Construct | Theme | ||
---|---|---|---|
Patients | MSF staff | External stakeholders | |
ACCEPTABILITY | |||
Affective attitude | Makes life easier Among those who did not switch or discontinued: Fear of unfamiliar Lack of control | Treatment improvement | Perception of high risk Ok for the poor/uninsured |
Intervention coherence | Attribution of side effects | Clarity regarding pill and how it works | |
Burden | Easier than previous treatment | Early effort, long-term reward | |
Self-efficacy | High capability to execute | Empowered by information | |
Ethicality | Helps achieve patient goals | Fit with values/patient welfare | |
Opportunity costs | Sacrifices treatment flexibility | ||
Perceived effectiveness | Make patients feel better | High efficiency Improved efficiency | |
Other | Trust in (MSF) doctors | ||
SUSTAINABILITY | |||
Challenges | Dependence on MSF/lack of faith in external system Financial barriers | Inconsistent supply of drugs to clinic Lack of coherence Lack of transition plan | Background context (i.e. political, social, health system factors outside of MSF control) Changing established practice of clinicians Lack of commercial interest outside MSF |
Supporting factors | Time investment Contextualisation of intervention within local health system and political circumstances. Intervention as advocacy | MSF as catalyst/precedent for change Stakeholder engagement Integration into health system Price/economic crisis as opportunity |