Background: The Knowledge Translation Unit (KTU), based in the University of Cape Town Lung Institute, has spent the past 16 years developing, implementing and evaluating health systems interventions in primary care settings in South Africa and other low- and middle-income country settings. The Practical Approach to Care Kit (PACK) is a strategy comprising 4 pillars that support the delivery of primary care: 1) a clinical guide, 2) a training strategy, 3) a health systems strengthening intervention and 4) a monitoring and evaluation component. This programme is complex and requires that the KTU is able to coherently explain it in order to enhance its implementability within local health systems.

Objectives: The KTU explored a detailed rationale for the PACK programme development, localisation and implementation processes. Examining the core principles which drive the programme as well as their actionable applications aimed to provide clarity and assist in explaining the programme.

Methods: We undertook to reflect on practical development and implementation experience over a period of 16 years, through a process of review, team workshops and high level leadership meetings, and created a list of principles that define the rationale behind the programme.

Results: A list of 16 core principles emerged. The first area of focus overlapped across the guide and training pillars and the other related to the health systems strengthening pillar.

Conclusions: The KTU can maintain the integrity of the PACK programme by using the core principles to convey the approach that PACK takes and why it is different to other programmes. These findings will be used and disseminated by publication in a journal article, included in implementation processes, updating toolkits as part of mentorship packages, and an design of an infographic conveying the message in a simple way to guide localisers, trainers and implementers, end-users and implementation scientists.