Journal Article
Verified
Protocol for an evaluation of the initiation of an integrated longitudinal outpatient care model for severe chronic non-communicable diseases (PEN-Plus) at secondary care facilities (district hospitals) in 10 lower-income countries.
Submitted by: Mary Theodory Mayige
Version: 1.0
Year: 2024
10.1136/bmjopen-2023-074182
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Description
INTRODUCTION: The Package of Essential Noncommunicable Disease Interventions-Plus (PEN-Plus) is a strategy decentralising care for severe non-communicable diseases (NCDs) including type 1 diabetes, rheumatic heart disease and sickle cell disease, to increase access to care. In the PEN-Plus model, mid-level clinicians in intermediary facilities in low and lower middle income countries are trained to provide integrated care for conditions where services traditionally were only available at tertiary referral facilities. For the upcoming phase of activities, 18 first-level hospitals in 9 countries and 1 state in India were selected for PEN-Plus expansion and will treat a variety of severe NCDs. Over 3 years, the countries and state are expected to: (1) establish PEN-Plus clinics in one or two district hospitals, (2) support these clinics to mature into training sites in preparation for national or state-level scale-up, and (3) work with the national or state-level stakeholders to describe, measure and advocate for PEN-Plus to support development of a national operational plan for scale-up. METHODS AND ANALYSIS: Guided by Proctor outcomes for implementation research, we are conducting a mixed-method evaluation consisting of 10 components to understand outcomes in clinical implementation, training and policy development. Data will be collected through a mix of quantitative surveys, routine reporting, routine clinical data and qualitative interviews. ETHICS AND DISSEMINATION: This protocol has been considered exempt or covered by central and local institutional review boards. Findings will be disseminated throughout the project's course, including through quarterly M&E discussions, semiannual formative assessments, dashboard mapping of progress, quarterly newsletters, regular feedback loops with national stakeholders and publication in peer-reviewed journals.
Creators / Authors
Alma J Adler
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA aadler2@bwh.harvard.edu.
Emily B Wroe
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Andrea Atzori
- Doctors with Africa CUAMM, Padova, Italy.
Neusa Bay
- Universidade Eduardo Mondlane, Maputo, Mozambique.
Wondu Bekele
- Mathiwos Wondu-Ye Ethiopia Cancer Society, Addis Ababa, Ethiopia.
Victoria M Bhambhani
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Remy Bitwayiki Nkwiro
- Partners In Health Sierra Leone, Kono, Sierra Leone.
Chantelle Boudreaux
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Dawson Calixte
- Zamni Lasante, Croix-des-Bouquets, Haiti.
Jonathan Chiwanda Banda
- NCD Division, Ministry of Health, Lilongwe, Malawi.
Matthew M Coates
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Wubaye Walelgne Dagnaw
- NCDI Poverty Network, Addis Ababa, Ethiopia.
Katia Domingues
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Laura Drown
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Symaque Dusabeyezu
- Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Darius Fenelon
- Zamni Lasante, Croix-des-Bouquets, Haiti.
Neil Gupta
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Isaac Ssinabulya
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.
Yogesh Jain
- NCDI Poverty Network, Surguja, Chhattisgarh, India.
Yogeshwar Kalkonde
- Chhattisgarh NCD Plus Initiative, Ambikapur, Chhattisgarh, India.
Innocent Kamali
- Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Catherine Karekezi
- Non-Communicable Diseases Alliance Kenya, Nairobi, Kenya.
Biraj Man Karmacharya
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
Bhagawan Koirala
- Kathmandu Institute of Child Health, Kathmandu, Nepal.
Julie Makani
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Fabio Manenti
- Doctors with Africa CUAMM, Padova, Italy.
Alexio Mangwiro
- Clinton Health Access Initiative, Harare, Zimbabwe.
Beatriz Manuel
- Department of Community Health, Universidade Eduardo Mondlane, Maputo, Mozambique.
Jones K Masiye
- Noncommunicable Diseases and Mental Health Clinical Services, Malawi Ministry of Health, Lilongwe, Malawi.
Fastone Mathew Goma
- Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.
Mary Theodory Mayige
- National Institute for Medical Research, Dar es Salaam, Tanzania.
Amy McLaughlin
- Partners In Health, Boston, Massachusetts, USA.
Emmanuel Mensah
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Nicole Mocumbi Salipa
- Universidade Eduardo Mondlane, Maputo, Mozambique.
Reuben Mutagaywa
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Alvern Mutengerere
- SolidarMed, Harare, Zimbabwe.
Gedeon Ngoga
- Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.
Marta Patiño
- Partners In Health Sierra Leone, Kono, Sierra Leone.
Giovanni Putoto
- Doctors with Africa CUAMM, Padova, Italy.
Todd Ruderman
- Partners In Health, Neno, Malawi.
Devashri Salvi
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Santigie Sesay
- Noncommunicable Diseases and Mental Health, Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone.
Fameti Taero
- Mozambique Institute for Health Education and Research, Maputo, Mozambique.
Emílio Tostão
- Department of Agricultural Economics and Development, Universidade Eduardo Mondlane, Maputo, Mozambique.
Sterman Toussaint
- Partners In Health, Maryland County, Liberia.
Gene Bukhman
- Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Ana Olga Mocumbi
- Universidade Eduardo Mondlane, Maputo, Mozambique.
PEN-Plus Partnership study group
Publication Details
Journal/Conference
BMJ open
Type
Journal Article
Peer Review
Unknown
Volume
14
Issue
1
Pages
e074182
Project
N/A
Publisher
BMJ open
Resource Category
Publication
Language
en
Visibility
public
Status
published
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