Implementation, interrupted: Identifying and leveraging factors that sustain after a programme interruption

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dc.contributor.authorHennein, Rachel
dc.contributor.authorGgita, Joseph
dc.contributor.authorSsuna, Bashir
dc.contributor.authorShelley, Donna
dc.contributor.authorAkiteng, Ann R.
dc.contributor.authorDavis, J. Lucian
dc.contributor.authorKatamba, Achilles
dc.contributor.authorArmstrong-Hough, Mari
dc.date.accessioned2023-01-18T17:23:37Z
dc.date.available2023-01-18T17:23:37Z
dc.date.issued2021
dc.description.abstractMany implementation efforts experience interruptions, especially in settings with developing health systems. Approaches for evaluating interruptions are needed to inform re-implementation strategies. We sought to devise an approach for evaluating interruptions by exploring the sustainability of a programme that implemented diabetes mellitus (DM) screening within tuberculosis clinics in Uganda in 2017. In 2019, we conducted nine interviews with clinic staff and observed clinic visits to determine their views and practices on providing integrated care. We mapped themes to a social ecological model with three levels derived from the Consolidated Framework for Implementation Research (CFIR): outer setting (i.e. community), inner setting (i.e. clinic), and individuals (i.e. clinicians). Respondents explained that DM screening ceased due to disruptions in the national supply chain for glucose test strips, which had cascading effects on clinics and clinicians. Lack of screening supplies in clinics limited clinicians’ opportunities to perform DM screening, which contributed to diminished self-efficacy. However, culture, compatibility and clinicians’ beliefs about DM screening sustained throughout the interruption. We propose an approach for evaluating interruptions using the CFIR and social ecological model; other programmes can adapt this approach to identify cascading effects of interruptions and target them for re-implementation.en_US
dc.identifier.citationRachel Hennein, Joseph Ggita, Bashir Ssuna, Donna Shelley, Ann R. Akiteng, J. Lucian Davis, Achilles Katamba & Mari Armstrong-Hough (2022) Implementation, interrupted: Identifying and leveraging factors that sustain after a programme interruption, Global Public Health, 17:9, 1868-1882, DOI: 10.1080/17441692.2021.2003838en_US
dc.identifier.urihttps://doi.org/10.1080/17441692.2021.2003838
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7045
dc.language.isoenen_US
dc.publisherGlobal Public Healthen_US
dc.subjectNon-communicable diseasesen_US
dc.subjectTuberculosisen_US
dc.subjectDiabetes mellitusen_US
dc.subjectInterruptionen_US
dc.subjectQualitative methodsen_US
dc.titleImplementation, interrupted: Identifying and leveraging factors that sustain after a programme interruptionen_US
dc.typeArticleen_US
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