Investigator(s)
| WHO Technical Officer |
Sadhana Bhagwat WHO Bangladesh Sadhana Bhagwat 
|
| Principal Investigator |
Aliya S Naheed icddr,b Aliya S Naheed
|
Title(s) and abstract
| Scientific title | Feasibility of a digital application for providing hypertension and diabetes care in rural Bangladesh: A community based pilot study |
| Public title | Digital App for hypertension and diabetes care |
| Background | In Bangladesh, the overall prevalence of hypertension is 17% and 26.4% [1-3], and diabetes is 7 between 7.8 % and 12.8% in Bangladesh [4-6]. 30% of the total deaths in Bangladesh are attributable to CVDs. Health facilities in Bangladesh are not adequately equipped to deliver comprehensive primary care for managing the high burden of HTN and DM [6].However, the government of Bangladesh has taken some major initiatives to combat NCDs at the system, institutional, and service delivery levels since 2012. The government also initiated the NCD corner initiative at Upazila (sub-district) Health Complexes (UHCs) and linked with other primary health care facilities including community clinics (CC), union health centers [13] for addressing common NCDs and related conditions such as cardiovascular diseases (CVDs), diabetes etc. and have been increasing capacity of the health workers. we propose to develop a comprehensive care model for HTN and DM treatment with support of digital application led by the community health workers at the primary care facilities. The proposed study will also support the government’s effort for electronic data capture system for to improve the NCD care |
| Objectives | General objective: Feasibility of integrating a multi component intervention using digital application for early detection, treatment and effective referral for control of hypertension and diabetes in rural Bangladesh. b. Specific objectives: 1. To strengthen the capacity of the community health workers for screening hypertension and diabetes in the rural communities for stepped-up referral to primary health care facilities (Upazila Health Complex/UHC) using a digital app. 2. To train the doctors on a digital application-based treatment algorithm for supporting decision-making for treating hypertension and diabetes at the primary care facility (UHC). 3. To strengthen the capacities of the Multipurpose Health Volunteers (MHVs) for lifestyle modification among individuals with hypertension and diabetes for mitigation of cardiometabolic risks. 4. To introduce a digital medicine disbursement system at the CC and UHC for monitoring supplies of drugs and promoting medication adherence of individuals with hypertension and diabetes in the community. |
| Study Methods | 4.1 Study design: Feasibility study with pre and post evaluation. 4.2 Study setting(s)/data sources: Our study setting will be the service area of the Upazila Health Complex (UHC) of Matlab South and Matlab North sub-districts in Chandpur district in Bangladesh. The selected UHCs are located in the areas where icddr, b has the longest-running HDSS surveillance system in Bangladesh. icddr,b offers maternal and child health services in Matlab South UHC on top of government routine health service deliveries, which is designated as ‘icddr,b service area’. Health services in Matlab North UHC is solely supported by government facilities, and designated as ‘government service area’.We will assign Matlab South UHC as ‘intervention area’ and Matlab North UHC as ‘comparison areas’, and randomly select one CC under each UHC. 4.3 Study population: We will recruit individuals who have been diagnosed as having hypertension and or diabetes living in the two selected Community Clinic catchment areas. we will require to recruit 120 hypertensive individuals (60 in intervention and 60 usual care arm) for a pre and post evaluation of systolic BP. 100 diabetes individuals (50 for intervention and 50 for usual care arm) to be recruited for pre and post evaluation of blood glucose level. Five components as below. Screening, and e-registration of HTN and DM patients at CC and stepped up referral using a digital app. Designated a nurse as the triage coordinator at the NCD corners of the UHC for hypertension and diabetes. Algorithm-based treatment protocol at the UHC for hypertension and diabetes by doctors using digital app and linking with the CHCP for follow-up at the CC. Strengthen capacity of the MHVs for providing Home Health Education Introduce a digital inventory for medicine |
| Expected outcomes and use of results | This proposed model could be a sustainable solution involving existing CHWs that enables linkage between the Community Clinic to Upazila Health Complex and enhance the continuum of care during any emergency period like the COVID pandemic. his study will also allow us to explore the acceptability, barriers, challenges and facilitators from both patients and providers perspective which will help policymakers to scale up the program. If this program is found feasible, we will be able to recommend to the government for scaling up in the primary care system that enables achieving the goal of Non Communicable Disease Control Program. |
| Keywords | Digital application NCD prevention, hypertension, diabetes |
Research Details
| Student research | No |
| Start Date | 01-Nov-2022 |
| End Date | 31-Oct-2023 |
| Key Implementing Institution | International Centre for Diarrhoeal Disease Research, Bangladesh |
| Multi-country research | No |
| Nationwide research | No |
| Bangladesh | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Non-communicable Disease |
| Involves human subjects | Yes |
| Intervention Evaluation Research | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |