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.
Highlights
Noncommunicable diseases (NCDs), such as diabetes, are a major global public health problem and are closely linked to poverty [1]
This study aims to evaluate the implementation of comprehensive diabetes care in two low-resource settings with different cultural, territorial, economic, and social conditions in Ecuador and to stimulate context-led health systems innovations to improve diabetes care and reduce inequity
To evaluate the implementation of diabetes care according to the 2017 Clinical Practice
Summary
Noncommunicable diseases (NCDs), such as diabetes, are a major global public health problem and are closely linked to poverty [1]. NCDs are more prevalent among low-income population groups with NCDs, and on the other hand, people with. NCDs have additional challenges in productivity which can impact economic development. Diabetes can lead to major health complications, as well as increasing the risk of all-cause 4.0/).
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