Table 1.
Study outcome derivations
| Instrument for data collection | Derivation | |
|---|---|---|
| Service provision | ||
| Number and proportion of outpatient visits related to each chronic disease | Service statistics | Averaged from July, 2012, to September, 2012, and types of facilities |
| Availability of guidelines and basic supplies | ||
| Availability of guidelines | SARA questionnaire | Guidelines observed in the outpatient clinic or respective specialist clinic for HIV, hypertension, or diabetes |
| Availability of basic diagnostic equipment | SARA questionnaire | HIV: screening and confirmatory rapid tests available and valid (not expired). Hypertension: digital blood pressure apparatus or manual blood pressure apparatus and stethoscope observed and functioning in outpatient department or hypertension clinic. Diabetes: glucometer observed and functioning in outpatient department or diabetes clinic, or available and often or always functioning in laboratory (with test strips never or only occasionally out of stock) |
| Availability of first-line drug therapy | SARA questionnaire | HIV: at least one first-line regimen available and valid (TDF+3TC or TDF+FTC or AZT+3TC or d4T+3TC and NVP or EFV). Hypertension: at least one thiazide diuretic (hydrochlorothiazide or bendrofluazide) available and valid. Diabetes: metformin available and valid |
| Management and training systems | ||
| Training | SARA questionnaire | Any outpatient staff member having received training in the diagnosis and management of HIV, hypertension, or diabetes within the past 2 years |
| Supervision | SARA questionnaire | Having received a monitoring or supervisory visit from a high level of the health service within past 3 months for HIV, hypertension, or diabetes (asked of non-communicable diseases combined and assumed to apply equally to hypertension and diabetes) |
| Reporting | SARA questionnaire | Able to show a monthly report for HIV, hypertension, or diabetes for some time in the past year |
| Preparedness of human resources | ||
| At least fair knowledge | Self-completed questionnaire | Assessed via case scenario questionnaires for HIV, hypertension, and diabetes, and defined as scoring at least 7/10 |
| Experienced | Self-completed questionnaire | Having seen more than five patients with each of HIV, hypertension, or diabetes in past 3 months |
| Comfortable | Self-completed questionnaire | Reporting “very comfortable” when asked whether feel comfortable with HIV, hypertension, or diabetes and know how to manage |
SARA=Service Availability and Readiness Assessment. TDF=tenofovir. FTC=emtricitabine. 3TC=lamivudine. AZT=zidovudine. d4T=stavudine. NVP=nevirapine. EFV=efavirenz.