Table 1 Key themes and sub-themes identified by mid-level managers in Uganda to implementing changes for IPT uptake in the SEARCH-IPT trial
Themes | Sub-theme |
|---|---|
Barriers and enablers identified by intervention managers | |
Agenda Setting | • Managers feeling of ownership over local strategies to promote IPT • Power to set agendas impeded by external funders and implementing partnersa |
Collaboration | • Collaborating with other districts enabled sharing of best practices • Positive effect of the pressure of social comparison and recognition • Collaboration within districts between cadres of mid-level managers (district health officers and district tuberculosis supervisors) enabled scaling of IPT • Ministry of Health meetings were top-down and did not facilitate collaboration or district input |
Barriers and enablers shared by intervention and control managers | |
Availability of resources | • Inadequate INH stocks and inconsistent supplies was a barrier to IPT uptake • Collaboration within districts and with other districts to redistribute available supplies • Frontline provider turnover and knowledge gaps was a barrier for scaling IPT |
Motivations | • Managers motivated by improving the health of their constituents • Lack of motivation of frontline providers was a barrier to IPT uptake • Lack of political leadership and prioritization of IPT scale up |