Challenges and Opportunities in the Continuity of Care for Hypertension: A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan

doi:10.1186/s12913-019-4779-5

Publication:
Challenges and Opportunities in the Continuity of Care for Hypertension: A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan

dc.contributor.author	Gong, Estelle
dc.contributor.author	Chukwuma, Adanna
dc.contributor.author	Latypova, Mutriba
dc.contributor.author	Fraser-Hurt, Nicole
dc.date.accessioned	2021-05-13T17:39:30Z
dc.date.available	2021-05-13T17:39:30Z
dc.date.issued	2019-12-03
dc.description.abstract	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.	en
dc.identifier.citation	BMC Health Services Research
dc.identifier.doi	10.1596/35573
dc.identifier.issn	1472-6963
dc.identifier.uri	https://hdl.handle.net/10986/35573
dc.publisher	Springer Nature
dc.rights	CC BY 4.0
dc.rights.holder	World Bank
dc.rights.uri	http://creativecommons.org/licenses/by/4.0
dc.subject	CONTINUITY OF CARE
dc.subject	CASCADE OF CARE
dc.subject	HYPERTENSION
dc.subject	IMPLEMENTATION RESEARCH
dc.title	Challenges and Opportunities in the Continuity of Care for Hypertension	en
dc.title.subtitle	A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan	en
dc.type	Journal Article	en
dc.type	Article de journal	fr
dc.type	Artículo de revista	es
dspace.entity.type	Publication
okr.associatedcontent	https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4779-5 Journal website (version of record)	en
okr.date.disclosure	2021-05-13
okr.date.doiregistration	2025-05-06T11:08:05.339092Z
okr.doctype	Publications & Research::Journal Article
okr.doctype	Publications & Research
okr.externalcontent	External Content
okr.guid	571831626073518809
okr.identifier.doi	10.1186/s12913-019-4779-5
okr.identifier.report	161481
okr.journal.nbpages	925
okr.language.supported	en
okr.peerreview	Academic Peer Review
okr.region.administrative	Europe and Central Asia
okr.region.country	Tajikistan
okr.topic	Health, Nutrition and Population::Health Service Management and Delivery
okr.unit	Health, Nutrition and Population Global Practice
okr.volume	19
relation.isAuthorOfPublication	41aa479e-8677-5046-8dc0-ceca0dc1aa7f
relation.isAuthorOfPublication.latestForDiscovery	41aa479e-8677-5046-8dc0-ceca0dc1aa7f