Table 3 Thematic reporting based on the implementation outcome variables

Acceptability

The perception among stakeholders that an intervention is agreeable

"But the contrast between her experiences at the clinic and the adherence club is more than just a matter of efficiency, she said. At club meetings, there’s a strong sense of solidarity, reassurance and openness" [53]

"The adherence club intervention also offers cost and time benefits to the health system" [5]

"The purpose of the adherence clubs from the healthcare worker’s point of view was to streamline clinic functioning and create conditions for faster processing of already-adherent patients" [25]

Adoption

The intention, initial decision or action to try to employ the new intervention

"The Global Fund to Fight AIDS, TB and Malaria, the country is planning to move treatment out of clinics and into patients’ homes, local libraries and maybe even their local chain-clothing store, like PEP, in the next three years" [54]

"Expansion of the model to include groups of relatively healthy HIV-infected individuals with inequitable access to and outcomes on ART, such as women who initiate ART in pregnancy, should be considered" [42]

Appropriateness

The perceived fit or relevance of the intervention in a particular setting or for a particular target audience (for example, provider or consumer) or problem

"The ART-adherence club model improves adherence and long-term retention in care among clinically stable ART patients while optimising health resources to manage new ART patients and patients at risk of failing treatment" [9]

"We observed an increased risk of loss to follow-up and viral rebound in younger patients; a finding that has been demonstrated in other studies" [18]

"ART clubs were generally felt to be efficient, accessible, convenient, patient-friendly, supportive, accommodating of the needs of working people, as well as decreasing the workload of the ART clinic and hospital pharmacy" [26]

Feasibility

The extent to which an intervention can be carried out in a particular setting or organisation

"The AC represents ‘the model to follow in task shifting and task sharing to more community-based care’. But to scale up the model, South Africa must train hundreds of thousands of community health workers" [28]

"Club availability has since been expanded and extended to all clinics in the sub-district, enabling ongoing increases in enrolment without additional clinical staff" [16]

"A total of 129,058 HIV stable patients decanted from 330 clinics to 4971 community-based adherence clubs across 15 districts" [31]

Fidelity

The degree to which an intervention was implemented as it was designed in an original protocol, plan or policy

"Groups are now meeting in the community, introducing challenges in the delivery of pre-packaged drugs to community settings, and the collection, transfer and review of patient and programme management data" [16]

"Fifteen locals, each carrying a small, green medication booklet, gather in the home of a woman who’s hosting a meeting of an adherence club for HIV-positive people" [40]

"The club model grew out of these experiences but appeared to have diverged somewhat from the earlier ‘support group’ ideas and dimensions of adherence counselling and peer support, focusing more on convenience for those with HIV" [32]

"The focus is on people taking ART who are clinically stable and includes those on ART who also have non-communicable diseases such as hypertension and diabetes" [45]

Implementation to cost

The incremental cost of the implementation strategy and the cost of the intervention itself

"Group-based models of chronic care are patient- friendly, budget-friendly and efficient ways of delivering ART in areas with a high burden of disease" [26]

"Saves the health system and patients invaluable time and money" [35]

"All costs were lower in the clubs compared to standard of care" [46]

Coverage

The degree to which the eligible population actually benefits from the intervention

"AC were implemented across the Cape Metro health district over a 4-year period providing ART care and support to more than 30,000 patients" [9]

"We are setting up over 150 clubs across the provinces of Mpumalanga, Gauteng and the Free State at the Department of Health facilities" [45]

"Adherence clubs in KwaZulu-Natal, the Eastern Cape and the Western Cape are also being rolled out" [45]

"AC club models were implemented in 10 facilities in Tswane, 10 facilities in Nkangala and 15 facilities in Capricorn. From July 2016 to December 2016, 1500 patients were enrolled in Tswane, 850 in Nkangala and 5524 in Capricorn, with retention rates of 90%, 94% and 95%, respectively" [51]

"MSF’s HIV adherence clubs have grown, in under two years, to include 11,000 members in the Mangaung district" [55]

Sustainability

The extent to which an intervention is maintained or institutionalised in a given setting

"There is a need to establish a working relationship with the health facilities that will lead to adoption and validation of the adherence club registers used in communities" [33]

"As a lot of the work of running the adherence clubs is administrative in nature, staff members were in agreement that ways had to be found to streamline work and involve non-clinical staff so that clinicians could be freed up to schedule regular check-ups and attend to sick patients" [26]

"The management of these groups is becoming increasingly challenging as the number of groups associated with a single clinic increases, requiring new management strategies and related research" [16]