We used a questionnaire (additional file 2) to collect data related to implementation outcomes, focusing mainly on the adoption and FOI of the program components, such as the recruitment and the training of program actors and materials for the program as reflected in our TOI. The questions on the adoption of the scheme focused on the functionality of Redesigned CHF structures and the usability of the guidelines in daily routines. FOI questions captured adherence to or departures from the CHF standard operating procedures (CHF-SOP) and the probable related moderating factors. The questionnaire was composed of yes/no, and Likert scale questions. To ensure validity and reliability of our questionnaire, 1) Development of the questionnaire was based on our theory of intervention 2) The questionnaire was discussed among the authors to agree on how the questions are constructed to improve the face validity 3) The questionnaire by the authors together with the trained research assistants 3) Principal component analysis was employed to ascertain key constructs and come up with scales and subscales 4) Cronbach’s alphas of each of the formulated scales were determined as an indication of consistency within the scales. Cronbach’s alpha of at least 0.7 was considered acceptable to measure the internal consistency of each of the scales and sub-scales [41].

We used a checklist to extract data from the documents relevant to the scheme adoption and implementation (additional file 3). The checklist aimed at extracting numerical information that could quantify districts’ adoption and FOI based on the redesigned CHF original plan.

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