Objective / domain (questions) | Sub-domain | Indicator | Methods (a methodology may feature under several headings) |
---|---|---|---|
Reach • Target population reached? | Coverage | ▪ % people among the target population eligible for programme and number served by the programme ▪ Prevalence of NCD and MH comorbidityb | • Existing MSF household survey a • Routine cohort data • Qualitative data |
“Effectiveness”/ Quality of Care ▪ Trends in clinical outcomes and quality indicators? ▪ Perceived benefits/unintended consequences from a patient and provider perspective? | Clinical Outcomes | ▪ % HTN patients with most recent BP < 140/90 mmHg, 6 & 12 months post enrolment and trend from baselineb ▪ % Patients with diabetes with last HbA1c < 8.0% 6 & 12 months post enrolment and trend from baselineb ▪ % Patients who report decreased/quitting smoking | • Routine cohort data • Qualitative data |
Quality Indicators | ▪ % activec CVD patients prescribed a statin ▪ % COPD/ asthma patients with inhaler technique check documented ▪ Trend in defaultersc and deaths as a proportion of active cohort | • Clinical audit • Routine cohort data | |
Perceived Effectiveness | ▪ Patients’ and providers’ perspectives on effectiveness of programme components (clinical review, medications, HE, HLO, MHPSS, HV) | • Qualitative data | |
Adoption/ acceptance ▪ Care model accessible and acceptable to patients, providers, organisation and community? ▪ Guideline acceptable to staff? | Accessibility/ acceptability | ▪ Availability and accessibility / barriers to access ▪ Acceptability/usability of NCD guideline ▪ Self-reported medication adherence and medication beliefs | ▪ Routine cohort data ▪ Qualitative data ▪ Self-report medication adherence questionnaire |
Adoption/participation | ▪ Description of intervention location, cadres of staff and qualifications ▪ Experience of receiving and providing NCD care, use of clinical guideline ▪ How participation influenced patient/staff well-being and/or work practices | ▪ Routine cohort data ▪ Qualitative data | |
Implementation ▪ Intervention delivered as intended? ▪ Facilitators and barriers to implementing the programme? ▪ Essential components and adaptations necessary? ▪ Implementation costs? | Fidelity of programme delivery | ▪ % DM patients with micro-albuminuria or urinary protein tested ▪ % Activec cohort attending a health education session at last clinical visit ▪ No. of MHPSS group sessions monthly during reporting period | ▪ Clinical audit ▪ Routine cohort data |
Adaptations | • NCD care adaptations to local setting (e.g. cultural; dietary, exercise) • Programme adaptations related to humanitarian setting e.g. response to patients’ psychosocial needs | ▪ Qualitative data | |
Cost | • Staff time; • Capital and recurrent implementation costsb | ▪ Qualitative data ▪ Medicine/supply/ staff costsb ▪ Staff time estimates | |
Maintenance • Challenges and facilitators for patients to stay in programme? • Organisational challenges, and costs; adaptations made to maintain programme? | Individual Level | • % Patients activec 6 months post enrolmentb • Self-reported medication adherence rates • Key challenges in altering lifestyle (diet, exercise, smoking) | ▪ Routine cohort data ▪ Clinical Audit ▪ Qualitative data ▪ Medicine/supply/staff costsb ▪ Staff time estimates ▪ Self-report medication adherence questionnaire |
Organisational Level | • Measures of cost of maintenanceb • Institutionalisation of the programme/modifications made for maintenance • Alignment with organisational mission |