Conclusions
About 6 years after the introduction of a multi-faceted NCD health service intervention in Uganda, and 4 years after the end of active research-related funding support, we found that the intervention was still normalized among health workers, at least to some extent. This was particularly the case with cognitive participation and reflexive monitoring at small and mid-level primary care facilities. Higher level primary care units need more supervisory support to improve cognitive participation and to foster teamwork (collective action). In particular lower-level primary care units need support enabling them to strengthen the domain of coherence (sense-making) through improving their organisational capacity and long-term strategic planning. All primary care levels will need to strengthen their evaluation and appraisal capacities to maintain optimal reflexive monitoring.Regarding intervention sustainability, we found that low and mid-level primary care units generally scored sub-optimally (or < 4) on all 8 domains. Higher level primary care units were weak on funding and with respect to supportive partnerships with other stakeholders. Overall, good funding stability, effective partnerships and long-term strategic planning are needed to ensure continuity in services and logistics at all levels.Future overall sustainability capacity may be enhanced by maintaining and strengthening supervisory support (e.g., in-service support supervision) and organisational capacity, a better communication strategy and adaptation in the absence of adequate or reliable funding. More studies are needed to understand exactly how and when each of these domains come into play in different settings during the life-course of an intervention and its post-implementation period.