Selection of health facilities
This study was conducted in 3 randomly selected higher-level facilities of the originally 6 referral units that participated in the trial, and in all the original 19 lower-level facilities (10 HCIIIs and 9 HCIIs) from the intervention arm of the trial.There were 7 facilities (4 HCIIIs, 3 HCIIs) in Mpigi and 12 facilities (6 HCIIIs, 6 HCIIs) in Wakiso district. Of these, only Wakiso district (Entebbe) had urban facilities (1 HCIIIs, 1 HCIIs) while the remaining 17 facilities (9 HCIIIs, 8HCIIs) were rural (Table 
Distribution of health facilities by district and facility levelSome HFs had originally been randomised as HCIIIs-HCIIs pairs due to their proximity and to minimise contamination whilst others had been independently randomised (defined here as ‘singleton’). The 2 urban HFs (1HCIIIs, 1HCIIs) were singleton while among the 17 rural HFs − 8 had been selected as pairs (4HCIIIs, 4HCIIs) and 9 (5HCIIIs, 4HCIIs) as singletons (Table Prior to the start of current study, a pilot study was carried out in two independent HFs (an urban HCIII and a peri urban HCII) to train the study team and to test data collection tools and procedures. Findings from these pilot HFs were used to improve our procedures but were not included in the research dataset of the study itself.