Strengthening Primary Healthcare Delivery for Diabetes and Hypertension in Eswatini
- Conditions
- Diabetes MellitusHypertension
- Interventions
- Other: CDPOther: DSD
- Registration Number
- NCT04183413
- Lead Sponsor
- University Hospital Heidelberg
- Brief Summary
The WHO-PEN@Scale project is a three-arm cluster-randomized trial that is investigating the population-level effects of a healthcare reform in Eswatini, which aims to strengthen primary care for diabetes and hypertension. Prior to the reform, healthcare for diabetes and hypertension was mostly provided through physician-led teams in hospital outpatient departments. The healthcare reform aims to strengthen the provision of nurse-led care for diabetes and hypertension in primary healthcare facilities and community health worker-led care for these conditions in the facilities' catchment areas. The reform will broadly be guided by the World Health Organization's "Package of Essential Noncommunicable Disease Interventions for Primary Health Care in Low-Resource Settings" (WHO-PEN). The trial will take place at 84 clusters (a primary healthcare facility and its catchment area) across the country.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 3500
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description CDP CDP Health services for diabetes and hypertension are provided in the scope of outreach activities set up on a monthly basis in communities. DSD DSD Clients are invited to participate in one of three Differentiated Service Delivery models tailored to their needs.
- Primary Outcome Measures
Name Time Method Glycemic control (continuous) among adults with diabetes 12 months Mean glycated haemoglobin (HbA1c) among adults aged 40 years and older with diabetes
Systolic blood pressure among adults with hypertension 12 months Mean systolic blood pressure among adults aged 40 years and older with hypertension
- Secondary Outcome Measures
Name Time Method Systolic blood pressure among adults with diabetes or prediabetes 12 months Mean systolic blood pressure among adults aged 40 years and older with diabetes or prediabetes
Diastolic blood pressure among adults with diabetes 12 months Mean diastolic blood pressure among adults aged 40 years and older with diabetes
Diastolic blood pressure among adults with diabetes or prediabetes 12 months Mean diastolic blood pressure among adults aged 40 years and older with diabetes or prediabetes
Diastolic blood pressure among adults with hypertension 12 months Mean diastolic blood pressure among adults aged 40 years and older with hypertension
HbA1c among adults with diabetes or prediabetes 12 months Mean glycated haemoglobin (HbA1c) among adults aged 40 years and older with diabetes or prediabetes
Glycemic control (binary) among adults with diabetes 12 months The proportion of adults aged 40 years and older with diabetes who have an HbA1c less than 7.0%
Glycemic control (binary) among adults with diabetes or prediabetes 12 months The proportion of adults aged 40 years and older with diabetes or prediabetes who have an HbA1c less than 7.0%
Awareness of one's diabetes diagnosis 12 months The proportion of adults aged 40 years and older with diabetes who report to have been diagnosed with diabetes prior to the household survey
Awareness of one's diabetes or prediabetes diagnosis 12 months The proportion of adults aged 40 years and older with diabetes or prediabetes who report to have been diagnosed with diabetes or prediabetes prior to the household survey
Probability of having been tested for diabetes among adults with diabetes or prediabetes 12 months The proportion of adults aged 40 years and older with diabetes or prediabetes who report to have ever been tested for diabetes
Probability of smoking among adults with diabetes, prediabetes, or hypertension 12 months The proportion of adults aged 40 years and older with diabetes, prediabetes, or hypertension who report to be a current smoker
Time spent doing moderate- or vigorous-intensity exercise among adults with diabetes, prediabetes, or hypertension 12 months The mean number of minutes in a typical week spent doing moderate- or vigorous-intensity exercise among adults aged 40 years and older with diabetes
Awareness of one's hypertension diagnosis 12 months The proportion of adults aged 40 years and older with hypertension who report to have been diagnosed with hypertension prior to the household survey
Probability of being treated for hypertension among adults with hypertension 12 months The proportion of adults aged 40 years and older with hypertension who report to be taking blood-pressure-lowering medication
Probability of being treated for diabetes among adults with diabetes 12 months The proportion of adults aged 40 years and older with diabetes who report to be taking medication for their diabetes
Systolic blood pressure among adults with diabetes 12 months Mean systolic blood pressure among adults aged 40 years and older with diabetes
Probability of having been tested for diabetes among adults with diabetes 12 months The proportion of adults aged 40 years and older with diabetes who report to have ever been tested for diabetes
Probability of having been tested for hypertension among adults with hypertension 12 months The proportion of adults aged 40 years and older with hypertension who report to have ever had their blood pressure measured
Hypertension control (binary) among adults with hypertension 12 months The proportion of adults aged 40 years and older with hypertension who have a systolic blood pressure \<140 mm Hg and a diastolic blood pressure \<90 mm Hg
Frequency of drinking alcohol in the past 12 months among adults with diabetes, prediabetes, or hypertension 12 months The proportion of adults aged 40 years and older with diabetes, prediabetes, or hypertension who report to having drunk daily, 5-6 days per week, 3-4 days per week, 1-2 days per week, 1-3 days per month, less than once a month, or never over the past 12 months.
21. Knowledge on diabetes and hypertension among adults with diabetes, prediabetes, or hypertension 12 months The proportion of adults aged 40 years and older with diabetes, prediabetes, or hypertension who correctly responded to each individual question on diabetes and hypertension related knowledge.
Trial Locations
- Locations (1)
Clinton Health Access Initiative
🇸🇿Mbabane, Swaziland