Tabriz Model: A Qualitative Study Protocol Exploring a Decade of Implementing a Comprehensive Ch

28 Apr 20264 min read0 viewsJournal Feed

GIST

Introduction Rapid and sensitive early childhood development is vital for lifelong health, cognition and socio-emotional well-being. Suboptimal care during these formative years increases the risk of developmental delays affecting motor, cognitive, speech, hearing and visual domains.

Early identification and intervention can mitigate these risks but structured, integrated service delivery remains limited in many low- and middle-income countries. Since 2014, comprehensive child development centres (CCDCs) have been established under Iran's Ministry of Health to address these gaps, with Tabriz hosting one of the pioneering centres.

This qualitative study protocol aims to systematically document the implementation of the Tabriz CCDC over a decade, identifying key facilitators and barriers essential for shaping a scalable, evidence-based model of comprehensive child development services adaptable to Iran's health system. Methods and analysis A qualitative, exploratory study design grounded in phenomenology will be employed to explore the lived experiences of key stakeholders involved in implementing the CCDC in Tabriz over 10 years.

Purposeful and snowball sampling will recruit diverse participants, including policymakers, healthcare providers and parents of children under five.

Clinical Editorial

Emergent aims and study scope

The protocol aims to document, over a decade, how a comprehensive child development centre (CCDC) in Tabriz has been implemented within Iran’s health system, to identify facilitators and barriers and to inform a scalable model adaptable to national contexts.

Theoretical and design framework

The study adopts a qualitative, exploratory approach rooted in phenomenology to capture the lived experiences of stakeholders involved in the CCDC’s implementation.
Data will be generated through purposeful and snowball sampling to assemble a diverse cohort, including policymakers, healthcare providers, and parents of children under five.
Data collection comprises semi-structured interviews and focus group discussions, conducted until thematic saturation is achieved.

Methods of data handling and analysis

Interviews and discussions will be audio-recorded, then transcribed verbatim.
Analysis will use framework-guided content analysis, with triangulation from document reviews and stakeholder questionnaires to enrich findings.
Methodological safeguards include member checking, peer debriefing, and double coding to enhance rigor.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) 32-item checklist will guide reporting to assure transparency and completeness.

Ethical considerations and governance

The Tabriz University of Medical Sciences Ethics Committee approved the study, issuing two separate ethics codes for the qualitative protocol: IR.TBZMED.REC.1404.025 and IR.TBZMED.REC.1404.139.
Separate informed consent forms have been prepared for each stakeholder group.
Consent procedures include oral and written forms, with audio recording contingent on participant permission; where recording is declined, detailed field notes will be used.
Participants retain the right to withdraw at any time without consequences.

Dissemination and practical aims

Findings will be disseminated through peer-reviewed journals, scientific conferences, and policy meetings.
The study intends to inform future strategies for comprehensive child development services by documenting operational experiences, facilitators, and barriers observed during the decade-long implementation in Tabriz.

Contextual background and potential implications

Early and integrated attention to child development is framed as critical for lifelong health, cognition, and socio-emotional well-being, with suboptimal care linked to a spectrum of developmental delays.
Since 2014, Iran has established CCDCs to address gaps in early identification and intervention for developmental needs, with Tabriz as an early exemplar.
The protocol emphasizes translating qualitative insights into an evidence-informed model that could be scalable across Iran’s health system.

Limitations and uncertainties

As a study protocol, the content outlines intended methods and anticipated analyses; actual findings, themes, and their generalizability will depend on study execution and participant engagement.
The report does not present results or quantified outcomes; it notes qualitative aims, sampling strategies, and ethical safeguards rather than measured effectiveness or impact.