Saturday, November 23, 2024
11/23/2024
Project Summary/Abstract Despite a high burden of non-communicable diseases (NCDs) in low- and middle-income countries, little is known about how to deliver patient-centered NCD care in these resource-constrained health systems. One-third of Malawian adults are hypertensive, and nearly all these cases are untreated. Low rates of care-seeking and treatment contribute to very high premature mortality due to NCDs. This project aims to understand patient preferences for receiving hypertension care in Malawi among an “expert” group of adults receiving treatment for HIV; this subpopulation is uniquely well-informed to comment on experiences and preferences for chronic disease care. We will conduct (1) a discrete choice experiment, with HIV+ and HIV- adults who have been prescribed at least one medication for hypertension, to understand care- seeking decisions and trade-offs in this low-resource context. Additionally, we will conduct (2) interviews with providers and key informants from the health system to understand the potential implications of implementing and scaling up a patient-centered approach to NCD care in Malawi. The project will leverage a long-standing partnership between UCLA and Partners in Hope, a Malawian medical organization. The team has collaborated previously on research, including about HIV and NCDs in Malawi; these earlier preliminary findings inform the proposed work. The ultimate objective is to develop an evidence-based, evaluable intervention for providing NCD care in Malawi. Patient preference and experience studies, as proposed here, are essential for informing the development and implementation of new models of NCD care worldwide. Discrete choice experiments are increasingly popular in health services research, but are used rarely for NCDs. Vulnerable populations face barriers in accessing chronic disease care in many countries, so this study may provide practice and policy insights that are globally relevant. It will also provide recommendations of opportunities to leverage other successful health services (i.e., for HIV care) to address NCDs, which is an area of emerging interest for researchers and policymakers in resource-poor settings worldwide, including in high-income countries.
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