Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan

Hypertension, a significant risk factor for ischemic heart disease and other chronic conditions, is the third-highest cause of death and disability in Tajikistan. Thus, ensuring the early detection and appropriate management of hypertension is a core element of strategies to improve population hea...

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Main Authors:	Chukwuma, Adanna, Gong, Estelle, Latypova, Mutriba, Fraser-Hurt, Nicole
Format:	Journal Article
Published:	Springer Nature 2021
Subjects:	CONTINUITY OF CARE CASCADE OF CARE HYPERTENSION IMPLEMENTATION RESEARCH
Online Access:	http://hdl.handle.net/10986/35573

id	okr-10986-35573
recordtype	oai_dc
spelling	okr-10986-355732021-07-19T16:33:09Z Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan Chukwuma, Adanna Gong, Estelle Latypova, Mutriba Fraser-Hurt, Nicole CONTINUITY OF CARE CASCADE OF CARE HYPERTENSION IMPLEMENTATION RESEARCH Hypertension, a significant risk factor for ischemic heart disease and other chronic conditions, is the third-highest cause of death and disability in Tajikistan. Thus, ensuring the early detection and appropriate management of hypertension is a core element of strategies to improve population health in Tajikistan. For a strategy to be successful, it should be informed by the causes of gaps in service delivery and feasible solutions to these challenges. The objective of this study was to undertake a systematic assessment of hypertension case detection and retention in care within Tajikistan’s primary health care system, and to identify challenges and appropriate solutions. We review the results for the case detection stage of the cascade of care, which had the most significant gaps. Of the half a million people with hypertension in Khatlon and Sogd Oblasts (administrative regions), about 10% have been diagnosed in Khatlon and only 5% in Sogd. Barriers to case detection include misinformation about hypertension, ambiguous protocols, and limited delivery capacity. Solutions identified to these challenges were mobilizing faith-based organizations, scaling up screening through health caravans, task-shifting to increase provider supply, and introducing job aids for providers. Translating findings on discontinuities in care for hypertension and other chronic diseases to actionable policy insights can be facilitated by collaboration with local stakeholders, triangulation of data sources, and identifying the intersection between the feasible and the effective in defining solutions to service delivery challenges. 2021-05-13T17:39:30Z 2021-05-13T17:39:30Z 2019-12-03 Journal Article BMC Health Services Research 1472-6963 http://hdl.handle.net/10986/35573 CC BY 4.0 http://creativecommons.org/licenses/by/4.0 World Bank Springer Nature Publications & Research :: Journal Article Publications & Research Europe and Central Asia Tajikistan
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
topic	CONTINUITY OF CARE CASCADE OF CARE HYPERTENSION IMPLEMENTATION RESEARCH
spellingShingle	CONTINUITY OF CARE CASCADE OF CARE HYPERTENSION IMPLEMENTATION RESEARCH Chukwuma, Adanna Gong, Estelle Latypova, Mutriba Fraser-Hurt, Nicole Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan
geographic_facet	Europe and Central Asia Tajikistan
description	Hypertension, a significant risk factor for ischemic heart disease and other chronic conditions, is the third-highest cause of death and disability in Tajikistan. Thus, ensuring the early detection and appropriate management of hypertension is a core element of strategies to improve population health in Tajikistan. For a strategy to be successful, it should be informed by the causes of gaps in service delivery and feasible solutions to these challenges. The objective of this study was to undertake a systematic assessment of hypertension case detection and retention in care within Tajikistan’s primary health care system, and to identify challenges and appropriate solutions. We review the results for the case detection stage of the cascade of care, which had the most significant gaps. Of the half a million people with hypertension in Khatlon and Sogd Oblasts (administrative regions), about 10% have been diagnosed in Khatlon and only 5% in Sogd. Barriers to case detection include misinformation about hypertension, ambiguous protocols, and limited delivery capacity. Solutions identified to these challenges were mobilizing faith-based organizations, scaling up screening through health caravans, task-shifting to increase provider supply, and introducing job aids for providers. Translating findings on discontinuities in care for hypertension and other chronic diseases to actionable policy insights can be facilitated by collaboration with local stakeholders, triangulation of data sources, and identifying the intersection between the feasible and the effective in defining solutions to service delivery challenges.
format	Journal Article
author	Chukwuma, Adanna Gong, Estelle Latypova, Mutriba Fraser-Hurt, Nicole
author_facet	Chukwuma, Adanna Gong, Estelle Latypova, Mutriba Fraser-Hurt, Nicole
author_sort	Chukwuma, Adanna
title	Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan
title_short	Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan
title_full	Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan
title_fullStr	Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan
title_full_unstemmed	Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan
title_sort	challenges and opportunities in the continuity of care for hypertension : a mixed-methods study embedded in a primary health care intervention in tajikistan
publisher	Springer Nature
publishDate	2021
url	http://hdl.handle.net/10986/35573
_version_	1764483355529707520

Challenges and Opportunities in the Continuity of Care for Hypertension : A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan

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