Table 5 Summary of results and outcomes

Amaral et al. [82]

None reported

Factors associated with the policy adoption

Data from state secretariats of health

New health interventions tend to be initially adopted by those who need them

Smaller and more distant municipalities were less likely to have IMCI

It is necessary to define health policies in each state that promote the strategy in higher-risk municipalities

Andrade et al. (2017) [75]

Pan American Health Organization consulted on data collection methods

Stakeholders involved in implementation included; Government of the State of Minas Gerais; Government of Santo Antonio do Monte; The National Council of Health Secretaries

Macro processes of attention to chronic conditions model (ACCM)

Health outcomes associated with primary healthcare (PHC)

Household surveys and medical records

Interviews

Focus groups

Increase in community health agent visits

Increase in individuals using public health services only among those with diabetes

A decrease in doctor visits for individuals with diabetes

Having a unified health system as the main provider of primary care in small municipalities was important

Establishing a PHC network in small municipalities was important

Importance in implementation of the macro process

Screening patients to receive treatment at different care levels

Armstrong et al. (2014) [90]

Reproductive and child health coordinators, a district laboratory technician, a district nursing officer, district medical officer (DMOs), health secretaries, and zonal maternal and perinatal death reviews (MPDR) medical officers were informants who were professionally involved in MPDR

The role and practices of MPDR in district and regional hospitals

Key stakeholders’ involvement in and perspectives regarding the MPDR process

Interviews

Implementation of MPDR was dysfunctional

The system still faces a number of challenges, most of which may be related to a lack of clarity in its intended purpose

It is unwise for providers to disengage

Facility-level reviews are an important iterative learning process that should remain the core of any effort to improve care in health facilities

Should Tanzania wish to change the MPDR system at the local level, evaluation, training and supervision are recommended

Bergerot et al. (2017) [79]

None reported

Patients’ distress, anxiety, depression and quality of life

Distress thermometer

Hospital anxiety and depression scale

Functional assessment of cancer therapy

Structured questionnaire

The prevalence of distress was high compared with developed countries

Promote the development of strategies that favour equity in cancer care and that offer interventions in a timely manner

Measures used were adequate for the identification of patients’ needs throughout the continuum of cancer

The development of this screening programme achieved the goal of better meeting the psychosocial needs of cancer patients

Blanco-Mancilla (2011) [84]

None reported

Effectiveness of policy implementation

Interviews

Newspaper articles

Official documents

Online news services and publications

Effective implementation in terms of access and capacity shows very different experiences between the policies analysed

More than half of the total number of primary health centres managed by the department of health were still not certified to treat policy beneficiaries, seriously affecting access to services

These policy recommendations may help to improve implementation of the policies, as well as other new or current policies either in Mexico or in other countries

Bryce et al. (2005) [58]

None reported

Compare findings of the Multi-Country Evaluation of IMCI Effectiveness, Cost and Impact (MCE-IMCI) relative to the programme expectation reflected in the IMCI impact model

12 country assessments

In-depth studies at five sites

Cross- site analysis

The quality of trained IMCI workers was better than that of the untrained workers, even with no supervision

Improving the quality of care in first-level government health facilities was not sufficient to increase low utilization levels

The model reflected issues directly related to service delivery, but showed insufficiencies with other aspects of the health system such as transition pathways from policy and strategy to operations, human resource issues including supportive supervision, financing and ensuring an equitable coverage of interventions

New attention to child survival, new leadership in key organizations, and a focus on achieving the Millennium Development Goal of reducing child mortality by two thirds all provide the impetus to move quickly, forcefully and in new ways to achieve universal coverage with proven child survival interventions

Callaghan-Koru et al. (2020) [86]

Ministry of Health and Family Welfare (MOHFW)’s IMCI unit acted as the resource team coordinating scale-up

A group composed of stakeholders from government, academia and NGOs to made policy recommendations and provided guidance

A local pharmaceutical company supplied single-dose bottles

Local NGOs were contracted to coordinate the training of providers in each district

