Strengths
DM, HT
The EACDRP intervention project had provided a strong and effective NCD service intervention with fully optimised elements against which it was easy to study potential changes in service readiness or service quality over time. For example, record keeping had been optimised in intervention HFs during the trial, data quality was high in both consecutive surveys. This applied to both routine data collection tools and records e.g., patient registers.Identical and standardised study tools were used at both time points. To avoid observed bias, care was taken to ensure that observed data collection in 2020 did not involve any staff member from the original intervention (implementation) team. Also, instead, we recruited staff from the original evaluation team, and this helped to ensure comparability of the data sets generated at the two time points. The restricted sampling technique used for the QoCE assessment, allowed us to sample up to 20 eligible patients who were invited without replacement for defaulting, and also to ensure appropriate representation of men and women and patient groups (i.e., for DM and HT). This also helped increase the power of the study.Lastly, most post-intervention evaluations in a research or programmatic setting are usually done after 2 or 5 years, the 2020 survey was conducted about 4 years after the end of the intervention trial. This interval was sufficiently long to study mid- to long-term sustainability and durability of intervention effects.