Table 2 Descriptions of assessments, organized by objective

 Endline Household Survey

The survey covers prior and recent use of CCSPT and FP services.

Women residing in the catchment areas for the health facilities; must be aged 15–50 years and cannot have had their cervix removed.

8000 women

 Baseline Assessment Form

The form collects information about the facility’s capabilities for providing CCSPT and FP services.

Completed by research assistants, one form per facility

16 forms (one per facility)

 Readiness Assessment Forms

The form includes Likert scale rankings for various parameters of the readiness of the facilities/health system to implement the two models. Participants will answer the survey in small groups, coming to consensus on each ranking.

District health management team members, health facility managers, and community stakeholders

16 forms (one per facility)

 Manager and coordinator in-depth interviews (IDIs)

Interviews assess facility managers’ and coordinators’ attitudes towards project implementation.

Facility managers and coordinators currently working at one of the 16 facilities

24 participants (3 from Zomba and 3 from Lilongwe each, at 4 time points)

 Provider and HSA focus group discussions (FGDs)

Focus group discussions address providers’ and HSAs’ attitudes towards project implementation, including barriers, facilitators, successes, and challenges.

Providers currently working at one of the 16 facilities; includes HSAs at facilities randomized to community model

16 FGDs, 2 FGDs per district (1 with providers, 1 with HSAs) at 4 time points

 Acceptability-Appropriateness-Feasibility tool

This survey is completed by the officer-in-charge and 2 providers at 4 time points and asks participants to rank acceptability, appropriateness, and feasibility of project activities using Likert scales.

1 officer-in-charge and 2 providers from each of the 16 facilities at each time point

Up to 192 forms (up to 48 participants per 4 time points)

 Client in-depth interviews (IDIs)

Interviews assess clients’ attitudes towards project implementation, including the acceptability of self-collection and of CCSPT/FP integration.

Clients who participated in cervical cancer screening via self-collection at one of the 16 facilities during the study period

32 participants (16 who were screened at facility and 16 who were screened in community)

 Client Exit Survey

This survey includes a 5-point Likert scale to measure clients’ opinions and perceptions on quality of CCSPT and FP services.

Clients who accessed CCSPT and FP services at the facilities

Up to 2370 participants (790 participants each at 3 time points, with the number of participants interviewed per facility proportional to the number of FP clients at that facility)

 Workload Assessment Tool

This survey asks providers and lab staff to self-assess their workload.

Providers, HSAs, and lab staff

240 participants (5 per facility per 3 time points)

 Observation checklist

Structured observation of providers and lab staff to assess fidelity to project protocols.

Providers and lab staff

Up to 1152 checklists (one per facility per week)

 Service utilization data

De-identified information about CCSPT and FP services will be collected from clinic, HSA, and lab registers on a monthly basis.

Providers routinely record visit information in registers; research team members collect data

N/A (difficult to estimate projected number of clients for each register type)

Time and motion study

Research assistants will continuously observe providers, e.g., nurses and HSAs record the time spent on health care activities such as CCSPT and FP including non-health care activities

Providers, nurses, clinicians, HSAs, and lab staff

At least 1 staff member per facility from each category (e.g. provider, HSA, lab staff).

Client Exit Survey

This survey asks clients about the money and time expended accessing CCSPT and FP services at the clinics. It also includes the EQ-5D-3L survey to assess health-related quality-of-life for the cost impact analyses.

Facility clients

Up to 2370 participants (790 participants each at 3 time points, with the number of participants interviewed per facility proportional to the number of FP clients at that facility)