Facilitators and barriers with respect to the institutionalization and expansion stages

Interviews

Focus groups

Documenting facilitators and barriers with respect to scale-up of chlorhexidine (CHX) policy (see Barriers/Enablers Table)

Strong leadership was a huge success factor

Public system was not evaluated given the complexity and limited regulatory control in this sector

Scale-up benchmarks would be useful approaches for identifying key institutionalization changes

Changes should be adapted to reflect the full structure of the health system

CHX counselling and distribution have not been routinely implemented in antenatal care expansion, suggesting that distinct plans and implementation strategies are needed to achieve goals within the two scale-up dimensions

The scale-up of CHX in Bangladesh was influenced by a range of factors from all five CFIR domains

Carneiro et al. (2018) [100]

None reported

Strategy performance

Population coverage estimated by primary care teams

Proportion of live births to mothers with/without prenatal consultations

Hospitalization rates due to primary care-sensitive condition

Infant mortality rate

Resulted in changes to the management and control models used in the region, and introduced universities to the process

The proportion of live births to mothers with/without prenatal consultations increased by 97% on average, predominantly with seven consultations or more and reducing the proportion of live births to mothers without prenatal visits

The infant mortality rate achieved a downward trend

The results indicated the contribution of the more physicians in Brazil programme (MPBP) towards improving primary care based on the selected indicators

Costa et al. (2014) [101]

None reported

Indication of coverage

Evidence of change and impact

Home visits made by doctors

Requested exams of clinical pathology

Referrals to specialists, and individual care provided by nurses

Number of hospitalizations due to conditions that would respond to outpatient care (i.e. indicator of impact)

A majority of municipalities maintained the coverage level verified in 2004

One municipality presented strong indications of change in 2008 and was reclassified as moderate so as to allow the conduction of the statistical test

An increase of 50% in the proportion of municipalities classified as high-impact

More coverage compared with previous periods

Lower rates of morbidity

The proportion of municipalities with the expected number of requests remained small

There should be revision of work processes in Family Health Strategy (FHS) units, and a more in-depth investigation of the factors driving the small number of medical home visits, referrals to a specialist, requests for clinical pathology exams, and limited nursing care in relation to the number of medical consultations

Ditlopo et al. (2011) [91]

None reported

The implementation and perceived effectiveness of a rural allowance policy

The motivation and retention of healthcare professionals (HCPs) in rural hospitals

Interviews

Policy review

Partial effectiveness of rural allowance in recruitment

Almost all policy-makers, hospital managers and HCPs consistently perceived the rural allowance to be divisive because it excluded junior nurses

Remoteness of the area not considered

Financial incentives alone were insufficient

Retention strategies that combined financial and nonfinancial incentives are likely to be more effective than increased remuneration alone, but these would need to be tailored to individual country contexts

Doherty et al. (2017) [92]

Stakeholders were involved in determining the reasons and sustainability of the policy

Impact of Prevention of mother-to-child transmission of HIV/AIDS (PMTCT) Option B+ implementation on the Uganda health system

Interviews

Focus groups

Financial sustainability of the programme was a recurring theme because of funding insecurity

Senior stakeholders voiced concerns about the health system’s readiness to adopt the policy and the rapid pace of scale-up

Uganda has achieved success in scaling up access to ART and reducing the number of children newly infected with HIV

If ongoing investments and technical support for the HIV/AIDS response in Uganda are not allocated to strengthen the health system across programme areas, a significant opportunity may be lost

Ejeta et al. (2020) [107]

City/town health offices

Sub-city and district offices

Community leaders

Regional health bureaus

Ethiopian Federal Ministry of Health

Members of the SEUHP programme

Health centres

Lessons learned

Challenges to implementation

Interviews

Document review

The pilot test enabled the urban health extension professionals (UHE-Ps) to comprehensively focus on the 15 health service packages

Use of tally sheet helped collect high-quality data and report it to city/town health offices

Systematic categorization of households, based on their economic status and health service needs allowed for effective time management and delivery of services to vulnerable populations

