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Table 3 Key assumptions, evidence and indicators

From: Developing a Theory of Change model of service user and caregiver involvement in mental health system strengthening in primary health care in rural Ethiopia

Outcomes levels Assumptions Evidence/experience base Indicators
Long-term outcome Preconditions at the community, health organization, service user and caregiver level met
Improved community organizations and inter-sector collaboration
Stated during the workshop by the participants that represented diverse stakeholder groups Health care system inclusive of service user and caregiver needs(service user and caregiver satisfaction, affordable medication, holistic care, including medication and psychosocial, involvement structure and strategies)
Comprehensives and reliability mental healthcare service (pharmacological and basic psychosocial interventions)
Established service user and caregiver involvement structures within healthcare systems (e.g. peer support, board/committee members)
Community intermediate outcomes Willingness of community stakeholders to work collaboratively to mobilize, support and empower service user and caregivers and their organization
Willingness of social organizations to promote mental health for their members
Stated during the ToC workshops and meetings by the participants that represented diverse stakeholder groups
Research evidence in the local context showed the need [110]
Number of stakeholders involved in ToC workshops
Number of stakeholders involved in service user and caregiver support meeting ToC map and narratives
Community stakeholders collaborate to empower service user and caregiver groups
Number and types of community support generated to empower service users
Health organization Willingness of health professionals and managers to undergo capacity building training; engage in participatory action research with service user and caregiver’s
Commitment to create enabling environment service user and caregiver involvement
Stated during the ToC workshops by the participants
Assessed need in the qualitative study
Several research findings from HICs [3, 12, 13] and international study [2]
Number of participants attendance at the capacity building training
Changes in knowledge and attitudes compared in pre-and-post training
Number of members involved in participatory action research activities
Reported personal experiences related to ToC model introduction
Service users and caregivers Willingness by service user and caregiver to undergo capacity building training
Willingness to work with health professionals, managers and community
Time and resources to engage in involvement activities
Stated during the ToC workshops by the participants
Identified needs in the qualitative study
Recommended by several studies from HICs [3, 12, 13], LMICs [30, 42, 91, 111] and international study [2]
Number of participants attended capacity building training
Changes in knowledge and attitude compared in pre-and-post training
Number of participants involved in participatory action research activities
Reported personal experiences related to ToC model introduction
Service user and caregiver groups organized