Development, Implementation, and Process Evaluation of Bukhali : An Intervention from Preconception to Early Childhood

This paper details the development, implementation, and process evaluation of the Bukhali intervention, a preconception-to-early-childhood program in South Africa's Healthy Life Trajectories Initiative. The intervention uses community health workers to deliver a complex, life-course approach targeting healthy weight and reducing non-communicable disease risk in young women and children. The authors document the intervention development process and the ongoing implementation science evaluation using frameworks like the Consolidated Framework for Implementation Research (CFIR). A key limitation acknowledged is the difficulty in fully capturing the intervention's complexity due to the long-term trial design. The implications are that the documented process provides a foundation for evaluating efficacy and, later, effectiveness within a public health system.