Early stakeholder engagement lessons from managing hypertension among people living with human-immunodeficiency virus: an integrated model (MAP-IT).
Early stakeholder engagement lessons from managing hypertension among people living with human-immunodeficiency virus: an integrated model (MAP-IT).
复制标题
从管理人类免疫缺陷病毒感染者的高血压中获得的早期利益相关者参与经验教训：综合模型（MAP-IT）。
DOI：
10.1093/eurheartj/ehac159
复制
发表时间：
2022
影响因子：
39.3
通讯作者：
MAP-ITStudyTeam
中科院分区：
文献类型：
--
作者：
Ojji,Dike;Aifah,Angela;Dulli,Lisa;Iwelunmor,Juliet;MAP-ITStudyTeam
尽管有控制高血压的循证干预措施（ebi），但非洲卫生保健人力短缺限制了将这些干预措施有效地纳入现有服务。1例如，据报道，卫生人力的严重短缺是尼日利亚控制高血压的主要障碍，2013年，每1万人中有3.8名医生和14.5名护士。1 .医生保健工作者的严重短缺限制了尼日利亚在初级保健中心（PHCs）提供高血压服务的能力，而大多数艾滋病毒感染者（PLWH）都在初级保健中心接受治疗。为了缓解这一问题，尼日利亚联邦卫生部在其整个医疗保健系统中制定了一项任务转移政策。2具体来说，护士被授权在初级保健中心履行临床职责，包括病例识别、病人咨询和治疗妇幼保健、结核病、疟疾和人类免疫缺陷病毒（艾滋病毒）。虽然“尼日利亚基本卫生保健服务的任务转移和任务分担政策”自2014年以来一直在实施，但它尚未被用作将非传染性疾病（NCD）管理纳入艾滋病毒护理的战略，直到最近护士才被允许治疗非传染性疾病患者。我们正在对尼日利亚阿克瓦伊博姆州的30家初级卫生保健机构进行一项由美国国立卫生研究院资助的集群随机对照试验，以比较实践促进（即对初级保健实践的质量改进支持）干预与常规护理对高血压控制任务强化策略采用率的影响，以及从基线到12个月收缩压（SBP）的变化。尽管早期利益相关者的参与对于采用此类ebi至关重要，但缺乏关于如何使他们尽早参与以提高这些干预措施的吸收的战略。这使得像尼日利亚这样的低收入和中等收入国家在现实环境中采用或采取行动实施以证据为基础的高血压控制战略非常具有挑战性。我们在研究的形成阶段与主要利益相关者分享我们的经验，目的是向他们介绍我们的研究，获得不同利益相关者对阿克瓦伊博姆州环境的看法，这些观点在项目实施中应该考虑，从不同利益相关者那里了解将导致项目成功的因素，并获得有关PLWH接受护理的当地环境的额外信息。
Despite the availability of evidence-based interventions (EBIs) for hypertension control, the healthcare workforce shortage in Africa limits the effective integration of these interventions into existing services. 1 For example, the critical shortage of the health workforce has been reported as a major barrier to hypertension control in Nigeria, where in 2013, there were 3.8 physicians and 14.5 nurses per 10 000 population. 1 An acute shortage of physician healthcare workers limits Nigeria’s capacity to offer hypertension services in primary health centres (PHCs), where the majority of people living with HIV (PLWH) receive their care. To mitigate this problem, the Nigerian Federal Ministry of Health enacted a task-shifting policy across its healthcare system. 2 Specifically, nurses are mandated to carry out clinical duties at PHCs including case identification, patient counselling and treatment for maternal and child health, tuberculosis, malaria, and human immunodeficiency virus (HIV). 2 Although the ‘Task-shifting and Task-sharing Policy for Essential Health Care Services in Nigeria’has been in place since 2014, 2 it has not been leveraged as a strategy to integrate non-communicable disease (NCD) management into HIV care where nurses were not allowed to treat patients with NCDs until recently. We are conducting an NIH-funded cluster randomized controlled trial of 30 primary healthcare facilities in Akwa Ibom State of Nigeria to compare the effect of practice facilitation (ie quality improvement support for primary care practices) intervention vs. usual care on the rate of adoption of task-strengthening strategy for hypertension control and change in systolic blood pressure (SBP) from baseline to 12 months.Even though early stakeholders’ engagement is essential for the adoption of such EBIs, strategies on how to engage them early to improve uptake of these interventions are lacking. This makes the adoption or actions to implement evidence-based strategies for hypertension control in real-world settings very challenging in lowand middle-income countries (LMICs) like Nigeria. We share our experience engaging major stakeholders in the formative stages of our study with the aims of introducing the study to them, obtaining different stakeholders’ perspectives on the context in Akwa Ibom state that should be considered in programme implementation, learning from different stakeholders the factors that will lead to the success of the programme and obtaining additional information pertaining to the local settings where PLWH receive care.
影响因子：
3.8
作者：
Rabkin, Miriam;de Pinho, Helen;Topp, Stephanie M.
通讯作者：
Topp, Stephanie M.
影响因子：
4.5
作者：
Daini BO;Okafor E;Baruwa S;Adeyanju O;Diallo R;Anyanti J
通讯作者：
Anyanti J