Professionals’ Experiences with Local Implementation of the Greenlandic Parenting Programme MANU 0–1 Year

Abstract

AbstractHistorically, public health interventions in Greenland are primarily adopted from a Scandinavian context or developed centrally in the capital city instead of building on communities’ local resources and strengths. The aim of this article is to identify implementation determinants from professionals’ perspectives in the implementation of the parenting programme Meeraq Angajoqqaat Nuannaarneq (MANU, meaning child’s and parent’s happiness) 0–1 Year, at the local level in three of Greenland’s five health regions. The study applied the Consolidated Framework for Implementation Research. Semi-structured interviews with 18 health professionals and six managers in healthcare and with four municipality personnel were held. Additionally, data on staffing from the Board for Health and Prevention was gathered. Professionals agree on the importance of having a universal parenting programme, but it is not a priority to them. Characteristics of the programme were a barrier in implementation in some local contexts, such as professionals experiencing parents being uncomfortable with participating in group sessions. Many professionals felt it was a daunting task to facilitate a group session. MANU was also incompatible with existing workflows. High turnover in the healthcare system makes it difficult to implement and sustain programmes. Professionals found it difficult to apply supervision provided by the MANU team and, at times, did not feel recognised in their efforts. Adaptations were made to MANU to fit local contexts. The identified determinants hindering local implementation link back to MANU’s complexity and inadequate preparatory investigations made into aspects influencing implementation during MANU’s conceptualisation and development. Many of the barriers identified could have been prevented by involving local community perspectives from professionals and families from the outset of MANU.