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Table 3 The 17 categories divided by framework level and specified as facilitator/barrier, and examples of how to build on facilitators and overcome barriers

From: Capitalizing on facilitators and addressing barriers when implementing active tuberculosis case-finding in six districts of Ho Chi Minh City, Vietnam: a qualitative study with key stakeholders

Level Categories F B Examples of how to build on facilitators and overcome barriers Highlighted in interview with
Patient Employee Volunteer Leader
Innovation 1 Access to healthcare through ACF x   IMPACT TB increased accessibility through mobile CXR events outside of working hours and during the weekend, and provided monetary incentives for ACF participants X X X X
2 Free screening, testing and treatment x   IMPACT TB offered free screening, transport vouchers to those referred for CXR, free CXR and support in enrolling for free treatment X X X X
3 Support for TB patients x   IMPACT TB provided financial support for food and fuel, besides free screening, testing and treatment X X X X
Individual professional 1 Dedication and motivation x   Employees and volunteers adapted their schedules based on patients’ availability, and encouraged patients X X X X
2 Experience and skills x   Employees and volunteers used communication, persuasion and advising skills, and shared experience with each other X X X X
3 Having a network that facilitates ACF implementation x   Volunteers used their networks and relationships to easily find their way around in the districts and to approach people with suspected TB X - X -
4 Good communication x   Employees and volunteers spoke local dialects, knew local context, used tools such as flyers and communication channels such as social networking app Zalo X X X X
Patient 1 Limited participation   x Employees and volunteers addressed stigma, discrimination, fear and mistrust (see next row) X X X X
2 Prevalence of stigma, discrimination and fear   x Employees and volunteers contacted patients on the telephone instead of visiting them at home, and invited whole communities instead of selected groups for ACF X X X X
3 Trust and mistrust x x Employees and volunteers communicated clearly and truthfully, were friendly and kind X X X X
Social context 1 Collaboration and engagement x x IMPACT TB and employees and volunteers collaborated with and engaged District TB Units, health stations, committees, local leaders, residential groups, etc. Communication and awareness-raising should improve to further strengthen collaboration and engagement (see next row) X X X X
2 Need to improve communication and awareness-raising   x IMPACT TB should use a variety of communication channels including television, radio and online media, and made community-wide announcements; employees and volunteers should communicate directly with patients and visit individual households X X X X
3 Commitment and support x   IMPACT TB and employees and volunteers ensured all stakeholder had a common understanding of ACF X X X X
Organizational context 1 Availability of and need to retain human and financial resources x   IMPACT TB offered human and financial resources for the project period (2017-2019) X X X X
2 Importance and appreciation of capacity-building x   IMPACT TB included capacity-building for employees and volunteers - X X X
3 Incentives for employees and volunteers x x IMPACT TB provided incentives; an increase of incentives should be considered X X X X
4 Challenges with preparation and logistics   x Employees and volunteers collaborated closely with District TB Units; IMPACT TB should prepare early, formulate clear implementation plan, and provide detailed instructions for employees and volunteers and District TB Units X X X X
  1. ACF active case-finding, IMPACT TB Implementing proven community-based active TB case finding intervention, CXR chest X-ray, TB tuberculosis, F facilitator, B barrier