| Abstrakt: |
This article discusses a clinical trial in rural Bangladesh that aims to improve hypertension and diabetes care. The trial will implement integrated, decentralized primary care, including healthcare provider training, mHealth technology, task shifting, and community-based care. The study will evaluate the effectiveness and cost-effectiveness of the multicomponent integrated care compared to usual care and mHealth intervention alone. It will also investigate factors influencing hypertension and diabetes management and explore barriers and facilitators to delivering and sustaining the intervention. The trial will assess lifestyle changes, patient burden, and conduct qualitative research to understand perspectives from patients, healthcare providers, and other stakeholders. A health economic evaluation will also be undertaken. The hypothesis is that the multicomponent decentralized primary care will improve all steps along the hypertension and diabetes care continuum, while the mHealth intervention alone will have a limited impact on screening, diagnosis, and treatment rates. The primary healthcare system in rural areas of Bangladesh consists of different levels of facilities, including Upazila Health Complexes, union health centers, and community clinics. Community clinics are the most basic level of care, with two rooms and basic facilities, and are staffed by Community Health Care Providers (CHCPs) who receive 4-month medical training. To improve access to primary care and quality of care for hypertension and diabetes, a multicomponent intervention package has been designed, which includes mHealth, decentralization with task sharing, community-based care, and supportive monitoring visits. The effectiveness of this intervention package is being compared to [Extracted from the article] |
