Table 2 Implementation phase study designs, study objectives, data collection tools, study participants, and timing of data collection

Healthcare worker survey

Assess changes in healthcare workers’ knowledge of mental illness and domestic violence and their attitudes towards people with mental health disorders and experiences of domestic violence

Self-administered questionnaires: organisational readiness for implementing change [30]; bespoke knowledge questionnaire; mental illness: Clinicians’ Attitudes Scale [31]; Professional Quality of Life Scale [32]; Effort-Reward Imbalance scale [33]

All healthcare workers involved in the intervention — CBS trainers, NPO managers, PACK facility trainers, psychiatric nurses, ANC nurses, OTLs, CHWs, health promotion officers, HIV counsellors, nursing assistants

Two timepoints — before receiving training and at the end of the implementation phase

Patient survey

Assess changes in pregnant women’s knowledge of mental illness and domestic violence and their attitudes towards people with mental health disorders and experiences of domestic violence

Self-administered bespoke questionnaire consisting of 16 questions

Pregnant women attending MOUs and BANC clinics

Two timepoints — before the delivery of health promotion talks and after delivery of the health promotion talks

Observation of health promotion talks

Assess uptake, fidelity, penetration, and sustainability of health promotion talks

Checklist to be completed by fieldworkers observing the talks

During the delivery of health promotion talks

Cohort study

Assess the presence of and risk factors for CMDs and experiences of domestic violence; assess whether the HSS interventions to improve awareness, detection, referral, and treatment resulted in improvement in clinical outcomes

Interviewer-administered questionnaires: Edinburgh postnatal depression scale [34]; psychological distress screening tool [12]; bespoke questionnaire to assess domestic violence; Household Food Insecurity and Access Scale [35]; Composite Abuse Scale [36]; WHO Disability Assessment Schedule [37]; Multidimensional Scale of Perceived Social Support [38]; Mother-to-Infant Bonding Scale [39]

Pregnant and postnatal women attending antenatal care clinics

Three timepoints — (1) when pregnant women are recruited, (2) when participants are 36 weeks pregnant, and (3) 6 weeks after participants have given birth

Patient file reviews

Assess changes in detection and referral rates of pregnant women with CMDs and experiences of domestic violence

Maternity case record [11]

Pregnant and postnatal women attending MOUs and BANC clinics

Weekly during the implementation phase

Documentation review

Assess coverage of the detection, referral, and treatment interventions

Bespoke patient registers and tracking forms

ANC nurses and OTLs

Daily during the intervention period

Counselling competence

Assess fidelity to the structured counselling format and content

Enhancing assessment of common therapeutic factors tool [40]; bespoke counselling evaluation form

Community health workers (CHWs)

During the last 2 months of the intervention

Qualitative assessments

Assess the acceptability, appropriateness, satisfaction, and feasibility of the selected HSS interventions

Topic guides for key informant interviews and focus group discussions

Pregnant and postnatal women involved in the intervention

Healthcare workers involved in the intervention

During the last 3 months of the intervention