Towards developing an initial programme theory: Programme designers and managers assumptions on the antiretroviral treatment adherence club programme in primary health care facilities in the metropolitan area of Western Cape Province, South Africa

dc.contributor.authorMukumbang, Ferdinand C.
dc.contributor.authorvan Belle, Sara
dc.contributor.authorMarchal, Bruno
dc.contributor.authorvan Wyk, Brian
dc.date.accessioned2018-07-06T09:32:33Z
dc.date.available2018-07-06T09:32:33Z
dc.date.issued2016
dc.description.abstractBACKGROUND The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theoryÐthe assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). METHODS We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. RESULTS We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. CONCLUSION The perspectives of the programme designers and managers provided an important step towards developing an initial programme theory, which will guide our realist evaluation of the adherence club programme in South Africa.en_US
dc.description.accreditationISI
dc.identifier.citationMukumbang, F.C. et al. (2016). Towards developing an initial programme theory: Programme designers and managers assumptions on the antiretroviral treatment adherence club programme in primary health care facilities in the metropolitan area of Western Cape Province, South Africa. PLOS one, 11(8): e0161790.en_US
dc.identifier.issn1932-6203
dc.identifier.urihttp://dx.doi.org/10.1371/journal. pone.0161790
dc.identifier.urihttp://hdl.handle.net/10566/3857
dc.language.isoenen_US
dc.privacy.showsubmitterFALSE
dc.publisherPublic Library of Scienceen_US
dc.rights© 2016 Mukumbang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.status.ispeerreviewedTRUE
dc.subjectAntiretroviral adherenceen_US
dc.subjectPrimary health care facilitiesen_US
dc.subjectWestern Capeen_US
dc.subjectRealist evaluation approachen_US
dc.subjectAntiretroviral club interventionen_US
dc.titleTowards developing an initial programme theory: Programme designers and managers assumptions on the antiretroviral treatment adherence club programme in primary health care facilities in the metropolitan area of Western Cape Province, South Africaen_US
dc.typeArticleen_US

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