Table 1 Example indicators and data method/source based on the RE-AIM domains

Reach

• Target population reached?

Coverage

▪ % people among the target population eligible for programme and number served by the programme

▪ Prevalence of NCD and MH comorbidity^b

• Existing MSF household survey ^a

• Routine cohort data

• Qualitative data

“Effectiveness”/ Quality of Care

▪ Trends in clinical outcomes and quality indicators?

▪ Perceived benefits/unintended consequences from a patient and provider perspective?

Clinical Outcomes

▪ % HTN patients with most recent BP < 140/90 mmHg, 6 & 12 months post enrolment and trend from baseline^b

▪ % Patients with diabetes with last HbA1c < 8.0% 6 & 12 months post enrolment and trend from baseline^b

▪ % Patients who report decreased/quitting smoking

• Routine cohort data

• Qualitative data

Quality Indicators

▪ % active^c CVD patients prescribed a statin

▪ % COPD/ asthma patients with inhaler technique check documented

▪ Trend in defaulters^c and deaths as a proportion of active cohort

• Clinical audit

• Routine cohort data

Perceived Effectiveness

▪ Patients’ and providers’ perspectives on effectiveness of programme components (clinical review, medications, HE, HLO, MHPSS, HV)

• Qualitative data

Adoption/ acceptance

▪ Care model accessible and acceptable to patients, providers, organisation and community?

▪ Guideline acceptable to staff?

Accessibility/ acceptability

▪ Availability and accessibility / barriers to access

▪ Acceptability/usability of NCD guideline

▪ Self-reported medication adherence and medication beliefs

▪ Routine cohort data

▪ Qualitative data

▪ Self-report medication adherence questionnaire

Adoption/participation

▪ Description of intervention location, cadres of staff and qualifications

▪ Experience of receiving and providing NCD care, use of clinical guideline

▪ How participation influenced patient/staff well-being and/or work practices

▪ Routine cohort data

▪ Qualitative data

Implementation

▪ Intervention delivered as intended?

▪ Facilitators and barriers to implementing the programme?

▪ Essential components and adaptations necessary?

▪ Implementation costs?

Fidelity of programme delivery

▪ % DM patients with micro-albuminuria or urinary protein tested

▪ % Active^c cohort attending a health education session at last clinical visit

▪ No. of MHPSS group sessions monthly during reporting period

▪ Clinical audit

▪ Routine cohort data

Adaptations

• NCD care adaptations to local setting (e.g. cultural; dietary, exercise)

• Programme adaptations related to humanitarian setting e.g. response to patients’ psychosocial needs

▪ Qualitative data

Cost

• Staff time;

• Capital and recurrent implementation costs^b

▪ Qualitative data

▪ Medicine/supply/ staff costs^b

▪ Staff time estimates

Maintenance

• Challenges and facilitators for patients to stay in programme?

• Organisational challenges, and costs; adaptations made to maintain programme?

Individual Level

• % Patients active^c 6 months post enrolment^b

• Self-reported medication adherence rates

• Key challenges in altering lifestyle (diet, exercise, smoking)

▪ Routine cohort data

▪ Clinical Audit

▪ Qualitative data

▪ Medicine/supply/staff costs^b

▪ Staff time estimates

▪ Self-report medication adherence questionnaire

Organisational Level

• Measures of cost of maintenance^b

• Institutionalisation of the programme/modifications made for maintenance

• Alignment with organisational mission