Background In 2019, the [1]National Catholic Health Service (NCHS) initiated the INTERPRACTICE-21st Study in Ghana: implementation of the [2]INTERGROWTH-21st (IG21) Preterm Postnatal Growth Standards and Feeding Protocols within its hospitals.

Implementation included

1. Monitoring the growth of preterm babies with the IG21 standards, rather than the traditional growth charts for term babies.

2. Training health professionals involved with neonatal care to use the IG21 standards and evidence-based, feeding protocols (with their focus on the use of breast milk).

3. Partner consultations.

Implementation includedWe present the results of the qualitative component of an evaluation study, conducted after the 15 month pilot phase, to inform future [3]spread and [4]scale-up of interventions.

[1] https://www.nchs.org.gh

[2] https://intergrowth21.tghn.org/interpractice-21st/

[3] Spread definition: https://qi.elft.nhs.uk/collection/scale-up-and-spread/

[4] Scale-up definition: https://qi.elft.nhs.uk/collection/scale-up-and-spread/

Objectives

• To describe stakeholder views and perspectives regarding the introduction of a novel public health intervention aimed at improving care for preterm babies in a low-resource setting.

• To compile lessons learned for national scale-up of preterm interventions.

Methods A questionnaire was developed based on the literature relating to implementation science. In-depth interviews were conducted with eight key stakeholders who were purposively sampled because of their prior knowledge of the INTERPRACTICE-21st Study and/or preterm care in Ghana. Eligible stakeholders were invited via email to participate. Interviewees included officials at the Ministry of Health and NCHS, and other stakeholders in the field of paediatrics and public health.

Due to COVID-19 restrictions, interviews were conducted virtually (via a video call). Verbal consent was obtained prior to the interviews. Recorded audio files were transcribed and thematic content analysis was performed using [5]Pope’s Approach to extract emerging themes from the interviews. The Oxford Tropical Research Ethics Committee approved the study (no. 536–20).

[5] https://www.bmj.com/content/320/7227/114

Results Emerging themes from the interviews are presented in table 1 below:

Conclusions

• Stakeholder responses show positive feedback to the pilot phase of the project.

• The study emphasises the need to seek the views of stakeholders in a pilot phase before embarking on nationwide scale-up of a preterm intervention in a low-resource setting.