Table 1.

Comparing in-country localisations of PALSA PLUS and Practical Approach of Care Kit (PACK) programmes

	Brazil (Minas Gerais)	Mexico	The Gambia	Malawi	Botswana	Brazil (Florianópolis)	Nigeria	Ethiopia
Name of local programme	PAL GARD Brasil (Practical Approach to Lung Health/Global Alliance against Respiratory Disease)	PAL AIRE Accion Integrada Por La Respiration/ Integrated Action for Respiration	PALSA PLUS Gambia	Practical Approach to Lung Health and HIV/AIDS in Malawi (PALM PLUS)	Botswana Primary Care Guideline	PACK Brasil Adulto—Versão Florianópolis	PACK Adult Nigeria	Ethiopian Primary Healthcare Clinical Guidelines
Driver of innovation	Need to improve diagnosis and management of respiratory disease	Need to improve diagnosis and management of respiratory disease	Need to implement PAL to address TB epidemic	Need to provide clinical support for integration of TB and HIV care	Need to prioritise and integrate non-communicable disease care in primary care	Need for integrated clinical guidance as part of primary care system overhaul	Need for clinical decision support for primary care health workers	Need for a standardised package to guide integration of communicable and non-communicable disease clinical care
Localisation model	Independent model	Independent model	Regional technical support—consultancy model	Consultancy model	Consultancy model	Mentorship model	Mentorship model	Mentorship model
Localiser	Local respiratory physicians	Led by local respiratory physicians with input from respiratory health stakeholders	Ministry of Health National TB programme supported by WHO Gambia office	Localising NGO partner in collaboration with Ministry of Health	University Family Medicine department collaborating with Ministry of Health Non-Communicable Diseases directorate	Municipal primary care team	Localising partner with close ties to Ministry of Health	Federal Ministry of Health Primary Care directorate
Funding source	Minas Gerais Province Health Authority	Unknown	The Global Fund to Fight AIDS, TB and Malaria Round 9	International Development Research Centre; Canadian International Development Agency	United States’ HRSA (Health Resources and Services Administration) funded Medical Education Partnership Initiative	Sowerby Foundation	Nigerian State Health Investment Project	United Kingdom’s National Institute of Health Research
Research	Small study of family physician management of respiratory cases, not yet published	None	Pilot study in two health regions39	Cluster randomised trial40 A study of health worker satisfaction41	Ministry of Health-led evaluation underway focussing on non-communicable disease care	Pragmatic randomised controlled trial42 Process evaluation—study submitted for publication 2018	Pretraining and post-training evaluation	Implementation research planned to evaluate the integration of depression and non-communicable disease care
Impact on health system	Prompted ‘RESPIRA Minas’: an extensive respiratory health intervention for all levels of care	Unknown	Unknown	Unknown	Expansion of Botswana essential medicines list	Improved interprofessional collaboration and task sharing between nurses and doctors; Improved healthcare worker morale	Pilot showed some reduction in polypharmacy	Not yet implemented
Adoption by government	Yes State level	Yes National level	Yes Federal level	No	Yes National level	Yes Municipal level	Yes Federal and state level	Yes Federal level
Current status	No longer active: project shelved by State Authority, reason unclear.	No longer widely active due to health system fragmentation: various authorities leading on different aspects of respiratory health, TB and primary care at both State and Federal level meant the absence of a unifying lead for the programme.	No longer active, reason unclear	No longer active: political instability and funding constraints prevented further implementation and scale up.	Active	Active	Active—post pilot, embarking on scale-up	Active—starting country-wide implementation