Textbox 2.

Organizational capacity

Progressive involvement of MoH staff and integration of activities in existing health services	Q1 – Often the groups are considered as a MSF project with little involvement of the MoH, however this improved a lot lately, MoH staff are much more involved in the care and the groups are considered as the work of everybody. – Counsellor during FGD with counsellors
Additional resources required in contrast to the limited MoH resources available, especially the need of a “regulatory cadre” (counsellor) to form and monitor groups	Q2 – The counsellor organizes the groups because no one in the community who knows better our situation, our problems, … only the counsellor does. Of each area, the counsellor knows exactly how many people are on ART and how many groups there are. Of each area! (S)he is our maximum chief, who has all the information. – Group leader during FGD with group leaders from rural areas Q3 – The counsellor is essential for the group to function, without the counsellor the groups will not continue as he is the only one who knows the people in the community. – Nurse during FGD with nurses working with counsellors Q4 – … need to incentivise patients for their active role in the health facilities for example through extra trainings to keep them motivated … – IDI with District health authority Q5 – … this programme is monitored by MSF, which has resources, and means, I do not have …, I notice how … how this functions. OK! A team comes, goes to the communities, organizes the groups … […] but I wonder […] Do the districts have these resources and capacity to continue these activities? – IDI with District health authority
Flexibility to adapt to changing patient needs over time	Q6 – A period of six months before being able to join CAG, cannot be, because is too long … because for us to evaluate if a person is adherent to treatment or not, two months should be sufficient to judge if a patient is adherent and stable or not and can join CAG. – Nurse during FGD with nurses working with counsellors Q7 – There is a need to adapt the entry criteria according to the needs of the patients and the context, the criteria need to be flexible for changes, […] new target groups might benefit for the CAG model, for example TB patients, pregnant women, patients on second line treatment … – IDI with MSF implementer