Table 4

Clinic context, mechanisms and outcome configuration for intervention clinics

Clinic nameContextMechanismsOutcomes
Clinic infrastructureBP machinesOther materials (files, drugs, packs for drugs)Clinic managementVisit per nurse per month (% change)Existing manager, staff and patient relationshipLHW interventionChronic care processesPatients adhering to appointmentsChronic care pathwayOther aspects of chronic carePatient attending on booked date
HillardModern spacious buildingBroke down a few timesErratic supplyStrong clinic manager in control of the clinic528 to 429
(−19%)
Good relationship among staff and with patientsSkilled LHWs.
36% workload increase per month. Good teamwork, supported by staff.
Strong manager led to good relations for staff. Better equipment. Low patient load motivated staff to be dedicated.Space facilitated quality counselling and confidential space. Skilled LHWs, dedicated queue led to lesser clinic time. Functional: chronic care pathway
Erratic: chronic consultation room
Did not happen: designated vital signs station
Functional: filing, appointments, prepacking medication, phone call remindersHTN: 76%
(n=4482)
Other chronic: 66%
TimberModern building but with limited spaceFrequently broke downErratic supplyStrong clinic manager but not liked by nurses433 to 202
(−53%)
Poor relations among staff and with patientsSkilled LHW. 7% workload decrease per month. Good teamwork, supported by staff.Nurses frustrated with breakdown of equipment and limited space. This led to lack of commitment and poor relations.Skilled LHWs ensured patients attend appointment, yet affected by lack of space and nurses were frustrated. Functional: chronic consultation room
Erratic: designated vital signs station
Did not happen: chronic care pathway
Functional: filing, appointments, phone call reminders
Erratic: Prepacking medication
HTN: 72%
(n=2035)
Other chronic: 56%
TroyModern building but with limited spaceFrequently broke downGood supply of materialsWeak clinic manager252–347
(+38%)
Poor relations among staff and with patientsSkilled LHW. 48% workload increase per month. Good teamwork, supported by very few staff.Weak manager, limited space and BP machines that broke down led to poor relations and staff not willing to work.Skilled LHW that ensured patients attend appointment, yet patients did not like staff attitude and long waiting. Erratic: chronic consultation room, chronic care pathway
Did not happen: designated vital signs station
Functional: filing, appointments, phone call reminders
Erratic: prepacking medication
HTN: 70%
(n=8960)
Other chronic: 63%
OrangeDilapidated building with limited spaceFrequently broke downErratic supplyWeak clinic manager276–413
(+50%)
Poor relations among staff and with patientsUnskilled LHW.
79% workload increase per month. Poor teamwork, supported by very few staff.
Weak manager, poor infrastructure, limited space and BP machines that broke down led to poor relations and staff not willing to work.Poor queuing, infrastructure, unskilled and uncoordinated LHWs led to long queues and patients unsatisfied with care services. Functional: chronic consultation room Erratic: chronic care pathway
Did not happen: designated vital signs station
Functional: phone call reminders, filing, appointments but with some mistakes.
Did not happen: prepacking of medication
HTN: 67%
(n=3123)
Other chronic: 56%
  • HTN: patients with hypertension; other chronic: patients without hypertension.

  • BP, blood pressure; LHW, lay health worker.