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Table 1 Processes for ensuring rigour in case-study analysis adapted from Gilson et al. (2012) [39]

From: “The number of clients is increasing but the supplies are reducing”: provider strategies for responding to chronic antiretroviral (ARV) medicines stock-outs in resource-limited settings: a qualitative study from Uganda

PRINCIPLE

 Prolonged engagement

Multiple on-site visits were made to the case-study facilities across three weeks. Informal discussions were held with ART clinic managers, clinicians and pharmacists coupled with face-to-face interviews with multiple informants.

 Use of theory

This study is derived from a larger mixed-methods study which is informed by the health systems dynamics frameworks by van Olmen et al. (2012) [33] which builds on the WHO’s building blocks of the health system framework (2007).

 Case selection

Sixteen health facilities were purposefully selected from a nationally-representative sample of 195 health facilities across Uganda which participated in Uganda’s national emergency ART roll-out.

 Sampling

We aimed for a sample that had appropriate representation of health facility demographics in Uganda with respect to a) setting (rural/urban), b) ownership-type (public, for-profit, not-for-profit)c) Level of care(tertiary, secondary, primary).

 Multiple methods

Multiple methods were used including face-to-face interviews, document review and informal engagements with clinicians and the head of the HIV Clinic.

 Triangulation

Case descriptions were constructed based on triangulation across multiple data sources (Questionnaire data, interviewee data and document review).

 Peer debriefing and support

Data analysis involved a team-based process involving at least three authors at each of the stages.

 Respondent validation

A data validation workshop was conducted with involving the head of the HIV clinic in 14 of the Participating health facilities.