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Chukwuma, Adanna

World Bank Health, Nutrition, and Population Global Practice
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HEALTH SYSTEM, HEALTH FINANCING, SERVICE DELIVERY, POLITICAL ECONOMY, ARMENIA, RUSSIA
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0000-0001-7873-7633
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World Bank Health, Nutrition, and Population Global Practice
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Last updated: January 5, 2024
Biography
Adanna is a Senior Health Specialist in the Health, Nutrition, and Population Global Practice, where she leads the design, implementation, and evaluation of investment operations. She has over ten years of experience advising national reforms to improve access to high-quality health care, through service delivery organization, strategic purchasing, revenue mobilization, and demand generation, including in Sri Lanka, Sierra Leone, India, Moldova, Tajikistan, the South Caucasus Countries, and Romania. She has published on health care financing, access, and quality in peer-reviewed journals, including the Bulletin of the World Health Organization and Social Science and Medicine. Adanna obtained a medical degree from the University of Nigeria, a Master of Science in Global Health from the University of Oxford, and a Doctor of Science in Health Systems from Harvard University.
Citations 198 Scopus

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2020 - 202332010 - 20191
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Subject: HYPERTENSION ×

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Now showing 1 - 4 of 4
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    Invitations, Incentives, and Conditions: A Randomized Evaluation of Demand-Side Interventions for Health Screenings
    (Elsevier, 2022-03) de Walque, Damien; Chukwuma, Adanna
    This randomized controlled trial investigates the impact of four demand-side interventions on health screening for diabetes and hypertension among Armenian adults. The interventions are 1) personalized invitations from a physician, 2) personalized invitations with information about peer screening behavior, 3) personalized invitations with a labeled but unconditional financial incentive, and 4) personal invitations with a conditional financial incentive. Compared with the control group, interventions 1 to 3 led to a significant increase in the screening rate of about 15 percentage points for diabetes and hypertension. The highest impact was measured for intervention 4 leading to a 31.2 percentage point increase in both screenings.
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    Invitations, Incentives, and Conditions: A Randomized Evaluation of Demand-Side Interventions for Health Screenings in Armenia
    (World Bank, Washington, DC, 2020-07) De Walque, Damien; Chukwuma, Adanna; Ayivi-Guedehoussou, Nono; Koshkakaryan, Marianna
    The study is a randomized controlled trial that investigates the impact of four demand-side interventions on health screening for diabetes and hypertension among Armenian adults ages 35-68 who had not been tested in the last 12 months. The interventions are personal invitations from a physician (intervention group 1), personal invitations with information about peer screening behavior (intervention group 2), a labeled but unconditional cash transfer in the form of a pharmacy voucher (intervention group 3), and a conditional cash transfer in the form of a pharmacy voucher (intervention group 4). Compared with the control group in which only 3.5 percent of participants went for both screenings during the study period, interventions 1 to 3 led to a significant increase in the screening rate of about 15 percentage points among participants. The highest intervention impact was measured among recipients in intervention group 4, whose uptake of screening on both tests increased by 31.2 percentage points. The levels of cost-effectiveness of intervention groups 1, 2, and 4 are similar while for intervention group 3 it is about twice more expensive per additional person screened.
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    Challenges and Opportunities in the Continuity of Care for Hypertension: A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan
    (Springer Nature, 2019-12-03) Gong, Estelle; Chukwuma, Adanna; Latypova, Mutriba; Fraser-Hurt, Nicole
    Hypertension, a significant risk factor for ischemic heart disease and other chronic conditions, is the third-highest cause of death and disability in Tajikistan. Thus, ensuring the early detection and appropriate management of hypertension is a core element of strategies to improve population health in Tajikistan. For a strategy to be successful, it should be informed by the causes of gaps in service delivery and feasible solutions to these challenges. The objective of this study was to undertake a systematic assessment of hypertension case detection and retention in care within Tajikistan’s primary health care system, and to identify challenges and appropriate solutions. We review the results for the case detection stage of the cascade of care, which had the most significant gaps. Of the half a million people with hypertension in Khatlon and Sogd Oblasts (administrative regions), about 10% have been diagnosed in Khatlon and only 5% in Sogd. Barriers to case detection include misinformation about hypertension, ambiguous protocols, and limited delivery capacity. Solutions identified to these challenges were mobilizing faith-based organizations, scaling up screening through health caravans, task-shifting to increase provider supply, and introducing job aids for providers. Translating findings on discontinuities in care for hypertension and other chronic diseases to actionable policy insights can be facilitated by collaboration with local stakeholders, triangulation of data sources, and identifying the intersection between the feasible and the effective in defining solutions to service delivery challenges.
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    Invitations and Incentives: A Qualitative Study of Behavioral Nudges for Primary Care Screenings in Armenia
    (Springer Nature, 2020-12) Gong, Estelle; Chukwuma, Adanna; Ghazaryan, Emma; de Walque, Damien
    Non-communicable diseases account for a growing proportion of deaths in Armenia, which require early detection to achieve disease control and prevent complications. To increase rates of screening, demand-side interventions of personalized invitations, descriptive social norms, labeled cash transfers, and conditional cash transfers were tested in a field experiment. Our complementary qualitative study explores factors leading to the decision to attend screening and following through with that decision, and experiences with different intervention components. An individual’s decision to screen depends on 1) the perceived need for screening based on how they value their own health and perceive hypertension and diabetes as a harmful but manageable condition, and 2) the perceived utility of a facility-based screening, and whether screening will provide useful information on disease status or care management and is socially acceptable. Following through with the decision to screen depends on their knowledge of and ability to attend screenings, as well as any external motivators such as an invitation or financial incentive. Personalized invitations from physicians can prompt individuals to reconsider their need for screening and can, along with financial incentives, motivate individuals to follow through with the decision to screen. The effect of descriptive social norms in invitations should be further studied. Efforts to increase preventive screenings as an entry point into primary care in Armenia may benefit from implementation of tailored messages and financial incentives.