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

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.

Instrument for assessing the performance of nursing professionals in primary health care of Diabetes Mellitus

“…Therefore, there is a need to develop clinical guidelines for chronic diseases that can be realistically applied in resource-limited primary care settings. (Bernal-Soriano et al, 2021) Health professionals, particularly nurses, aim to promote the health of people with Diabetes Mellitus, so that they can have better control of the disease. Promoting the person's adherence to care and treatment is of great relevance for the proper management of Diabetes Mellitus.…”

Realizando una encuesta poblacional en tiempos de pandemia: Experiencias de campo desde Ecuador

“…El proyecto "Contextualización de la Evidencia para la Acción en Diabetes en entornos con bajos recursos: Un estudio utilizando métodos mixtos en Quito y Esmeraldas, Ecuador" es un proyecto de ciencia de implementación cuyo objetivo es explorar los procesos por los cuales las recomendaciones en salud pública pueden ser traducidas a acciones informadas por la evidencia y adaptadas al contexto específico 3,4 .…”