Implementing a competency-based Advanced Field Epidemiology Training Programme in Sierra Leone: Protocol for a mixed-methods pilot evaluation

Introduction: Advanced Field Epidemiology Training Programmes depend on prolonged, mentored public health service. Sierra Leone operates Frontline and Intermediate training, while its 2023 Joint External Evaluation recommended expansion to advanced training. A prospective pilot is needed to determine whether a complete national Advanced programme can operate with sufficient fidelity, field exposure, research support, equitable opportunity, safety and cost control. Methods: We will conduct a prospective, single-cohort, longitudinal mixed-methods implementation pilot with a three-month pre-implementation period, a 24-month programme and six-month follow-up. The complete first cohort comprises 15 residents at eight accredited national or subnational field sites. The intervention includes 17 modules, 102 terminal outcomes, 70 facilitated sessions, 36 exercises, at least 68 supervised field-practice weeks, named mentorship and eight assessed field-product categories. Each resident receives two authentic outbreak or urgent field-investigation opportunities and leads at least one analytic response. Research planning ends by Month 12; implementation, analysis, thesis or dissertation writing, examination and correction occupy most of Year 2. Graduation evidence includes two accepted or published internal or national-channel articles from distinct field products, one independently certified lead-author manuscript submitted to a legitimate peer-reviewed journal, one policy brief and one scientific presentation. An Independent Research and Evaluation Team, separate from programme delivery and assessment, controls consent, source-evidence inventory, fidelity scoring, data locking, analysis and scientific reporting. Overall implementation fidelity at Month 24 is the primary outcome. The team scores 20 unweighted components from verified source records; critical components are non-compensatory, and the component census receives no sampling confidence interval. Key secondary outcomes are field-practice attainment, retention, acceptability, appropriateness, perceived feasibility and primary-data completeness. The Framework Method, mixed-methods joint displays and time-driven activity-based costing support qualitative, integrated and economic analysis. Results: The pilot will estimate implementation fidelity, feasibility, stakeholder experience, educational and service outcomes, recommendation uptake, equity, cost and sustainability readiness. Prespecified green, amber and red decision rules will support an auditable scale-up decision. Conclusion: This protocol tests whether Sierra Leone can deliver a complete competency-based Advanced FETP safely and consistently before wider implementation. It does not estimate causal effectiveness.