Improving Services for Chronic Non-communicable Diseases in Samoa : An Implementation Research Study Using the Care Cascade Framework

Samoa needs to intensify the response to the growing non-communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. The mixed-methods study used the cascade framework as an analysis tool and hypertension as a tracer condition for chroni...

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Bibliographic Details
Main Authors: Fraser-Hurt, Nicole, Naseri, Leausa Take, Thomsen, Robert, Matalavea, Athena, Ieremia-Faasili, Victoria, Reupena, Muagatutia Sefuiva, Hawley, Nicola L., Pomer, Alysa, Rivara, Anna C., Obure, Dayo Carol, Zhang, Zhang
Format: Journal Article
Published: John Wiley and Sons, Inc. 2021
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Online Access:http://hdl.handle.net/10986/36033
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Summary:Samoa needs to intensify the response to the growing non-communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. The mixed-methods study used the cascade framework as an analysis tool and hypertension as a tracer condition for chronic non-communicable diseases. Household survey data were integrated with medical record data of hypertension patients and results from focus group discussions with patients and healthcare providers. Hypertension prevalence was 38.1% but only 4.7% of hypertensive individuals had controlled blood pressure. There were large gaps in the care continuum especially at screening and referral due to multiple socio-cultural, economic and service delivery constraints. In Samoa, care for chronic non-communicable diseases is not effectively addressing patient needs. This calls for better health communication, demand creation, treatment support, nutritional interventions and health service redesign, with a focus on primary healthcare and effective patient and community engagement.