Table 2 Implementation strategies and implementation outcome measurement methods
Implementation strategies | Actors | Actions | Action targets | Temporality/Dose | Implementation outcomes | What is measured | Sources of data |
|---|---|---|---|---|---|---|---|
Developing stakeholder relationships by engaging CBO leaderships | IHRI | In-depth interviews | CBO leaderships | Once during pre-implementation phase and at months 6 and 12 | Sustainability | Attitudes of CBO leadership to CB-SDART service over time The degree to which CBO leadership supports, owns and plans on continuing delivery of CB-SDART | In-depth interviews with CBO leadership as well as staff: Interview notes, audio recordings, transcripts; Meeting minutes from progress update meetings |
Regular meetings for planning and consultation between CBOs and IHRI | Once during pre-implementation phase and at months 1, 3, 6, 9, and 12 | ||||||
Training and educating KP lay providers | IHRI, PIDCU | Didactic and practical training provided by IHRI and PIDCU; certification; service dry-run | CBO leaderships | Once during pre-implementation phase | Feasibility | Number of CBO providers achieving a passing score on tests Number of CBO providers certified to provide CB-SDART related services The level of competency of CBO providers in leading CB-SDART | Test scores of didactic and practical tests;Â Certification records; Meeting minutes from coaching sessions |
Ongoing coaching/mentoring provided by IHRI and PIDCU | At months 1, 3, 6, 9, and 12, or upon request | ||||||
Adapting and tailoring SDART to CBO context | IHRI, CBO | SOP development | CBO | Once during pre-implementation phase | Feasibility | The degree to which CB-SDART service fits with each CBO The level of comfort in delivering CB-SDART related services The extent to which CB-SDART adaptations are necessary after initial implementation | In-depth interviews: Interview notes, audio recordings, transcripts; Meeting minutes of progress update meetings; SOP revision history records |
In-depth interviews | Once during pre-implementation phase and at months 6 and 12 | ||||||
Regular meetings for feedback between CBOs, IHRI, and PIDCU; SOP revision | Once during pre-implementation phase and at months 1, 3, 6, 9, and 12 | ||||||
Using evaluative and iterative strategies to assess adherence to SOP | IHRI, CBO | Regular meetings for feedback between CBOs, IHRI, and PIDCU; internal service flow assessment | CBO | At months 1, 3, 6, 9, and 12 | Fidelity | The degree to which CB-SDART is delivered as intended: Proportion of HIV diagnosed clients who are offered SDART Proportion of clients who accepted SDART which undergoes symptomatic screening Proportion of eligible clients initiating ART within the same day of HIV diagnosis Proportion of clients who are followed up for at least one year to ensure retention in care | eCRF; Service delivery checklists; Meeting minutes of CBO internal meetings; SOP deviation records |
Developing stakeholder relationship by engaging external stakeholders | IHRI, CBO | Submission of quarterly progress report | BMA, NHSO | At months 3, 6, 9, and 12 | Sustainability | The level of support by NHSO and BMA for CB-SDART The extent of endorsement by NHSO and BMA for CB-SDART | Communication records; Meeting minutes of the strategic meeting |
Strategic meeting with national stakeholders | During post-implementation phase |