Table 1

Characteristics of high, moderate and low implementation fidelity clinics

VariableAll clinicsHigh fidelityMedium fidelityLow fidelityP value
Participants’ demographicsn=90n=30n=30n=30
Females (N; %)78 (86.7)25 (83.3)28 (93.3)25 (83.3)0.421
Age (mean; SD)38.8 (10.35)39.4 (9.38)38.7 (12.07)38.6 (9.73)0.951
Years in this role (mean; SD)6.4 (6.26)6.03 (6.45)7.0 (7.19)6.2 (5.12)0.810
Role (N; %)
 Nurses49 (54.4)15 (30.6)17 (34.7)17 (34.7)
 Administrators18 (20.0)7 (23.3)6 (20.0)5 (16.7)
 Other support staff23 (25.6)8 (26.7)7 (23.3)8 (26.7)
Clinic characteristicsn=6 clinics
Mean (SD)
n=2 clinics
Mean (SD)
n=2 clinics
Mean (SD)
n=2 clinics
Mean (SD)
Personnel
 Nurses10 (5.67)6 (1.41)8 (4.24)16 (6.36)0.231
 Medical officers (generalist doctors)2 (1.63)1 (0.00)3 (2.82)1 (0.00)0.465
 Administrative staff5 (3.08)3 (1.41)7 (4.95)4 (2.83)0.619
 Ratio: head counts per nurse410 (179.21)532 (281.7)423 (75.1)274 (92.61)0.445
 Ratio: headcounts per doctor2847 (1250.14)2992 (938)1597 (1108)3953 (308.3)0.150
Patient consultations
 Total PHC consultations per month3389 (825.31)2992 (938)3224 (1194)3953 (308)0.592
 Patients >20 years per month2420 (592.47)1994 (656)2372 (697)2895 (142)0.390
 Adults in care for HIV/AIDS1724 (744.89)1490 (1113)1605 (657)2077 (846)0.797
 New TB diagnosis per month6 (4.91)3 (1.65)4 (1.53)11 (6.36)0.233
 Diabetic patient consultation per month88 (39.21)81 (24.28)126 (41.60)56 (17.32)0.199
 Hypertensive patient consultations per month385 (207.32)294 (71.06)617 (212.60)244 (24.87)0.115
 Mental health patients in care98 (68.59)15 (9.19)147 (45.25)133 (16.26)0.330
ICDM implementation fidelity score
 Facility reorganisation (max: 37*)27.7 (2.16)28.0 (1.41)28.5 (2.12)26.5 (3.54)0.735
 Clinical supportive management (max: 39*)28.8 (5.81)35.0 (2.83)28.0 (1.41)23.5 (4.95)0.920
 Assisted self-management (max: 39*)32 (4.24)36.5 (0.71)30.5 (4.95)29.0 (1.41)0.164
 Strengthening of support systems (max: 43*)32 (4.38)35.5 (2.12)33.5 (2.12)27.0 (2.83)0.075
 Overall fidelity score (max: 158*)120.5 (13.05)135.0 (1.41)120.5 (0.71)106.0 (2.83)0.001†
  • *Max=maximum possible fidelity score.

  • †Statistically significant at the 0.05.

  • ICDM, Integrated Chronic Disease Management; PHC, primary healthcare; TB, tuberculosis.