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dc.contributor.author
Klein, Karen
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dc.contributor.author
Roberti, Javier Eugenio
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Rouvier, Mariel Vanesa
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Belizan, Maria
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Cafferata, Maria Luisa
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Berrueta, Amanda Mabel
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Alonso, Juan Pedro
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dc.date.available
2024-01-09T13:49:56Z
dc.date.issued
2022-12
dc.identifier.citation
Klein, Karen; Roberti, Javier Eugenio; Rouvier, Mariel Vanesa; Belizan, Maria; Cafferata, Maria Luisa; et al.; Design and feasibility of an implementation strategy to address Chagas guidelines engagement focused on attending women of childbearing age and children at the primary healthcare level in Argentina: a pilot study; BioMed Central; BMC Primary Care; 23; 1; 12-2022; 1-9
dc.identifier.uri
http://hdl.handle.net/11336/223021
dc.description.abstract
Background: Chagas is a public health problem, especially in Latin America, exacerbated by migratory movements and increasing urbanization. Argentina is among the countries with the highest estimated prevalence in the region, with 1,500,000 people infected, with mother to child as the main mode of transmission. Vertical transmission has been significantly reduced by treating women of childbearing age; several guidelines in the region recommend treatment as a primary prevention strategy for the child and a secondary prevention strategy for women and their families. Despite recommendations, women of childbearing age are not always treated, and children do not receive timely diagnosis and treatment. The objective of this research was to design an implementation strategy to improve using Chagas guidelines focused on attending women of childbearing age and children at the primary healthcare level and pilot it in three primary health care centers in Argentina. Methods: We conducted a pilot feasibility study using the Consolidated Framework for Implementation Research. A qualitative process evaluation was conducted using semi-structured interviews with health care providers and observations in primary health care centers. Results: We developed a multifaceted implementation strategy including training, flowcharts and reminders, a register of suspected and confirmed cases, and the selection of a management facilitator. The pilot study took place between September 2019 and May 2020. The implementation level was heterogeneous and varied depending on the components, being the facilitating factors, the simplicity of the intervention, professionals’ willingness to expand the indication of serologic tests, and staff commitment to the adoption of intervention components. The main barriers found were the change of authorities at the local level, some professionals´ reluctance to administer etiological treatment, staff shortages, lack of diagnostic supplies, and the health emergency caused by the COVID-19 pandemic. Conclusions: Behavioral change strategies should be applied to improve implementation to address some of the main barriers, including support actions offered by opinion leaders, medical experts, and local health authorities. Rapid diagnostic tests should be readily available to maintain behavior changes. We suggest further refinement of the strategy and its implementation in more centers to assess outcomes prospectively with a hybrid implementation research design.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
BioMed Central
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dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by/2.5/ar/
dc.subject
CHAGAS
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EFFECTIVE INTERVENTION
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FEASIBILITY
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GUIDELINE
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IMPLEMENTATION STRATEGY
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PRIMARY HEALTH CARE
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Ciencias y Servicios de Cuidado de la Salud
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Ciencias de la Salud
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CIENCIAS MÉDICAS Y DE LA SALUD
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dc.title
Design and feasibility of an implementation strategy to address Chagas guidelines engagement focused on attending women of childbearing age and children at the primary healthcare level in Argentina: a pilot study
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2024-01-03T11:47:36Z
dc.identifier.eissn
2731-4553
dc.journal.volume
23
dc.journal.number
1
dc.journal.pagination
1-9
dc.journal.pais
Reino Unido
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dc.journal.ciudad
Londres
dc.description.fil
Fil: Klein, Karen. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
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Fil: Rouvier, Mariel Vanesa. Gobierno de la Provincia de Chaco. Ministerio de Salud Publica; Argentina
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Fil: Belizan, Maria. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Cafferata, Maria Luisa. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Alonso, Juan Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
dc.journal.title
BMC Primary Care
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-022-01886-6
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1186/s12875-022-01886-6
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