Table 3 Health system-related outcomes to be evaluated before and after HPV trial

Adoption

a) Extent to which cervical screening is available in settings in study areas

b) N, % of settings and staff allocated to the interventions that adopted HPV intervention

c) Key differences between adopters and non -adopters

d) Qualitative: barriers and facilitators

Facility assessment survey checklist^a

Qualitative study^a

Trial evaluation of settings and providers

Qualitative study^a

Implementation

a) Fidelity of local implementation in comparison to national/state guidelines over time

b) Nature of adaptations made and reasons

c) Implementation costs

Facility assessment survey checklist^a

Qualitative study^a

Screening registry for trial

Feedback survey

Qualitative study^a

Maintenance

a) Assessing sustainability of the screening programme and scale up to all areas

Trends in VIA screening coverage and frequency of offer of screening and fidelity to guidelines over time

Post-trial stakeholder assessment of sustainability and modifications, using qualitative interviews and ISAT^b