Browsing by Author "Lu, Hongsheng"

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    Feasibility assessment of invigorating grassrooTs primary healthcare for prevention and management of cardiometabolic diseases in resource-limited settings in China, Kenya, Nepal, Vietnam (the FAITH study): rationale and design.
    (Global health research and policy, 2019-01) Gong, Enying; Lu, Hongsheng; Shao, Shuai; Tao, Xuanchen; Peoples, Nicholas; Kohrt, Brandon A; Xiong, Shangzhi; Kyobutungi, Catherine; Haregu, Tilahun Nigatu; Khayeka-Wandabwa, Christopher; Van Minh, Hoang; Hanh, Tran Thi Duc; Koirala, Suraj; Gautam, Kamal; Yan, Lijing L
    Background:Cardiometabolic diseases are the leading cause of death and disability in many low- and middle-income countries. As the already severe burden from these conditions continues to increase in low- and middle-income countries, cardiometabolic diseases introduce new and salient public health challenges to primary health care systems. In this mixed-method study, we aim to assess the capacity of grassroots primary health care facilities to deliver essential services for the prevention and control of cardiometabolic diseases. Built on this information, our goal is to propose evidence-based recommendations to promote a stronger primary health care system in resource-limited settings. Methods:The study will be conducted in resource-limited settings in China, Kenya, Nepal, and Vietnam using a mixed-method approach that incorporates a literature review, surveys, and in-depth interviews. The literature, statistics, and document review will extract secondary data on the burden of cardiometabolic diseases in each country, the existing policies and interventions related to strengthening primary health care services, and improving care related to non-communicable disease prevention and control. We will also conduct primary data collection. In each country, ten grassroots primary health care facilities across representative urban-rural regions will be selected. Health care professionals and patients recruited from these facilities will be invited to participate in the facility assessment questionnaire and patients' survey. Stakeholders - including patients, health care professionals, policymakers at the local, regional, and national levels, and local authorities - will be invited to participate in in-depth interviews. A standard protocol will be designed to allow for adaption and localization in data collection instruments and procedures within each country. Discussion:With a special focus on the capacity of primary health care facilities in resource-limited settings in low- and middle-income countries, this study has the potential to add new evidence for policymakers and academia by identifying the most common and significant barriers primary health care services face in managing and preventing cardiometabolic diseases. With these findings, we will generate evidence-based recommendations on potential strategies that are feasible for resource-limited settings in combating the increasing challenges of cardiometabolic diseases.
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    Strengthening Urban Primary Healthcare Service Delivery through the Use of eHealth Programs - The SUPER Study in Peru
    (2020) Lu, Hongsheng

    Background: Primary healthcare is an important facet of non-communicable disease treatment and eHealth is a viable strategy to strengthen PHC in urban low-middle income settings such as in Lima, Peru. This study aimed to describe the current use of eHealth technologies in primary healthcare settings in urban Peru, assess the perceived effectiveness of eHealth technologies in NCD service delivery at the PHC level, and identify barriers and facilitators to the utilization of eHealth technologies at the PHC level.

    Methods: In-depth interviews using a semi-structured interview guide were conducted among identified and invited policy makers, researchers and experts, and healthcare workers in Lima, Peru. Three districts in Lima were selected and interviews with healthcare workers were conducted at facilities from those districts. Interviews were transcribed and thematic analysis was utilized to identify themes in the data.

    Results: A total of 14 participants were interviewed, including 2 policymakers, 5 experts, and 7 healthcare workers. Current use of eHealth were electronic medical records and telehealth applications. Participants were in favor of eHealth use and perceived eHealth as being effective. Human resources and digital literacy were factors cited as facilitators while data security, political climate, and compatibility were seen as barriers to implementation and utilization of eHealth.

    Conclusions: The use of eHealth in Peru is still in its early stages, particularly in PHC settings and for service delivery of NCDs. At the intersection of these three topics there has been little progression of integration and utilization. Sentiment towards eHealth among researchers, policymakers, and healthcare workers is high and a number of barriers must be addressed to implement and utilize eHealth and reap its benefits.