Plans are made to scale up the programme to major cities

Febir et al. (2015) [103]

None reported

Perceptions of healthcare workers (HCWs) regarding the issues faced

Interviews

Implementation faced challenges given the weak health systems in most developing counties

The perceptions of frontline HCWs on the accuracy and need for the guideline together with the capacity of health systems to support implementation played a crucial role

Guidelines on financing of diagnostics and treatments are influencing clinical decision-making in this setting

Further research is needed to understand the impact of the National Health Interview Survey (NHIS) on the feasibility of integrating test-based management for malaria of the IMCI guidelines

Findings suggest that the problem is heightened by beliefs and habits of frontline health staff in health facilities in developing countries that are used to presumptive treatment and perceive every fever to be malaria

Gueye et al. (2016) [108]

None reported

Ways in which countries have implemented elimination programmes

The development and adoption of programmes

How programmes operated within their context

Review of case study reports

Malaria programmes did not show a high level of capacity for anticipation of threats to elimination

There were many examples of major development projections that combined a potential for increased receptivity and vulnerability

Monitoring and evaluation included monitoring programme outputs and evaluation of impact

Global malaria eradication will require well-managed malaria programmes providing high-quality implementation of evidence-based strategies, founded upon strong surveillance and response strategies tailored to the subnational level transmission context

Adequate funding and human resources to sustain malaria elimination and prevention of reintroduction is also required

Halpern et al. (2010) [77]

Stakeholders agreed on the ideal system for Guyana

Implementation strategy

Benefits of monitoring national programmes

Cross-sectional reports

Cohort analysis reports

Monthly visits from a member of the working group

Patient charts and registers

A large discrepancy was found between the data provided in the cross-sectional reports submitted prior to the use of the PMS and the data from those submitted after its implementation

79% of a combined national cohort who started ART were alive and on first-line ART regimens. After 6 years, 58% of the first cohort of ART patients in the country were alive and on ART, with only 8% patients on second-line regimens

The lessons learned during implementation can be used to better inform other countries in the region in need of information systems that can both improve patient care and produce high-quality data to inform programmatic and policy decisions

Investigators of WHO Low Birth Weight (LBW) Feeding Study Group (2016) [110]

None reported

Assessment of facilities, supplies and equipment

Assessment of quality of care

Assessment of knowledge, clinical skills and counselling skills of HCPs

Observation visit by expert paediatrician

Written test

Five objective structured clinical examinations

Interviews with HCPs for feedback (in post-implementation phase only)

30% of nurses reported a significant increase in their workload following implementation of the guidelines

No significant change in key practices like early initiation of breastfeeding, exclusive breastfeeding and prelacteal feeding

Resulted in significant improvement in the knowledge and skills of HCPs and mothers and were instrumental in promoting positive health behaviour at hospital discharge

Needed additional efforts on part of HCWs/additional staff and efforts to promote generic early feeding practice

Kavle et al. (2018) [114]

Ministry of Health

UNICEF Kenya Partnerships

NGO

Implementation experience of Baby-Friendly Community Initiative (BFCI)

Successes, challenge, and lessons learned

Opportunities for integration

Discuss the future and next steps

Review of key governmental programme documents

Implementation monitoring

Coverage of BFCI was high and it surpassed the government target of 28% of all “community units implementing BFCI” by 2016/2017

Improved early initiation of breastfeeding and exclusive breastfeeding (EBF) were notable during and after implementation for a 3-month period

Buy-in from national leaders is key

Mentorship by trainers played a key role

Social mobilization efforts promote EBF

Implementation can motivate early and frequent antenatal care (ANC) attendance, encourage attendance to health facility for childbirth and may improve immunization uptake

Kihembo et al. (2018) [57]

UKAid Department for International Development

United Nations Central Emergency Response Fund (CERF)

Newborn, adolescent and child health

United States Agency for International Development (USAID)

Centers for Disease Control and Prevention (CDC)

