Preventive Community-Based Strategies of Cardiovascular Diseases in Iran: A Multi-Method Study

Alizadeh, Gisoo; Gholipour, Kamal; Khosravi, Mohammad Farough; Khodayari‐Zarnaq, Rahim

doi:10.1080/19371918.2020.1764432

Cited by 9 publications

(11 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CHW's motivation in healthcare delivery can be taken as a key factor in implementing NCD related services and achieving Sustainable Development Goal 3, "Health and Wellbeing" in Bangladesh by 2030 [14]. Results from our study are in concordance with the findings from other settings where CHWs expressed the need of capacity building for the prevention and control of NCDs [27,39,46]. These findings are plausible because in past decades the CHWs were very much capacitated on maternal and child health services and were mostly dealing with communicable diseases.…”

Section: Discussionsupporting

confidence: 84%

“…Findings of this study suggest that the CHWs in Bangladesh are the primary drivers of delivering preventive health and NCDs related services at the community level, which is consistent with the initiatives considered by other neighbouring countries of Asia [28,34,35]. Evidence shows that engaging CHWs for delivery of health services and health promotion interventions is increasing in LMICs and proven to be effective [36][37][38][39]. CHWs provide opportunities for effective implementation of health promotion interventions within the existing healthcare systems without engaging new personnel with whom families have had no prior contact.…”

Section: Discussionsupporting

confidence: 78%

See 1 more Smart Citation

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

Rawal

Jubayer

Choudhury

et al. 2021

glob health res policy

View full text Add to dashboard Cite

Background The increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh. Methods We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n = 4); key informant interviews with central level health policymakers/ managers (n = 15) and focus group discussions with CHWs (4 FGDs; total n = 29). Participants in a stakeholder consultative meeting included members from the government (n = 4), non-government organisations (n = 2), private sector (n = 1) and universities (n = 2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses. Results The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation. Conclusion Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 78%

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

Rawal

Jubayer

Choudhury

et al. 2021

glob health res policy

View full text Add to dashboard Cite

show abstract

“…CHW's motivation in healthcare delivery can be taken as a key factor in implementing NCD related services and achieving Sustainable Development Goal 3, "Health and Wellbeing" in Bangladesh by 2030 [14]. Results from our study are in concordance with the ndings from other settings where CHWs expressed the need of capacity building for the prevention and control of NCDs [27,39,46]. These ndings are plausible because in past decades the CHWs were very much capacitated on maternal and child health services and were mostly dealing with communicable diseases.…”

Section: Facilitating and Enabling Factors In Engaging Chws In Ncdsupporting

confidence: 82%

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

Rawal

Jubayer

Choudhury

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh.Methods: We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n=4); key informant interviews with central level health policymakers/ managers (n=15) and focus group discussions with CHWs (4 FGDs; total n=29). Participants in a stakeholder consultative meeting included members from the government (n=4), non-government organisations (n=2), private sector (n=1) and universities (n=2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses.Results: The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation.Conclusion: Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.

show abstract

“…Implementing multicomponent community-based prevention strategies in the form of NGOs and charitable organizations, health marketing strategies to raise public awareness about health behaviors, using community health workers (Behvarz) especially in deprived rural areas, applying smartphone preventive program to improve the quality of health care, adopting general practitioners and other health workers to assign community members to a link worker, and finally preventive, diagnostic, and therapeutic services may improve cardiovascular health status. Major gains will likely achieve from public health strategies targeting incorrect diet, physical inactivity, and preventing or stopping cigarette smoking 32 . As a successful example, in a community-based study in Tehran, it was shown that family-school and community based educational sessions resulted in about 20% decrease incidence of metabolic syndrome during 6 years follow up 33 .…”

Section: Discussionmentioning

confidence: 99%

National trends in cardiovascular health metrics among Iranian adults using results of three cross-sectional STEPwise approaches to surveillance surveys

Rahmani

Asgari

Khalili

et al. 2021

Sci Rep

View full text Add to dashboard Cite

To examine the trends of 7 cardiovascular health metrics (CVH metrics) incorporate of smoking, physical activity, diet, body mass index (BMI), fasting plasma glucose (FPG), total cholesterol (TC), and blood pressure (BP) level during three cross-sectional STEPwise approaches to surveillance (STEPS), 2007–2016, among Iranian adults. The study population consisted of 19,841 women and 17,243 men, aged 20–65 years. The CVH metrics were categorized as ‘ideal’, ‘intermediate’, and ‘poor’. The sex-stratified weighted prevalence rate of each CVH metrics was reported. The conditional probability of each poor versus combined intermediate and ideal metric was analyzed using logistic regression. In 2016 compared to 2007, the prevalence of poor BP level (20.4% vs. 23.7%), smoking (13.7% vs. 23.8%), TC ≥ 240 mg/dl (2.4% vs. 11.2%) and FPG < 100 mg/dl (75.6% vs. 82.3%) declined, whereas poor physical activity level (49.7% vs. 30%), poor healthy diet score (38.1% vs. 4.1%), BMI levels ≥ 25 kg/m2 (62.8% vs. 57.8%) increased. Despite a high prevalence of obesity among women, it remained constant in women but showed an increasing trend in men; moreover, the trends of low physical activity and current smoking were better for women. Despite some improvement in CVH metrics, < 4% of Iranian adults meet ≥ 6 CVH metrics in 2016; this issue needs intervention at the public health level using a multi-component strategy.

show abstract

Preventive Community-Based Strategies of Cardiovascular Diseases in Iran: A Multi-Method Study

Cited by 9 publications

References 18 publications

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

National trends in cardiovascular health metrics among Iranian adults using results of three cross-sectional STEPwise approaches to surveillance surveys

Contact Info

Product

Resources

About