Using systems thinking tools to inform the implementation of a cysticercosis control program in rural Peru
Presenter Biography
Lisset Dumet is a Health Systems and Policy Ph.D. candidate at Oregon Health and Science University and Portland State University School of Public Health. Currently, she is working on her dissertation that applies the One Health approach, a holistic approach that integrates the interaction of humans, animals, and the environment to study the national and regional policy processes and networks for implementing collaborative initiatives to address zoonotic diseases in low-resource settings.
Institution
OHSU
Program/Major
Health Systems and Policy PhD Program
Degree
PhD
Presentation Type
Presentation
Start Date
4-4-2024 11:04 AM
Keywords
systems thinking, implementation science, zoonoses prevention and control, low-resource setting
Abstract
Cysticercosis is an infectious disease responsible for 30-40% of acquired epilepsy in endemic areas such as rural Peru. Ring Treatment (RT) is a community-engaged cysticercosis control strategy, shown to be efficacious when delivered by research teams. We applied the Consolidated Framework for Implementation Research with additional constructs compatible with low-resource contexts in the formative evaluation to develop a protocol for implementing RT.
We included small, medium, and large municipal districts from northern Peru representing different rural primary health delivery settings. We collected 169 semi-structured and 341 network interviews. We applied Social-Network-Analysis to identify key players, roles, and collaborations to inform the RT implementation. We developed process maps to identify the steps and critical people to deliver RT. In preparation for a subsequent pilot study, our team delivered workshops where participants proposed and presented process maps for implementing RT.
Social-Network-Analysis and process mapping tools helped refine the implementation protocol by integrating stakeholder feedback. Districts' network sizes differed among small, medium, and large districts. However, some key players for successful implementation were similar among districts, such as the community health care worker (CHW). The CHW had more nominations in the small district. Proposed process maps created in the workshops identified the importance of integrating other community players in the intervention, such as the mayor, and brought new ideas for community case reporting and incentives.
This presentation describes implementation tools that allowed us to integrate health professionals' feedback for better optimization of the protocol which is currently scaled up in multiple health districts.
Using systems thinking tools to inform the implementation of a cysticercosis control program in rural Peru
Cysticercosis is an infectious disease responsible for 30-40% of acquired epilepsy in endemic areas such as rural Peru. Ring Treatment (RT) is a community-engaged cysticercosis control strategy, shown to be efficacious when delivered by research teams. We applied the Consolidated Framework for Implementation Research with additional constructs compatible with low-resource contexts in the formative evaluation to develop a protocol for implementing RT.
We included small, medium, and large municipal districts from northern Peru representing different rural primary health delivery settings. We collected 169 semi-structured and 341 network interviews. We applied Social-Network-Analysis to identify key players, roles, and collaborations to inform the RT implementation. We developed process maps to identify the steps and critical people to deliver RT. In preparation for a subsequent pilot study, our team delivered workshops where participants proposed and presented process maps for implementing RT.
Social-Network-Analysis and process mapping tools helped refine the implementation protocol by integrating stakeholder feedback. Districts' network sizes differed among small, medium, and large districts. However, some key players for successful implementation were similar among districts, such as the community health care worker (CHW). The CHW had more nominations in the small district. Proposed process maps created in the workshops identified the importance of integrating other community players in the intervention, such as the mayor, and brought new ideas for community case reporting and incentives.
This presentation describes implementation tools that allowed us to integrate health professionals' feedback for better optimization of the protocol which is currently scaled up in multiple health districts.