Table 5 Summary matrix of modifications made and reasons
Classification | Modification type | Reason for modification | Level modification initiated |
|---|---|---|---|
Format | Reducing the frequency of clinic appointments | Decongesting ART Clinics | Provider organization level/clinician |
Optimizing clinician time and expertise | |||
Pharmacy-only refill program | Decongesting ART clinics | Provider organization | |
Cost reduction | |||
Setting | Home-based care program | Patient convenience | Provider organization |
Decongesting ART clinics | |||
Information system-based reviews | Loss of principal funding from donor | Provider organization level/clinician | |
Patient convenience | |||
Personnel | Task sharing with non-physician cadre | Shortage of physician cadre | Provider organization |
Nurse-led care model | Inability to attract physician-level cadre | Provider organization | |
Use of “expert clients” | Labor intensive nature of intervention | Provider organization | |
Staffing shortages due high ART demand | |||
Population | ART clinic sub-population designation | Rationalizing visits to clinic | Provider organization/clinician |
Scoping of service zones | Align with new donor priorities | Provider organization/clinician | |
Patient convenience | |||
Capping patient numbers | Align with delivery capacities: | Provider organization | |
(a) Staffing (b) physical space |