Multi-criteria decision analysis approach for strategy scale-up with application to Chagas disease management in Bolivia

Pinazo, María Jesús; Cidoncha, Ainize; Gopal, Gurram; Moriana, Silvia; Saravia, Ruth; Torrico, Faustino; Gascón, Joaquim

doi:10.1371/journal.pntd.0009249

Cited by 7 publications

(3 citation statements)

References 11 publications

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“…Since municipal authorities are responsible for planning and prioritizing the financing of health interventions in first- and second-level facilities, it is advisable to intensify the coordination and monitoring of the processes together with SEDES, the ChNP and the Ministry of Health, as well as with other sectors, to comprehensively address Chagas disease [ 36 , 50 ]. A project developed by the Global Chagas Coalition, ISGlobal, and the Illinois Institute of Technology has implemented an innovative tool (Xtrategy) in municipalities of the Bolivian Chaco region that strengthens dialogue and intersectional planning capacity to assess the impact and complexity of strategies and adequately select the interventions to be included in the municipal Annual Operating Plan [ 91 ].…”

Section: Discussionmentioning

confidence: 99%

Social determinants in the access to health care for Chagas disease: A qualitative research on family life in the “Valle Alto” of Cochabamba, Bolivia

et al. 2021

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Introduction Chagas disease is caused by the Trypanosoma cruzi infection. It is a neglected tropical disease with considerable impact on the physical, psychological, familiar, and social spheres. The Valle Alto of Cochabamba is a hyperendemic region of Bolivia where efforts to control the transmission of the disease have progressed over the years. However, many challenges remain, above all, timely detection and health-care access. Methods Following the Science Shop process, this bottom-up research emerged with the participation of the civil society from Valle Alto and representatives of the Association of Corazones Unidos por el Chagas from Cochabamba. The aim of this study is to explore the social determinants in the living realities of those affected by Chagas disease or the silent infection and how families in the Valle Alto of Cochabamba cope with it. An interdisciplinary research team conducted a case study of the life stories of three families using information from in-depth interviews and performed a descriptive qualitative content analysis and triangulation processes. Findings Findings provide insights into social circumstances of the research subjects’ lives; particularly, on how exposure to Trypanosoma cruzi infection affects their daily lives in terms of seeking comprehensive health care. Research subjects revealed needs and shared their experiences, thus providing an understanding of the complexity of Chagas disease from the socioeconomic, sociocultural, political, and biomedical perspectives. Results enlighten on three dimensions: structural, psychosocial, and plural health system. The diverse perceptions and attitudes toward Chagas within families, including the denial of its existence, are remarkable as gender and ethnocultural aspects. Findings support recommendations to various stakeholders and translation materials. Conclusions Intersectional disease management and community involvement are essential for deciding the most appropriate and effective actions. Education, detection, health care, and social programs engaging family units ought to be the pillars of a promising approach.

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Section: Discussionmentioning

confidence: 99%

Social determinants in the access to health care for Chagas disease: A qualitative research on family life in the “Valle Alto” of Cochabamba, Bolivia

et al. 2021

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“…Training is a key element in institutionalization and scaling-up of strategies, and should cover training and continuous evaluation of healthcare personnel, and training reinforcement in public health, data analysis, planification and evaluation. [ 19 ]…”

Section: Resultsmentioning

confidence: 99%

Results and evaluation of the expansion of a model of comprehensive care for Chagas disease within the National Health System: The Bolivian Chagas network

et al. 2022

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Background Most people with chronic Chagas disease do not receive specific care and therefore are undiagnosed and do not receive accurate treatment. This manuscript discusses and evaluates a collaborative strategy to improve access to healthcare for patients with Chagas in Bolivia, a country with the highest prevalence of Chagas in the world. Methods With the aim of reinforcing the Chagas National Programme, the Bolivian Chagas Platform was born in 2009. The first stage of the project was to implement a vertical pilot program in order to introduce and consolidate a consensual protocol-based healthcare, working in seven centers (Chagas Platform Centers). From 2015 on the model was extended to 52 primary healthcare centers, through decentralized, horizontal scaling-up. To evaluate the strategy, we have used the WHO ExpandNet program. Results The strategy has significantly increased the number of patients cared for, with 181,397 people at risk of having T. cruzi infection tested and 57,871 (31·9%) new diagnostics performed. In those with treatment criteria, 79·2% completed the treatment. The program has also trained a significant number of health personnel through the specific Chagas guidelines (67% of healthcare workers in the intervention area). Conclusions After being recognized by the Chagas National Programme as a healthcare model aligned with national laws and priorities, the Bolivian platform of Chagas as an innovation, includes attributes that they have made it possible to expand the strategy at the national level and could also be adapted in other countries.

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“…Therefore, it is of the utmost importance to take measures to early detection of cases, focusing on the age of the child, with two purposes: to identify the active area of infection and to intervene to prevent the transmission vector of the disease, on the other hand, it reveals incurable diseases. Changes before the appearance, opportune treatment against parasites (14).…”

Section: Discussionmentioning

confidence: 99%

Cardiac involvement in chagas disease

Vélez¹,

Mesa²,

Vélez³

et al. 2022

World J. Adv. Res. Rev.

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Chagas disease is an infectious disease caused by Trypanosoma cruzy, this is a highly frequent disease in rural areas of Latin America, it is characterized by presenting two phases, an acute one which is often asymptomatic and with low mortality which is mostly conferred to acute myocarditis due to Chagas, and a chronic phase which consists of three presentations, one indeterminate, one digestive and one cardiac, the latter being the most serious and the cause of greater complications and higher mortality in patients that occur with this, it should be noted that the alterations presented at the cardiac level that affect the heart in its structural, autonomic, functional and electrical conduction aspects, which require specialized treatment and diagnostic aids to determine characteristic myocardial involvement, degree of involvement and patient prognosis due to Chagas disease.

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Multi-criteria decision analysis approach for strategy scale-up with application to Chagas disease management in Bolivia

Cited by 7 publications

References 11 publications

Social determinants in the access to health care for Chagas disease: A qualitative research on family life in the “Valle Alto” of Cochabamba, Bolivia

Social determinants in the access to health care for Chagas disease: A qualitative research on family life in the “Valle Alto” of Cochabamba, Bolivia

Results and evaluation of the expansion of a model of comprehensive care for Chagas disease within the National Health System: The Bolivian Chagas network

Cardiac involvement in chagas disease

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