TY - JOUR
T1 - Applying systems thinking to identify enablers and challenges to scale-up interventions for hypertension and diabetes in low-income and middle-income countries
T2 - protocol for a longitudinal mixed-methods study
AU - Global Alliance for Chronic Diseases Upscaling Working Group Collaborators.
AU - Ramani-Chander, Anusha
AU - Joshi, Rohina
AU - van Olmen, Josefien
AU - Wouters, Edwin
AU - Delobelle, Peter
AU - Vedanthan, Rajesh
AU - Miranda, J Jaime
AU - Oldenburg, Brian
AU - Sherwood, Stephen
AU - Rawal, Lal B
AU - Mash, Robert James
AU - Irazola, Vilma Edith
AU - Martens, Monika
AU - Lazo-Porras, Maria
AU - Liu, Hueiming
AU - Agarwal, Gina
AU - Waqa, Gade
AU - Marcolino, Milena Soriano
AU - Esandi, Maria Eugenia
AU - Ribeiro, Antonio Luiz Pinho
AU - Probandari, Ari
AU - González-Salazar, Francisco
AU - Shrestha, Abha
AU - Sujarwoto, Sujarwoto
AU - Levitt, Naomi
AU - Paredes, Myriam
AU - Sugishita, Tomohiko
AU - Batal, Malek
AU - Li, Yuan
AU - Haghparast-Bidgoli, Hassan
AU - Naanyu, Violet
AU - He, Feng J
AU - Zhang, Puhong
AU - Mfinanga, Sayoki Godfrey
AU - De Neve, Jan-Walter
AU - Daivadanam, Meena
AU - Siddiqi, Kamran
AU - Geldsetzer, Pascal
AU - Klipstein-Grobusch, Kerstin
AU - Huffman, Mark D
AU - Webster, Jacqui
AU - Ojji, Dike
AU - Beratarrechea, Andrea
AU - Tian, Maoyi
AU - Postma, Maarten
AU - Owolabi, Mayowa O
AU - Birungi, Josephine
AU - Antonietti, Laura
AU - Ortiz, Zulma
AU - Patel, Anushka
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/4/18
Y1 - 2022/4/18
N2 - INTRODUCTION: There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million. These projects represent diverse countries, contexts and adopt varied approaches and study designs to scale-up complex, evidence-based interventions to improve hypertension and diabetes outcomes. A systematic inquiry of these projects will provide necessary scientific insights into the enablers and challenges in the scale up of complex NCD interventions.METHODS AND ANALYSIS: We will apply systems thinking (a holistic approach to analyse the inter-relationship between constituent parts of scaleup interventions and the context in which the interventions are implemented) and adopt a longitudinal mixed-methods study design to explore the planning and early implementation phases of scale up projects. Data will be gathered at three time periods, namely, at planning (TP), initiation of implementation (T0) and 1-year postinitiation (T1). We will extract project-related data from secondary documents at TP and conduct multistakeholder qualitative interviews to gather data at T0 and T1. We will undertake descriptive statistical analysis of TP data and analyse T0 and T1 data using inductive thematic coding. The data extraction tool and interview guides were developed based on a literature review of scale-up frameworks.ETHICS AND DISSEMINATION: The current protocol was approved by the Monash University Human Research Ethics Committee (HREC number 23482). Informed consent will be obtained from all participants. The study findings will be disseminated through peer-reviewed publications and more broadly through the GACD network.
AB - INTRODUCTION: There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million. These projects represent diverse countries, contexts and adopt varied approaches and study designs to scale-up complex, evidence-based interventions to improve hypertension and diabetes outcomes. A systematic inquiry of these projects will provide necessary scientific insights into the enablers and challenges in the scale up of complex NCD interventions.METHODS AND ANALYSIS: We will apply systems thinking (a holistic approach to analyse the inter-relationship between constituent parts of scaleup interventions and the context in which the interventions are implemented) and adopt a longitudinal mixed-methods study design to explore the planning and early implementation phases of scale up projects. Data will be gathered at three time periods, namely, at planning (TP), initiation of implementation (T0) and 1-year postinitiation (T1). We will extract project-related data from secondary documents at TP and conduct multistakeholder qualitative interviews to gather data at T0 and T1. We will undertake descriptive statistical analysis of TP data and analyse T0 and T1 data using inductive thematic coding. The data extraction tool and interview guides were developed based on a literature review of scale-up frameworks.ETHICS AND DISSEMINATION: The current protocol was approved by the Monash University Human Research Ethics Committee (HREC number 23482). Informed consent will be obtained from all participants. The study findings will be disseminated through peer-reviewed publications and more broadly through the GACD network.
KW - Developing Countries
KW - Diabetes Mellitus/therapy
KW - Humans
KW - Hypertension/diagnosis
KW - Noncommunicable Diseases/therapy
KW - Systems Analysis
U2 - 10.1136/bmjopen-2021-053122
DO - 10.1136/bmjopen-2021-053122
M3 - Article
C2 - 35437244
SN - 2044-6055
VL - 12
SP - e053122
JO - BMJ Open
JF - BMJ Open
IS - 4
ER -