Decision makers perceptions and experiences of developing population-level interventions targeting risk factors for hypertension and diabetes in South Africa: a qualitative study

BMC Health Services Research

Research Article

Taryn Young¹  Jeannine Uwimana-Nicol²  Lynn Hendricks³ 

[1] Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kicukiro- Kigali, Rwanda;Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Social Research Methodology Group, Faculty of Social Sciences, KU Leuven, Leuven, Belgium;

关键词: Development;    Planning;    Monitoring and evaluation;    Policy;    Program;    Risk factors;    Diabetes;    Hypertension;    Qualitative;    South Africa;   

DOI  :  10.1186/s12913-023-09135-x

 received in 2022-05-04, accepted in 2023-01-31,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPeople in low- and middle-income countries are disproportionately affected by Noncommunicable diseases (NCDs). NCD’s such as heart disease, cancer, chronic respiratory disease, and diabetes, are the leading cause of premature death worldwide and represent an emerging global health threat. The purpose of this qualitative study was to explore decision makers perceptions of developing population-level interventions (policies and programmes), targeting risk factors for hypertension and diabetes, in South Africa.MethodsUsing purposive sampling we recruited fifteen participants, who were well informed about the policies, programs or supportive environment for prevention and management of diabetes and hypertension in South Africa. We conducted 12 individual interviews and 1 group interview (consisting of 3 participants). Data was analysed thematically in NVivo. The results were shared and discussed in two consultative stakeholder workshops, with participants, as part of a member validation process in qualitative research. All communication with participants was done virtually using MS Teams or ZOOM.ResultsFor development of population-level interventions, key enablers included, stakeholders’ engagement and collaboration, contextualization of policies and programs, and evaluation and organic growth. Challenges for supportive policy and program formulation, and to enable supportive environments, included the lack of time and resources, lack of consultation with stakeholders, regulations and competing priorities, and ineffective monitoring and evaluation. The main drivers of population-level interventions for diabetes and hypertension were perceived as the current contextual realities, costs, organizational reasons, and communication between various stakeholders.ConclusionTo address the risk factors for hypertension and diabetes in South Africa, policies and programs must account for the needs of the public and the historical and socio-economic climate. Feasibility and sustainability of programs can only be ensured when the resources are provided, and environments enabled to promote behavior change on a population-level. A holistic public health approach, which is contextually relevant, and evidence informed, is considered best practice in the formulation of population-level interventions.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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