Document the IDSR implementation framework

Evaluate planning and monitoring

Understand the design and organization

Understand the logistics and resources deployed in the process

Pre- and post-training scores

Review of published and unpublished guidelines

Review of preparedness and response protocols

Review of training documents

Interviews

Meeting minutes

Through a coordinated partner support and response, funding, which was not primarily earmarked for IDSR implementation, was mobilized and harnessed to achieve nationwide equipping of multidisciplinary district teams with skill sets and tools necessary for performing relevant functions

A collaborative effort results in a coordinated significant impact on public health

The revitalization of the IDSR programme highlights unique features which can be easily adopted and applied by other countries that wished to strengthen their IDSR programmes

Lavôr et al. (2016) [111]

None reported

Degree of implementation

Interviews with nurses

Record book of symptomatic respiratory patients

Record book and monitoring of TB cases

Patient charts

Treatment form

Monthly report activity

In bacteriological diagnosis, classification was partially implemented

Only bacilloscopies for follow-up treatment are carried out in 100% of basic health units (BHU)

There was no relationship between the degree of implementation and effectiveness of the programme

Political organization in the implementation of the direct observation of therapy (DOTS) strategy was impaired and weakened by its implementation

Mobilized community partners with HCPs can be organized in support of a cause and build their own strategies of actions to strengthen public health policies, through the inclusion in the formal social control agencies

The DOTS strategy was classified as partially implemented in the BHU studied

Leethongdee (2007) [83]

None reported

Influences of implementation

Interviews

Focus groups

Documentary analysis

Main changes focused on the role of public organizations, and tensions between the old and new administrative structures

The choice of funding mechanism was an important area of local discretion

Many respondents, especially at lower levels, had a poor understanding of the purchaser/provider split about to be implemented in the Thai system, which highlighted the huge shift in culture that would be required in the new system

There was a macro-level problem concerning the distribution of finance and the workforce across the nation

There was a micro-level problem concerning the distribution of resources by contracting units for primary care (CUPs) to hospitals and health centres

There was a cycle of policy prescriptions, local adaptations and higher-level policy revisions that affected several aspects of the reforms and particularly the financing mechanism, which resulted in the lower-level actors having the most impact

Li et al. (2015) [112]

None reported

Impact of essential drug policy on primary care services

Effectiveness of implementing essential drug policy

Field observation

Main operation indicators

Implementation was very stable

The health administrative departments should strengthen the choice, confirmation, assessment and control of distribution companies, establish the industry standards of drug distribution industry as soon as possible, and improve the access threshold

Through the investigation of grassroots medical institutions, we can determine the principles, varieties and prices of specifically supplied drugs, and the state can designate specialized manufacturers for drug manufacturing and government can provide financial subsidies

Lovero et al. (2019) [93]

None reported

The procedures for stepped care management

Perceived challenges to implementation

HCP training

HCP experiences of managing mental illness

Interviews

Questionnaires

Mental health screening should be conducted by nurses for all patients at PHC facilities

Mental healthcare referrals should be made within clinic to MHPs and/or to other facilities based on case severity and availability of mental health personnel within clinic

There is a lack of training and consistency in the uptake of roles and responsibilities by nurses and MHPs

Improved district-level administrative coordination, mental health awareness and financial resources are critical to the success of integration efforts

Miguel-Esponda et al. (2020) [69]

None reported

The extent to which the programme activities have been integrated into the organization and the PHC clinics

Sociodemographic and clinical characteristics

Interviews

Challenges to delivery of services within the programme included time constraints coupled with the many competing priorities present at the clinics, and the limited availability of specialists to provide mentorship to MDs

All MDs and clinical supervisors perceived a need for more involvement of either psychologists or psychiatrists to improve the training and supervision and also to advise on difficult cases

Integration of mental healthcare services in PHC will require improved financing and resource management of PHC and specialist services, ongoing capacity-building, the development of effective referral systems, further development of community-based services, and linking of PHC with locally relevant social interventions

