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The fact that Mozambican authorities reported high coverage of CPT among patients with HIV, has led to this qualitative case study aimed at exploring possible factors responsible for the successful implementation of CPT in the Province of Maputo.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Between February and April 2019, we individually interviewed nine governmental stakeholders, including the person responsible for the HIV Program, the person responsible for the TB Program and the person responsible for Pharmaceutical management at three administrative levels (central, provincial and district level). Interviews were recorded, transcribed, and analysed thematically using MAXQDA Analytics Pro. Findings were translated from Portuguese into English.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Five themes iteratively emerged: (a) Role of governance &amp; leadership, (b) Pharmaceutical strategies, (c) Service delivery modifications, (d) Health care provider factors, and (e) Patients\u2019 perspectives.<\/jats:p>\n                <jats:p>Interviews revealed that continuous supply of cotrimoxazole (CTZ) had been facilitated through multiple-source procurement and a push-pull strategy. One part of CTZ arrived in kits that were imported from overseas and distributed to public health facilities based on their number of outpatient consultations (push strategy). Another part of CTZ was locally produced and distributed as per health facility demand (pull strategy). Strong district level accountability also contributed to the public availability of CTZ. Interviewees praised models of differentiated care, the integrated HIV service delivery and drug delivery strategies for reducing long queues at the health facility, better accommodating patients\u2019 needs and reducing their financial and organisational burden.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study presents aspects that governmental experts believed to be key for the implementation of CPT in the Province of Maputo, Mozambique. Enhancing the implementation outcomes \u2013 drug availability and feasibility of the health facility-based service delivery \u2013 seemed crucial for the implementation progress. Reasons for the remarkable patient acceptability of CPT in our study setting should be further investigated.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-024-10631-x","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T12:02:14Z","timestamp":1711540934000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reasons for implementation success despite health system constraints: qualitative insights on \u2018what worked\u2019 for cotrimoxazole preventive therapy"],"prefix":"10.1186","volume":"24","author":[{"given":"Pia","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edna","family":"Mabasso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00eds Velez","family":"Lap\u00e3o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohsin","family":"Sidat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"issue":"4","key":"10631_CR1","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s11904-016-0318-8","volume":"13","author":"J Kagaayi","year":"2016","unstructured":"Kagaayi J, Serwadda D. 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It was reviewed and approved (Protocol ID: CIBS FM&HCM\/069\/2018) by the Institutional Bioethics Committee at the Faculty of Medicine & Central Hospital of Maputo (CIBS FM & HCM). Mozambican Ministry of Health and the Instituto de Higiene e Medicina Tropical (Portugal) also authorised this study. At the beginning of each interview, written informed consent was obtained from all the participants. Names and personal information of governmental stakeholders are kept confidential.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"379"}}