This study is a great example of how #RealistEvaluation can unpack not just what works, but why, for whom, and under what conditions.

Key takeaway: Digital BCC programmes must go beyond content delivery. To foster sustained engagement, they need to be emotionally supportive, context-sensitive, and equity-oriented. Tech is just the shell—context is the fuel.

Not all mechanisms were positive. Some women felt “watched” by the government (who co-implemented mNutrition). Fear of surveillance, not trust, drove their engagement, raising concerns about coercion in digital health.

Some mothers used SMS messages to negotiate gendered power dynamics. Credible information backed their decisions on feeding practices, helping them assert themselves in male-dominated households. #Empowerment.

Messages that opened with “Beloved Mum” offered emotional support & recognition. These cues made mothers feel seen, validated, and part of a caring network, sustaining their connection.

Realist interviews revealed 7 key CMO configurations. Example: Mothers who felt anxious about their child’s health valued regular SMS advice. It reduced anxiety and restored a sense of control, driving continued engagement.

Sustained engagement wasn’t due to a single factor. It emerged from interactions between programme features (like message tone, delivery mode, sender perception) and contextual inequities (like time poverty, isolation, gender dynamics). #RealistLens #HealthEquity.

This study focused on the mNutrition programme—a large-scale SMS behaviour change intervention targeting maternal & child nutrition. Despite high reach, only 12% of users engaged consistently. So, what kept those users engaged?.

Why do some mothers keep engaging with SMS-based nutrition programmes while others don’t? This realist evaluation from rural Tanzania explores the mechanisms behind sustained engagement. #RealistEvaluation #DigitalHealth .

RT @seyeabimbola: Please read our new @HPP_LSHTM paper: “Unfair knowledge practices in global health: a realist synthesis” .

The authors argue that Indigenous realist evaluation is a promising pathway toward decolonising research partnerships, especially when it amplifies participant agency and foregrounds local epistemologies.

The Indigenous realist approach reframes evaluation as a tool not only to understand “what works for whom in what contexts,” but also to challenge power structures and catalyse transformative change.

Indigenous principles like reflexivity and rights and regulations added methodological value. For instance, transcript review empowered participants and deepened insights into partnership dynamics and power asymmetries. #Ethics #IndigenousKnowledge.

Key contexts enabling these mechanisms were:. Partner allyship.Shared interests/priorities.Intentional design for equity. These generated equitable partnerships and addressed local health research needs.

The authors demonstrate the approach using a case study from the ARISE programme, focused on health research capacity strengthening in Africa. The key generative mechanisms identified: autonomy/independence, empowerment, and control/power.

Indigenous realist evaluation retains initial programme theories (IPTs), realist interviewing, and retroduction, but centres participant voices, ethical conduct, and equity, aligning with Chilisa & Mertens’ Indigenous research principles. #Methodology.

In this paradigm, colonialism and its power structures are treated as causal forces—"real" and "actual"—with visible and invisible impacts on outcomes. The approach goes beyond explanation toward social transformation for better social conditions.

The Indigenous realist stance recognises Bhaskar’s three domains (empirical, actual, real) and integrates emancipatory goals of critical realism with Indigenous values: relationality, reciprocity, reverence, and responsivity. #CriticalRealism.

Drawing on a realist evaluation of the ARISE programme, Mutua et al. propose an Indigenous realist evaluation—an approach that fuses scientific and critical realism with postcolonial Indigenous paradigms. #CMO #EvaluationTheory.

Fourth in our series of threads on #RealistMethods. How can realist evaluation meaningfully contribute to decolonisation? A new methodological reflection explores the promise of an Indigenous realist evaluation approach. #RealistEvaluation @Mcferdious .