Improving the detection and management of non-communicable diseases among the adult population of the catchment areas of a rural primary healthcare unit in Sidama National Regional State, Ethiopia: A study protocol

BackgroundThe World Health Organization has designed a package of essential non-communicable diseases (PEN) strategy to improve the detection and management of NCDs. However, the implementation of the PEN in Ethiopia is at an early stage and the readiness of rural primary healthcare units (PHCUs) to implement the strategy is unknown. We, therefore, propose to apply the strategy in the catchment areas of Dobe-Toga Health Center, a rural PHCU in Sidama National Regional State (SNRS), Ethiopia, and improve the NCDs care among adults aged[≥]45 years. AimWe aim to determine the prevalence of undiagnosed hypertension, pre-T2DM mellitus, T2DM, and comorbidity of hypertension and T2DM among the older adults in the study areas, apply the WHO-PEN- based care model for the participants diagnosed with T2DM and/or hypertension and evaluate its effectiveness in controlling blood glucose and/or pressure. The readiness of PHCUs to implement the WHO-PEN approach in the region will also be determined. Additionally, we examine the influence of diagnosis with hypertension and/or T2DM on the willingness of the study participants to join and/or renew membership in community-based health insurance (CBHI). MethodsThe study will be conducted in catchment areas of Dobe-Toga Health Center from April to November 2024. A cross-sectional survey of 41 health centers and 4 primary hospitals, triangulated with qualitative data, will be employed to assess the readiness of the PHCUs to implement the WHO-PEN interventions while the qualitative data for this study has not been collected yet, the quantitative data was collected through observation checklist of inputs. The remaining studies will be conducted in two phases. In Phase 1, cross- sectional surveys will be conducted to determine the prevalence of undiagnosed hypertension, T2DM, pre- T2DM, and comorbidity of T2DM and hypertension in a randomly selected sample of 3301 older adults. Additionally, the participants willingness to pay (WTP) for HbA1c tests will be assessed, and CBHI-related surveys will be conducted. In the second phase, the cohorts will be linked to the health center and will receive the WHO-PEN-based care model. In phase 2, the effects of the care model in controlling blood pressure and glucose will be examined. Furthermore, the adherence to self-care practices of the cohorts will be determined.