Realist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocol

dc.contributor.authorMukumbang, Ferdinand C.
dc.contributor.authorVan Belle, Sara
dc.contributor.authorMarchal, Bruno
dc.contributor.authorvan Wyk, Brian Eduard
dc.date.accessioned2016-04-14T21:10:25Z
dc.date.available2016-04-14T21:10:25Z
dc.date.issued2016
dc.description.abstractINTRODUCTION: Suboptimal retention in care and poor treatment adherence are key challenges to antiretroviral therapy (ART) in sub-Saharan Africa. Communitybased approaches to HIV service delivery are recommended to improve patient retention in care and ART adherence. The implementation of the adherence clubs in the Western Cape province of South Africa was with variable success in terms of implementation and outcomes. The need for operational guidelines for its implementation has been identified. Therefore, understanding the contexts and mechanisms for successful implementation of the adherence clubs is crucial to inform the roll-out to the rest of South Africa. The protocol outlines an evaluation of adherence club intervention in selected primary healthcare facilities in the metropolitan area of the Western Cape Province, using the realist approach. METHODS AND ANALYSIS: In the first phase, an exploratory study design will be used. Document review and key informant interviews will be used to elicit the programme theory. In phase two, a multiple case study design will be used to describe the adherence clubs in five contrastive sites. Semistructured interviews will be conducted with purposively selected programme implementers and members of the clubs to assess the context and mechanisms of the adherence clubs. For the programme’s primary outcomes, a longitudinal retrospective cohort analysis will be conducted using routine patient data. Data analysis will involve classifying emerging themes using the contextmechanism- outcome (CMO) configuration, and refining the primary CMO configurations to conjectured CMO configurations. Finally, we will compare the conjectured CMO configurations from the cases with the initial programme theory. The final CMOs obtained will be translated into middle range theories. ETHICS AND DISSEMINATION: The study will be conducted according to the principles of the declaration of Helsinki (1964). Ethics clearance was obtained from the University of the Western Cape. Dissemination will be done through publications and curation.en_US
dc.description.accreditationWeb of Scienceen_US
dc.identifier.citationMukumbang, F.C. et al (2016). Realist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocol. BMJ Open, 6:e009977en_US
dc.identifier.issn0959-8138
dc.identifier.urihttp://hdl.handle.net/10566/2117
dc.language.isoenen_US
dc.privacy.showsubmitterfalse
dc.publisherBMJen_US
dc.rightsBMJ Open is an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas.
dc.source.urihttp://dx.doi.org/10.1136/bmjopen-2015-009977
dc.status.ispeerreviewedtrue
dc.subjectAntiretroviral therapyen_US
dc.subjectSub-Saharan Africaen_US
dc.subjectWestern Cape Provinceen_US
dc.subjectSouth Africaen_US
dc.subjectHealthcareen_US
dc.titleRealist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocolen_US
dc.typeArticleen_US

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