Mkoka et al. (2014) [94]

Involved in implementation

Exploring the experience of respondents in implementing emergency obstetric care (EmOC)

Perceived role of partners in EmOC implementation

Interviews

Focus groups

Facility survey

Documentary reviews

Council health management team (CHMT) took the lead and worked with team spirit

There was increased demand for services

There was resource scarcity in terms of skilled HCPs, funds and time

Working with competing needs

Acknowledging importance of partners, partially because they play different roles

A need for clear working arrangements

A desire for community participation

Progressing towards better service

Advocates working together in partnerships to govern implementation

To have effective partnerships, the roles and responsibilities for each actor should be clearly stipulated in a clear working framework within the district health system

Moshiri et al. (2016) [95]

Because the implementation requirements, including staffing, structure and funding, were in the hands of the deputy for health, there was limited collaboration with the other sections of the MOH

Details of implementation

Interviews

The implementation approach better corresponded with a top-down approach that realizes policy change versus a hierarchical process

Existence of a working PHC network served as proper infrastructure for its implementation

Mutabazi et al. (2020) [87]

Stakeholders included the United States President’s Emergency Plan for AIDS Relief; Global Fund to Fight AIDS, Tuberculosis and Malaria; USAID; CDC; International NGOs

Experiences involved in daily activities

Interviews

Self-administered questionnaire

Agreement on the importance of guideline integration

Frontline HCPs experienced high workloads, high staff turnover and lack of infrastructure

Additional assistance from HCP and nurses was essential for support

Increased testing from the implementation of PMTCT programme showed a reduction in diagnosed HIV/AIDS in children

Addressing the challenges of integration of PMTCT will help in eliminating mother-to-child transmission of HIV/AIDS

Muthathi et al. (2020) [96]

Involved in design and implementation

Policy context, rationale and philosophy

Intergovernmental relationships, perceptions of roles and responsibilities in implementation

ICRM programme resourcing

Implementation progress, challenges and constraints

Interviews

The central theme was the imperative to improve the quality of PHC in preparation for implementation

Four themes emerged related to structural context: contestations about roles and responsibilities; weak intergovernmental relationships; enabling local leadership; and insufficient resourcing of the ICRM programme

Three themes emerged related to specific context: gaps in the existing NCS; insufficient policy coherence; disjuncture between the NCS and ICRM programme

The design of any health reform should consider policies or initiatives that ensure coherence and the availability of resources

Major change initiative requires involvement of all relevant policy actors in design and implementation

Clear communication strategies and ongoing monitoring and evaluation are prerequisites for the success of policy implementation

Pyone et al. (2017) [104]

Qualitative research was carried out using semi-structured interviews with 39 key stakeholders from six countries in Kenya

The implications of the implementation of the free maternity services (FMS) policy on health system governance

Strength of the implementation programme

Semi-structured interviews

Institutional analysis as a theoretical framework

The newly introduced formal institutional (re)arrangements were unclear

Implementers faced challenges of accountability, especially adherence to the FMS policy

When resources were constrained, HCPs were less likely to be accountable, as they were not provided with the resources to work

There were discrepancies between formal and informal rules which created a misalignment of incentives for policy implementation

Aligning the objectives of the implementers with new policies, corresponding institutional (re)arrangements, enforcement mechanisms and incentives is crucial

Rahman et al. (2020) [105]

Stakeholders discussed the challenges and opportunities for implementation of the WHO recommendations that emerged from the study

Facilitators and barriers to implementation

Interviews

Documents analysis

Advocacy initiatives should be undertaken to promote policy revisions

Training and instructions should be provided

Incomplete policy adoption can be attributed to insufficient coordination among divisions; lack of central procurement of amoxicillin dispersible tablets (DT); and perceptions of the efficacy of antibiotics and formulations at the national and district levels

Significant progress occurred, but key challenges remain at the national and subnational levels, contributing to slow adoption of the WHO recommendations for the case management of childhood pneumonia and possible serious bacterial infection (PSBI) using amoxicillin DT

