The following 5-step HCD approach will be implemented: (1) community-driven discovery through qualitative descriptive research methods using focus group discussions and key informant interviews; (2) co-design of an intervention package through consultative ideation and cocreation meetings with nurses, clients, and other stakeholders; (3) prototype validation through qualitative insight gathering using focus group discussions; (4) refinement and adaptation meeting; and (5) documentation and sharing of lessons learned before the final prototype is tested and validated in a broader community.

          Results

          A prototype characterized by a package of interventions for improving nurse-client relationships in MCH care in rural contexts is expected to be developed from the co-design process.

          Conclusions

          An HCD approach provides a novel entry point for strengthening provider-client relationships, where clients are invited to partner with providers in the design of acceptable and feasible interventions.

          International Registered Report Identifier (IRRID)

          DERR1-10.2196/37947

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          Most cited references42

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          Using thematic analysis in psychology

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            Employing a Qualitative Description Approach in Health Care Research

            A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage.
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              Sample sizes for saturation in qualitative research: A systematic review of empirical tests

              To review empirical studies that assess saturation in qualitative research in order to identify sample sizes for saturation, strategies used to assess saturation, and guidance we can draw from these studies.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                July 2022
                7 July 2022
                : 11
                : 7
                : e37947
                Affiliations
                [1 ] School of Nursing and Midwifery Aga Khan University Dar Es Salaam United Republic of Tanzania
                [2 ] School of Nursing and Midwifery Aga Khan University Nairobi Kenya
                Author notes
                Corresponding Author: Kahabi Isangula kahabi.isangula@ 123456aku.edu
                Author information
                https://orcid.org/0000-0001-5409-0097
                https://orcid.org/0000-0001-7787-9998
                https://orcid.org/0000-0002-1001-361X
                https://orcid.org/0000-0002-3322-4057
                https://orcid.org/0000-0001-8594-0808
                Article
                v11i7e37947
                10.2196/37947
                9305451
                35797107
                fb11783a-a069-4783-b442-672c1b1bb4cb
                ©Kahabi Isangula, Constance Shumba, Eunice S Pallangyo, Columba Mbekenga, Eunice Ndirangu-Mugo. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 07.07.2022.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 12 March 2022
                : 10 May 2022
                : 19 May 2022
                : 24 May 2022
                Categories
                Protocol
                Protocol

                human-centered design,user-centred design,human-centred design,provider-patient relationship,nurse-client relationship,nurse,nursing,maternal and child health,maternal,maternity,mother,child,primary health care,primary care,rural,tanzania,africa,community-based,focus group,co-design,prototype,validation,nurse-patient,provider-client

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