Project 3

Effectiveness of frontline health workers and strengthening primary health care system for delivery of PEN interventions for prevention and control of Type 2 Diabetes and Cardiovascular diseases in South Asia.

Our aim is to develop and evaluate platforms for training and care-co-ordination by primary health care (PHC) teams in South Asia, to improve prevention of T2D and CVD. We will use a pragmatic non-randomized trial to quantify the impact of our interventions on clinical, health system and health economic outcomes, taking advantage of the established Health Observatories in Bangladesh, India, Pakistan and Sri Lanka.

To achieve this, we are conducting a literature search on current programmes, policy documents training manuals, guidelines and care pathways for prevention of T2D and CVD that are directly relevant to primary health care for CVD and T2D. This will be followed up by a small number of semi-structured interviews with key informants such as policy makers and health administrators overseeing program delivery as well as service providers (including at the community level) and their clients. Additionally, we will conduct baseline assessment of NCD service availability and readiness of the PHC system at a representative sample of the study sites using WHO and USAID developed service availability and readiness assessment (SARA) tools customized for collecting data related to T2D and CVD (SARA-NCD). Finally, we will be integrating findings to describe diabetes and CVD related health services context using the health system building blocks approach (service delivery, health workforce, health information system, access to essential medicines, financing and leadership/ governance). All the work undertaken will be aligned with key stakeholders to refine and agree the design and implementation of the interventions planned for strengthening of PHC in the current project, including the care pathways.