Table 1 Outcome, context and mechanism components obtained from the thematic analysis of the document review and in-depth interviews with programme managers and designers. Source: Mukumbang et al. [44]
Context | Mechanisms | Outcomes |
|---|---|---|
Distal (Macro) Context | Provider/Management Level | Long-term Outcomes |
- Monitoring and evaluation | - Buy-in | - Programme standardisation |
- Higher level support | - Interaction (perceived social support) | - Retention in care and adherence to medication |
- Stakeholder collaboration | - Motivation | - Healthier communities |
Organisational (Meso) Context | Social mechanisms | Intermediate Outcomes |
- Sustained hierarchical pressure | - Group dynamics - Social/Peer support | - Decongestion of clinic |
- Human resources (staffing dynamics) | - Mutual learning (empowerment) | - Improved patient self-management |
- Implementation methodology | - Bonding (sense of belonging) | |
Local (Micro) Context | Patient (individual)-Level | Immediate Outcomes |
- Availability of conducive space | - Encouragement | - Decreased workload for operational staff |
- Programme champions | - Trust | - Decreased patient opportunity cost |
- Oppressive surveillance | - Nudging | |
- Fear | ||
- Motivation |