The following is a summary of “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” published in the November 2022 issue of Primary Care by Klein et al.
Migration and urbanization contribute to the spread of Chagas disease, a major public health concern in Latin America. Transmission from mothers to their children is the primary route of spread, making Argentina 1 of the countries with the greatest estimated prevalence in the region (1,500,000 infected). Reducing the risk of vertical transmission by treating women of reproductive age has proven effective. Numerous regional guidelines support this approach as a primary prevention strategy for the child and a secondary prevention strategy for women and their families. Women of childbearing age are not always treated, and children are not always diagnosed and treated promptly, despite recommendations. The purpose of this study was to develop and test an implementation plan to increase adherence to the Chagas guidelines for primary healthcare providers treating women of reproductive age and children in three Argentine primary healthcare facilities.
Using the Consolidated Framework for Implementation Research, researchers tested the waters with a small-scale feasibility study. Semi-structured interviews with healthcare providers and field observations in primary care settings were used to compile this qualitative process evaluation. As a result, they came up with a comprehensive rollout plan involving training, flowcharts and reminders, an incident log for both suspected and verified cases, and the appointment of a management facilitator. The time frame for the pilot research was from September 2019 to May 2020. Staff commitment to adopting intervention components, professionals’ willingness to broaden the indication of serologic tests, and the presence of supportive variables were all factors that affected the implementation level.
The COVID-19 pandemic health emergency, personnel shortages, a lack of diagnostic supplies, and the reluctance of some experts to offer etiological treatment were identified as the key obstacles. Some key barriers can be overcome with the help of behavioral change initiatives, such as those of opinion leaders, medical professionals, and local health authorities. Maintaining behavioral modifications requires ready access to rapid diagnostic tests. Researchers recommend adjusting the technique and rolling it out to more facilities so that a hybrid implementation research design can be used to evaluate results prospectively.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-022-01886-6
