Table 1

Coding framework

Element	Item	Definition
Social and political context		Broader social and political environment, discourse and norms that shape policy decisions and the structure, organisation and practice within health systems, for example, social stigmatisation and wider political priorities.
Policy and decisions	Health policy	‘Health policy is commonly seen as the formal written documents, rules and guidelines that present policymakers’ decisions about what actions are deemed legitimate and necessary to strengthen the health system and improve health,’28 for example, availability and content of TB-IPC guidelines at national or facility level.
Policy and decisions	Policy decisions	‘The processes of decision-making at all levels of the health system and the wider influences that underpin the prioritisation of policy issues, the formulation of policy, the processes of bringing them alive in practice and their evaluation’,28 for example, the translation of policy into formal programmes.
Health system hardware	Human resources	Availability and types of health workforce and aspects of human resource capacity (eg, TB-IPC knowledge, skills and training).
	Organisational structure	Governance structures, including logistics, coordination, support and supervision systems. Procedures and processes of care, forms of service delivery, routines, allocation and management of responsibilities and demand.
	Medicine and technology	Availability of medications, for example, isoniazid preventive therapy and TB medication. Availability and functionality of medical devices and equipment, for example, respirators, surgical masks, extractor fans and ultraviolet germicidal irradiation.
	Service infrastructure	Physical infrastructure, including space, its layout and ventilation. Technologies targeting augmentation of physical environment (eg, whirlybirds, retrofits).
	Information systems	Availability of patient information systems (eg, record systems). Information dissemination, communication and reporting structures/mechanisms, flows and ways in which these are constructed.
	Financing	Any financing implications affecting system hardware (eg, budget allocation for equipment) and software (eg, incentives).
Health system software	Values and norms	System actors’ priorities. Accepted practices and established ways of behaviour of patients at health facility level and healthcare providers across the system, workplace culture. Professional identity and cultural beliefs and perceptions of actors in the system.
	Relationships and power	Constellation and communication of actors in the system, their inter-relation and relative power over relationships, hardware and policy space (eg, authority, autonomy, issues of legitimacy).
	Ideas and interests	Expectations, motivation, willingness and satisfaction of actors in system.

TB-IPC, tuberculosis infection prevention and control.