Implementation of the PE
multi-morbidity, hypertension, HIV, diabetes
RECRUITMENT, HYPERTENSION
The PE was conducted within one primary healthcare facility (formerly a HIV clinic providing anti-retro-viral treatment or ART) in the intervention arm. This site was selected for several reasons; it was sub-urban and served the largest patient population with HIV, diabetes and hypertension in the 17 sites, had a record of consistent drug supply for HIV and NCD drugs, and was within the restricted travel zone for the research team during COVID-19 restrictions.Data collection consisted of 48 in-depth interviews with stakeholders (patient, healthcare provider, policy-maker, international organisation and clinical researcher); three focus group discussions with community leaders and members (n = 15); and 8 h of clinic-based observation in one day (8am to 5pm). Interviews and focus group discussions lasted between 30 and 60 min. Professional stakeholders were purposively selected to get a breadth of perspectives across the respective roles in providing integrated care.Adult patients over 18 years were selected based on various criteria; the participant had to have been in the trial for 12 months; patients of both genders with a single conditions, as well as patients with co and multi-morbidity were included. Only patients residing within the restricted travel zone during COVID-19 restrictions partook. Very sick patients who needed immediate medical attention were excluded. All efforts were made to ensure maximum variation in experience of integrated care and experience of living with different combinations of conditions. Recruitment and data collection continued until data saturation was achieved.Qualitative data collection guides and observational checklists were designed based on scoping reviews and Delphi studies [