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Table 2 A summary of results from the chlorhexidine acceptability in central Uganda study, reported using constructs from the Theoretical Framework of Acceptability (TFA) by Sekhon et al

From: “We shall count it as a part of kyogero”: acceptability and considerations for scale up of single dose chlorhexidine for umbilical cord care in Central Uganda

TFA construct Definition Finding (subtheme) Anticipated impact on scale up and potential solutions
Affective attitude Affective attitude implies how an individual feels about the intervention Chlorhexidine is a pleasant solution This will ease scale up
Burden and self-efficacy Burden: The perceived amount of effort required to participate in the intervention
Self-efficacy: Participant’s confidence that they can perform behavior required by intervention
Chlorhexidine is easy to use This will ease scale up
Intervention Coherence and perceived effectiveness Intervention coherence: Extent to which the participant understands the intervention and how it works
Perceived effectiveness: Extent to which intervention is perceived to achieve it’s purpose
Chlorhexidine reduces bad smell
Chlorhexidine prevents abdominal colic
This will ease scale up
Opportunity costs and Ethicality Opportunity costs: Extent to which benefits, profits, or values must be given up to engage in the intervention
Ethicality: Extent to which the intervention has good fit with an individual’s value system
‘Without Kyogero there is no blessing’: Desire to continue using kyogero These are anticipated hindrances. A potential solution is to request participants to wait for umbilical cord separation before using kyogero.
‘We shall call it value added kyogero’: Desire to add chlorhexidine to the potentially ‘unhygienic’ herbal solution
‘The cord should fall off quickly’: Desire for quick umbilical cord separation This is an anticipated hindrance. A potential solution to this is to inform participants about the possibility of prolonged umbilical cord separation and emphasize that there is no danger with this.
‘It is my mother who decides’: Multiple powerful actors and decision makers in the newborn period This is an anticipated hindrance. A potential solution is involvement of elderly relatives in the intervention scale up.