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Ethics approval
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National and provincial health authorities
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National ethics committee
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Ethics committee of the Ministry of Health and Social Welfare
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National bioethics committee
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National, provincial and municipal government research committees, UWC ethics committee
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Period of data collection
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2009 April-June
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2009 February- June
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2008 July- 2009 February
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2007 March- September; 2008
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2008 September -2010 October
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2010 May
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2011 March- June
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2010 February-May
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2011 June-September
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Language of data collection
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Portuguese
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French / Kirundi
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English
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Portuguese and English
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English, Xhosa, Afrikaans, Zulu
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Number and type of interviews
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National level: Ministry of Health (minister, advisors from the Ministry of Health / PAV-MINSA “immunization program”), and offices of selected Implementing Partners (UNICEF, ONUSIDA, EU, WHO) and NGOs 11 in 2009 1 in 2010
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National level: MoH officials (senior managers, HRH/ planning/ programs managers), National AIDS Council secretariat, NGOs representatives, GHIs representatives 27 in 2009 26 in 2011
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National level : in-depth key informant interviews with 22 representatives of the government, bilateral and multilateral development agencies and other stakeholders at the national level
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National level: 21 in 2008; Ministry of Health (MoH) officials, offices of selected Implementing Partners (WHO, UNAIDS, UNICEF, Irish Aid, PMI/CDC, World Bank, USAID, CDC, DFID) and NGOs (MONASO-network of national NGOs working on AIDS, Malaria Consortium, Health Alliance International
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National level: MoH officials, SANAC, international NGO coordinators, international health agencies coordinators 19 in 2008–2009 18 in 2010
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Sub-national level: provincial government officers, NGOs, district managers, facility managers 30 in 2011
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Sub-national level: provincial government officers, provincial AIDS committee, NGOs, district managers, facility managers and employees 35 in 2009 45 in 2011
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Sub-national level: around 60 with provincial and district health directorates, HR managers, NGO managers, individuals in charge of health facilities and services responsible in 2010
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Sub-national levels: Provincial and municipal governments, sub-provincial management levels (general manager, HR manager, finance manager) N = 105 from 2009 to 2010
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Facility and NGO level: NGO representative, health workers, facility manager N = 144
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Type of documents analyzed
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National health policy, national programs of Malaria, Tuberculosis and Maternal Health and national and international reports; Published literature and unpublished documents provided by key informants of MINSA, national and international NGOs, Provincial Health Department and Municipal Hospitals.
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Policy and planning documents from programs and HRH unit, national health plan, proposals for GHIs
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Review of Lesotho’s Round 5 Grant Score Cards Grant Performance reports and policy and planning documents from programs and HRH unit, national plan : 10-15
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Policy and planning documents from National programs and HR National Directorate, national health plan, grey documents
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Policy and planning documents from national department of health, grey documents, proposals for GHIs, draft policies
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Quantitative sampling method (sub-national level
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NA
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3 provinces (2 rural and one urban, in each of which 3 or 4 facilities (NGO, private and public) were selected (14 in 2009 and 12 in 2011)
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NA
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NA
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3 provinces, minimum of 2 districts in each, minimum of two facilities in each district at lowest level providing ART initiation. Rural/urban sampling where possible at each level
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Type of quantitative data
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HRH national report and national HIV program report for ART patients figures
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Survey at facility level (N = 105 in 2009, N = 78 in 2011) to health workers (salary level, incentives, trainings, supervision)
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NA
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Surveys at facility level for HRH, infrastructures mapping, health information system, and pharmacy information; surveys for NGO mapping and district health services network
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Health system trust database for HRH data;
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National ART report for ART patients number
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Surveys at facility level for HRH number and trainings, surveys for NGO mapping and district health services network
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HRH national review and national HIV program report for ART patients figures
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Analysis method (software used)
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Qualitative data: Thematic analysis - analyzed manually
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Qualitative data: Framework analysis using Atlas.ti for
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Qualitative data: Framework analysis using Atlas.ti
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Qualitative data: Thematic analysis using Nvivo and content analysis
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Qualitative data: Thematic analysis both manually and using Atlas.ti
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Quantitative data: analyzed using Stata (version 8)
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