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Table 3 Primary study outcome definitions. All patient and facility-level outcomes refer to all patients attended in outpatient mental health services in target health facilities

From: Systems analysis and improvement approach to optimize outpatient mental health treatment cascades in Mozambique (SAIA-MH): study protocol for a cluster randomized trial




Patient-level clinical

Primary: functional improvement

Patients w/ ≥ 1 follow-up w/ score ≤ 10 or ≥ 50% reduction in baseline WHODAS 2.0

Secondary: medication adherence

Patients returning for follow-up visit not missing a dose (patient report and pill counts)

Secondary: retention in care

Patients attending scheduled follow-up appointments; and attending those appointments on time.

Patient-level process and quality

Vitals recorded

Patients with height, weight, and blood pressure recorded

Facility-level process and quality

New patient diagnosis

# of new MH patients diagnosed

Treatment initiation

# of new MH patients starting medication

Total patient load

# of MH patients with ≥ 1 follow-up visits in last 3 months

Implementation outcomes


% of facility staff reporting satisfaction with SAIA-MH and various strategy components


% of trained facility staff engaging in ≥ 1 implementation plan in first 3 months; # of SAIA-MH cycles completed in first 6 months


% of teams following 5-step SAIA-MH process


See economic evaluation section


% of trained facility staff engaging in ≥ 1 implementation plan during 1-year sustainment phase


# of SAIA-MH cycles completed during sustainment phase; facility staff intent-to-continue-use; clinical, process, and quality outcome trends during sustainment