Roman et al. (2014) [66]

Stakeholders helped inform the development of key informant interview guides

Qualitative data were collected through in-depth interviews among key stakeholders at the national level

Promising practices/strategies that have support programming success

Implementation barriers

Lessons learned

Secondary data (literature review)

Interviews

Integration—strengthening and creating national groups (stakeholders)

Policy—in line with WHO guidelines and also interpreted in a similar manner across health systems

Commodities—availability in drug resources and stock

Quality assurance—assessment tools to monitor progress and alleviate barriers at the time

Capacity-building—successful when focused on pre-training and in-service training

Community involvement/engagement—linking community- with facility-level care and promoting community engagement and knowledge about MIP programme

Monitoring and evaluating—three case studies did implement this and caused challenges for national synthesis and reporting

Financing—more dedicated support for MIP programme by advocating building of in-country awareness from community to national level

The timing affords countries the opportunity to reprioritize MIP programming to ensure effective technical oversight and programme management

Ryan et al. (2020) [109]

Meetings with the CBM mental health advisor for Nigeria; welfare officers from community-based rehabilitation centres, the Bishop of the Methodist Church Diocese of Otukpo in Benue State, the Benue state health management information systems officer, the Benue state director of public health and other state and local government officials

Environment and health system in which the programme functions

History of the programme

Programme model and conceptual framework

Engagement with broader systems

Programme resources and management

Client characteristics

Pathways to care

Clinical interventions

Medications

Psychosocial interventions

Accessibility of services

Information systems used

Field visits

Service utilization data

It is possible to leverage a public–private partnership (PPP) with not-for-profit partners to rapidly expand mental health services in primary care

Coordinated efforts across primary, secondary and tertiary care is needed

More research is needed to document and evaluate PPPs for mental health in LMICS, with a focus on sustainability

Saddi et al. (2018) [88]

None reported

Perceptions about primary care access and quality (PMAQ)

Organizational barriers to the implementation of FHS

Semi-structured interviews

Questionnaires

Low organizational capacity influenced the perceived impact of the doctors, nurses and community HCPs

Adherence to PMAQ at the front line follows a top-down pattern; 46% of HCPs reported that adherence was the result of the PMAQ being imposed by the municipal health secretary (SMS), and 26% of HCPs reported adherence was due to trying to improve service quality

More contextualized public policy or health policy research, focusing on frontline workers, could be implemented

Sami et al. (2018) [102]

None reported

Explain the main health system bottlenecks for implementation

Barriers and facilitators

Recommended solutions

Focus groups

Direct observations

Collection of variety of documents

See barriers and enablers in Table 7

Further research to improve the implementation of community- and facility-level newborn interventions in settings with ongoing conflict

Understanding the feasibility of guidelines recommended in context would allow for specific adaptations and innovations

Schneider and Nxumalo (2017) [97]

None reported

Policy formation/adoption

Reallocation of roles and responsibilities

Development of new systems

How change is led and managed

Interviews

Observations

Document review

Routine and audit data

Negotiating a fit between national mandates, provincial and district histories and strategies of community-based services

Defining new organizational and accountability relationships between CHWs, local health services, communities and NGOs

Revising and developing new aligned and integrated planning, human resources, financing and information systems

Leading change by building new collective visions, mobilizing political support and designing implementation strategies

Contributed to an understanding of leadership and governance functions in strengthening CHW programmes

Suggest the need for multilevel frameworks that provide both direction and flexibility, allowing for emergence and negotiation

Highlighted the multifaceted, negotiated and distributed nature of these functions, spanning analytical, managerial, technical and political roles

Future work includes evaluating the implications of assessing or strengthening the leadership and governance of national CHW programmes

Sheikh et al. (2010) [98]

None reported

Perspectives of different groups of actors on their own participation in the implementation process

Interviews

Informed consent was seen as unwelcome obstacles

Physicians typically followed unwritten rules that were based on their own clinical judgement and the best interest of the patient, not necessarily the guideline

