Limitations
’
REGRESSION
This study was a one-time point cross-sectional assessment as a similar assessment was not done in 2016. Due to lack of this temporal comparison, there is reason to wonder about reverse causality – does current sustainability capacity say more about future capacity (post-intervention) or the previous intervention’s residual capacity? However, the post-intervention period lasted about 4 years which should provide adequate time for honing out of any temporary benefits attributable to the previous intervention. Any benefits still present are probably genuinely institutionalised and should continue to do so well into the future.Response to scalar score-based questions is usually subjective and prone to respondents choosing the middle ground or null (i.e., between the extreme scores) or a regression to the mean. Additionally, respondents may choose what is perceived as socially desirable or acceptable to them. These were both minimised by allowing for a lack of responses (e.g., if participants responded that a question was ‘not applicable’ or that they did not know the answer). Also, most respondents whether HWs or patients had interacted with the intervention for long which minimised the chance of difference between what they observed and what really prevails [Impact of the COVID-19 epidemic: The COVID-19 outbreak in Uganda represented a challenge to our study. The immediate effect was protraction of the study duration as field activities and data collection had to be suspended for about 4 months. Restrictions on travel and work lasted even longer so that fewer than expected HWs could be interviewed. However, due to the longevity of the intervention we believe that the possible effect of this on the variation of HWs’ responses was small as the majority of HWs (78%) had been based at their health facilities for 3 years or longer.