DOI: 10.17037/data.00001954
title: Data for: "Informed Decisions for Actions to Improve Maternal and Newborn Health: The role of context in the implementation of Nigeria Healthcare Quality Initiative in Lagos State, Nigeria"

description: The study was conducted to understand the influence of context in the implementation of the Nigeria Healthcare Quality Initiative (NHQI) in Lagos State, Nigeria. A series of health facility assessments, in-depth interviews, and focus group discussions were performed concurrently at 6 Primary Health Care (PHCs) facilities, 19 public hospitals and 25 private facilities located in the region.
This collection contains three tabular datasets collected during the study: (1) a Health Facility (HF) dataset collected as part of the readiness assessment, review of facility records and interviews with birth attendants at 50 HHQI facilities. (2) a Family Planning (FP) dataset that contains information collected as part of exit interviews with 400 clients (women within the 18-45 years reproductive age group) who were accessing family planning services, covering their experience and level of satisfaction with the services provided. (3) Antenatal Clinic (ANC) dataset that contains information collected as part of exit interviews with 400 clients (women within the 18-45 years reproductive age group) who were accessing antenatal clinic services, covering their experience and level of satisfaction with the services provided. It also includes tools produced to guide the data collection process. These include the Understanding NHQI evaluation protocol and data collection manual, topic guides for performing Antenatal Clinic (ANC) and Family Planning (FP) client exit interviews, health facility survey form, a topic guide for focus group discussion with facility QI team members participating in cluster meetings, and other relevant documentation.
description: Data were collected to: (1) characterise the Nigeria Healthcare Quality Initiative (NHQI); (2) investigate the implementation of the intervention and its mechanism of impact at the collaboratives and the health facilities; (3) describe the context in which the intervention took place and how contextual factors affect implementation and mechanism of impact of the intervention; (4) specifically examine the role of governance in the collaboratives and the health facilities; and (5) estimate the costs associated with implementing QI in the different facility types in Lagos State.
The evaluation team conducted health facility assessments of 6 PHCs, 19 public hospitals and 25 private facilities between April and May 2019. The assessment comprised a readiness assessment, review of facility records and interviews with birth attendants. The facility questionnaire included a check list of staff, equipment, drugs, and infrastructure items present on the day of survey, and data extraction from maternity registers to ascertain facility workload during the six months preceding the survey. Relevant information was obtained through interviewer-administered questionnaires and where relevant using a data extraction form to obtain information from the facility registers. 
Exit interviews were performed with women within the reproductive age group (18-45 years) who were accessing antenatal and family planning services, in order to assess their experience and level of satisfaction with the services received. These interviews took place concurrently with the health facility assessment in the same facilities.
Document review: All 50 NHQI facilities were approached for reports of the QI team meetings that took place between February 2019 and January 2020. These reports were developed using a common template to aid comparison within and across facility types. The template comprised sections on problem description, method of problem identification, aim statement, change ideas and measures used to track performance. At the outset of data collection, there was an expectation that reports would be submitted monthly. 
Key informant interviews (KIIs) were conducted at state and facility levels to: (1) confirm findings from the QI team meeting reports (2) explore individual experiences of the intervention. Participants were selected using pre-agreed selection criteria. Select individuals at the state level were interviewed to describe the key characteristics of the intervention, role in implementation and the various contextual factors which may have influenced the implementation of the intervention in the three facility types (PHCs, public hospitals and private facilities). Facility-level interviews were used to explore the experiences of the facility QI team members, identify the change ideas that were targeted by these QI teams and describe how and why these were targeted. 
Observations of collaborative learning sessions and cluster meetings were carried out to explore how QI teams operate and the context of the collaborative learning sessions and cluster meetings of each facility type was explored, and its facilities will be explored. 
The file of expanded field notes for this study are stored on the LSHTM Secure Server, but cannot be made available due to the extent of personal information and difficulty of anonymisation without context loss.