Lack of private rooms resulted in physicians disclosing confidential results in front of other patients

Contributed an understanding of health policy implementation in India from the “emic” perspectives of the various participant actors

Shelley et al. (2016) [99]

This process evaluation utilized interviews with a variety of stakeholders to explore perspectives and lessons from the first 6 months of community health assistant (CHA) deployment

Lessons learned

Barriers to and facilitators of fidelity

Interviews

Community acceptance is essential to successful programme implementation

Effective and reliable supervision is considered a cornerstone to success

Findings allowed the government to make informed decisions and adjustments prior to second deployment of CHAs

Stein et al. (2008) [106]

None reported

Perceptions of those involved in the programme

Value of the training approach

Participants’ observations

Interviews

Focus groups

Training was interactive and effective

Integrative training approach allowed for supervisory feedback

A horizontal training approach facilitated the implementation process

Training was effective and more likely to be effective within a health system framework which consistently provides PHC services

Improved quality of care was seen in a range of illnesses

Nurses were overstretched and many PHC clinics were understaffed

All levels of healthcare system teams should be engaged in programme implementation

Wingfield et al. (2015) [113]

Formative activities included consultations, focus group discussions and questionnaires conducted with the project team, project participants, civil society and key NGO stakeholders

Cash delivery strategy

Cash transfer size

Cash transfer timing

Cash transfer conditions, levels and responsiveness

Performed an acceptability assessment

Quantitative and qualitative data from participants, a civil society group of ex-patient community representatives, CRESIPT [community randomized evaluation of a socioeconomic intervention to prevent TB] project staff and local and regional Peruvian TB programme staff and coordinators

A novel TB-specific socioeconomic intervention proved to be feasible in an impoverished, urban environment and is now ready for impact assessment, including by the CRESIPT project

Of potential cash transfers, 74% were achieved, 19% were not achieved, and 7% were yet to be achieved

Of those achieved, 92% were achieved optimally and 8% suboptimally

Cash transfer strategy should be tailored to household needs

Lessons from CRESIPT will aim to assist TB control programmes to effectively implement the recent global policy change of including socioeconomic support as part of TB control activities

Xia et al. (2015) [89]

Stakeholders were interviewed and surveyed

Service user views on integrated prenatal HIV, syphilis and hepatitis B testing (PHSHT) services

Service users’ knowledge and satisfaction of PHSHT services

Factors affecting how the integration of services was coordinated

Survey

Routine monitoring

Interviews

Focus groups

Pregnant women had little knowledge of PHSHT services and found the service process to be long and complicated

HIV tests were above the national standard, unlike syphilis and Hep B

Lack of referral network between lab results resulted in significant delays

Conducting regular meetings between health agencies could improve information exchange

Establishing a proper client referral system with an integrated information systems could help reduce redundancy

Decentralization of services could help simplify process

Facilitate task-shifting and community participation

Zakumumpa et al. [85]

None reported

Sustainability of ART scale-up implementation

Access to ART medicines

Interconnections in health system subcomponents

National survey of health facilities

Organizational case studies

Access to ART medicines at the level of frontline health facilities were influenced by information systems, human resources, governance and leadership

Failure to maintain basic ART programme records, owing to health workforce shortages, contributed to chronic ART medicines stock-outs

Health system strengthening interventions, especially targeting lower-level and rural-based health facilities, are recommended to promote ART programme sustainability

Zhou et al. (2019) [67]

Consultations with stakeholders

Formulation process, content and implementation issues

Interviews

Open-ended surveys

Strategies to achieve the four policy objectives were unevenly covered

Two action areas, namely “quality improvement” and “procedure and distribution of essential medicines”, were not covered

The limited human resources made working part-time very common

Considering policy operationality, targets, time frames and evaluation indicated were consistent with national ones, but mainly set for priority strategies

Solid evidence, high-level approval, involvement of multiple stakeholders, detailed and comprehensive arrangements in operational issues, and clear policy focuses will promote successful implementation of mental health policy