Contextualizing Evidence for Action on Diabetes in Low-Resource Settings—Project CEAD Part-II, Strengthening the Health System: A Mixed-Methods Study Protocol

Mari Carmen Bernal-Soriano, Francisco Barrera-Guarderas, Alfonso Alonso-Jaquete, Elisa Chilet-Rosell, Ikram Benazizi, Cintia Caicedo-Montaño, Mónica Márquez-Figueroa, Marta Puig-García, Blanca Lumbreras, Ildefonso Hernández-Aguado, Ana Lucía Torres-Castillo and Lucy Anne Parker
Additional contact information
Mari Carmen Bernal-Soriano: Department of Public Health, Universidad Miguel Hernández, Sant Joan d’Alacant, 03550 Alicante, Spain
Francisco Barrera-Guarderas: Faculty of Medicine, Pontificia Universidad Católica del Ecuador (PUCE), Quito 170143, Ecuador
Alfonso Alonso-Jaquete: Unidad Docente de Medicina Preventiva y Salud Pública de Cantabria, Consejería de Sanidad de Cantabria, 39009 Santander, Spain
Elisa Chilet-Rosell: Department of Public Health, Universidad Miguel Hernández, Sant Joan d’Alacant, 03550 Alicante, Spain
Ikram Benazizi: Department of Public Health, Universidad Miguel Hernández, Sant Joan d’Alacant, 03550 Alicante, Spain
Cintia Caicedo-Montaño: Centre of Community Epidemiology and Tropical Medicine (CECOMET), Esmeraldas 0801265, Ecuador
Mónica Márquez-Figueroa: Centre of Community Epidemiology and Tropical Medicine (CECOMET), Esmeraldas 0801265, Ecuador
Marta Puig-García: Department of Public Health, Universidad Miguel Hernández, Sant Joan d’Alacant, 03550 Alicante, Spain
Blanca Lumbreras: Department of Public Health, Universidad Miguel Hernández, Sant Joan d’Alacant, 03550 Alicante, Spain
Ildefonso Hernández-Aguado: Department of Public Health, Universidad Miguel Hernández, Sant Joan d’Alacant, 03550 Alicante, Spain
Ana Lucía Torres-Castillo: Institute of Public Health, Pontificia Universidad Católica del Ecuador (PUCE), Quito 170143, Ecuador
Lucy Anne Parker: Department of Public Health, Universidad Miguel Hernández, Sant Joan d’Alacant, 03550 Alicante, Spain

IJERPH, 2021, vol. 18, issue 7, 1-13

Abstract: Diabetes is a major public health problem, increasingly affecting low- and middle-income countries. The project CEAD (Contextualizing Evidence for Action in Diabetes in low-resource settings) aims to evaluate the implementation of comprehensive diabetes care in two low-resource settings in Ecuador and to stimulate context-led health systems innovations to improve diabetes care and reduce inequity. The mixed-methods approach includes a 24-month retrospective study to assess the current level of implementation of comprehensive diabetes care and participants will be followed up prospectively for two years to assess changes in healthcare and clinical outcomes from the outset of the research. We will include individuals diagnosed with type-2 diabetes aged over 18 years, who are accessing diabetes care in health facilities in the study districts. Varied stakeholders (patients and family members, community members, healthcare workers and decision-makers) will interpret the underlying causes of the observed weaknesses and propose solutions to strengthen diabetes-related healthcare in focus group discussions (FG). A second set of FG will analyze perceived improvements in healthcare based on prospective cohort findings and consider the success/failure of any context-led innovations occurring throughout the research. Our study will demonstrate how evidence can be contextualized to stimulate local innovations and overcome weaknesses of diabetes-related healthcare in low resource settings.

Keywords: implementation science; diabetes mellitus; diabetes type 2; public health; health systems; low- and middle-income countries (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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