by enhanced supportive supervision through LHSs. However, considering the context specific barriers and the structural gaps in the LHW-P, implementation of NIGRAAN was nevertheless challenging. This study describes the barriers and challenges encountered while implementing various phases of project NIGRAAN. Methods Study setting: Project NIGRAAN was rolled out in district Badin, province of Sindh. Badin is a coastal district with 84% of its population living in rural areas. In addition to a network of primary and secondary level healthcare facilities [19], there is an operational LHW-P in the district to cater to the maternal and child healthcare needs of the population (Table 1) [17].
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