Characteristics of high, moderate and low implementation fidelity clinics
| Variable | All clinics | High fidelity | Medium fidelity | Low fidelity | P value |
| Participants’ demographics | n=90 | n=30 | n=30 | n=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; %) | |||||
| Nurses | 49 (54.4) | 15 (30.6) | 17 (34.7) | 17 (34.7) | |
| Administrators | 18 (20.0) | 7 (23.3) | 6 (20.0) | 5 (16.7) | |
| Other support staff | 23 (25.6) | 8 (26.7) | 7 (23.3) | 8 (26.7) | |
| Clinic characteristics | n=6 clinics Mean (SD) | n=2 clinics Mean (SD) | n=2 clinics Mean (SD) | n=2 clinics Mean (SD) | |
| Personnel | |||||
| Nurses | 10 (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 staff | 5 (3.08) | 3 (1.41) | 7 (4.95) | 4 (2.83) | 0.619 |
| Ratio: head counts per nurse | 410 (179.21) | 532 (281.7) | 423 (75.1) | 274 (92.61) | 0.445 |
| Ratio: headcounts per doctor | 2847 (1250.14) | 2992 (938) | 1597 (1108) | 3953 (308.3) | 0.150 |
| Patient consultations | |||||
| Total PHC consultations per month | 3389 (825.31) | 2992 (938) | 3224 (1194) | 3953 (308) | 0.592 |
| Patients >20 years per month | 2420 (592.47) | 1994 (656) | 2372 (697) | 2895 (142) | 0.390 |
| Adults in care for HIV/AIDS | 1724 (744.89) | 1490 (1113) | 1605 (657) | 2077 (846) | 0.797 |
| New TB diagnosis per month | 6 (4.91) | 3 (1.65) | 4 (1.53) | 11 (6.36) | 0.233 |
| Diabetic patient consultation per month | 88 (39.21) | 81 (24.28) | 126 (41.60) | 56 (17.32) | 0.199 |
| Hypertensive patient consultations per month | 385 (207.32) | 294 (71.06) | 617 (212.60) | 244 (24.87) | 0.115 |
| Mental health patients in care | 98 (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.