• PI: Brian van Wyk
  • Funder: Medical Research Council (UK)
  • Dates: 01/05/2014 - 30/04/2015

Project Summary

The main objective of the research were:

1) To address knowledge gaps about factors contributing to good performance for retention in care for facilities that are postive deviants in the ART programme in the Western Cape;

2) To design a large scale intervention study aimed at improving the perfomance of programmes to support effective and affordable treatment of chronic lifelong conditions, such as HIV infection and diabetes;

3) To contribute to the development of a method for using a positive deviance approach to strengthen implementation of large scale programmes for treating CLLC in complex contexts.

Key Activities

The first phase of this project consisted of a systematic scoping review examining the breadth of evidence on this topic that provided a descriptive account based on studies identified. The primary review question was: What models of community-based distribution of medicines are available for CLLCs in low- and middle- income countries and for vulnerable communities in high-income countries? The themes that guided the description included characteristics of the models; links with the supply chain and management of medicines; policy and regulatory issues; dimension(s) of access to medicines addressed; indicators by which these interventions have been measured; and the types of studies that have generated this evidence. 

The second phase of this research project had been completed using the ‘positive deviance’ approach. This phase was a scoping study to explore patient, management, organisational and community factors that affect retention in care of patients on ART. Some of the organisational challenges were identified faced by some health facilities with respect to managing CLLC’s.


Institute of Development Studies (IDS)

School of Public Health, University of the Western Cape
Robert Sobukwe Road, Bellville 7535, Republic of South Africa
Tel: +27-21 - 959 2809 | Fax: +27- 21 - 959 2872 | Email: nkomeni@uwc.ac.za