Tabriz model: a qualitative study protocol exploring a decade of implementing a comprehensive child development...

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.

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. Data collection will include semi-structured interviews and focus group discussions conducted until thematic saturation is reached. Audio-recorded data will be transcribed verbatim and analysed using framework-guided content analysis. A triangulated approach will integrate document reviews and stakeholder questionnaires to enrich findings. Methodological rigour will be ensured through member checking, peer debriefing and double coding. Ethical considerations such as informed consent and confidentiality will be strictly maintained. The study's reporting will adhere to the Consolidated Criteria for Reporting Qualitative Research (COREQ) 32-item checklist, guaranteeing transparency, completeness and methodological rigour.

This study was approved by the Ethics Committee of Tabriz University of Medical Sciences. Two separate ethical approval codes were issued for the qualitative protocol of this study IR.TBZMED.REC.1404.025 and IR.TBZMED.REC.1404.139. Separate informed consent forms have been developed for all stakeholder groups. Participants will provide oral and written consent before interviews or focus group discussions, and audio recordings will be conducted only with their permission; for those who do not consent to recording, detailed notes will be taken. Participants will be informed of their right to withdraw from the study at any time without consequence. Study results will be disseminated through peer-reviewed journals, scientific conferences and policy meetings to inform future strategies for comprehensive child development services.