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Table 1 Main domains of exploration (based on Obrist et al. [24])a

From: Integrated community case management in a peri-urban setting: a qualitative evaluation in Wakiso District, Uganda

Dimension of access (defined by Obrist et al.)

Key questions adapted in relation to iCCM services

Availability

The existing health services and goods meet clients’ needs.

• What services do iCCM VHT members provide? Are the types of services provided by VHT members perceived to be appropriate? (What should VHT members be allowed to do or not do? Do iCCM services and goods meet caregivers’ needs?)

• Are there sufficient numbers of iCCM VHT members available to perform services? Are they able to meet demand?

• Are iCCM treatment and commodities available? Is supply sufficient to meet demand? Are the types of commodities available sufficient and appropriate to the services provided?

Accessibility

The location of supply is in line with the location of clients.

• Is the location of iCCM VHT members in line with the location of the community?

• Are iCCM services easily accessible via VHT members? (Are they proximally located? Is transport required? Time required to reach?)

• Are services at the referral health facility easily accessible (distance, time and transport required to reach)?

Affordability

The prices of services fit the clients’ income and ability to pay.

• What are the direct and indirect costs associated with accessing iCCM services?

• What are the direct and indirect costs (transportation, lost time and income, fees) associated with accessing referral services?

Adequacy

The organization of health care meets the clients’ expectations.

• Does the organisation of iCCM services meet community expectations? (i.e. how services are provided)

• Is there adequate space for service provision?

• Are the VHT members’ homes and treatment areas clean and well-kept?

• Are supplies and other materials well organised? Is the organisational set-up adequate?

• Do the opening hours (availability of VHT members for service provision) match caregiver needs? Can the VHT members be easily located when needed?

Acceptability

The characteristics of providers match with those of the clients.

• Do the characteristics of iCCM service providers match with the expectations of the community? Do caregivers feel welcome and cared for?

• How do the characteristics (attitudinal and performance) or personality of VHT members influence iCCM acceptability?

• How do perceptions of VHT member competency or skills influence iCCM acceptability? (Are VHT members perceived to be qualified to provide services? Do caregivers trust the competency of VHT members?)

• What is the acceptability of the available iCCM treatments and information provided?

• What was the acceptability of the process through which VHT members were selected? Was the community sufficiently engaged? How did VHT selection influence VHT member acceptability?

  1. aAdapted from Obrist et al. ‘Five Dimensions of Access to Health Care Services’ in the ‘Health Access Livelihoods Framework’ [24]