Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysis
Abstract Background Hypertension and diabetes are on the rise both in Rwanda and South Africa. The responsibility for NCD risk factors cut across different sectors, which makes it complex to effectively manage. Policy-relevant intervention research is thus critical for addressing the NCD challenge....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-16537-3 |
| _version_ | 1797555908532764672 |
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| author | Uwimana Nicol J Nganabashaka JP Tumusiime KD Young T Rehfuess E Burns J |
| author_facet | Uwimana Nicol J Nganabashaka JP Tumusiime KD Young T Rehfuess E Burns J |
| author_sort | Uwimana Nicol J |
| collection | DOAJ |
| description | Abstract Background Hypertension and diabetes are on the rise both in Rwanda and South Africa. The responsibility for NCD risk factors cut across different sectors, which makes it complex to effectively manage. Policy-relevant intervention research is thus critical for addressing the NCD challenge. We conducted a situational analysis in both countries to identify and describe current population-level interventions targeting risk factors for diabetes and hypertension. This paper presents this methodology and shares challenges encountered, and lessons learnt in applying the methodology. Methods We describe a multi-component methodology for conducting a situational analysis, which included a desk review, stakeholder mapping, survey, key informant interviews, and a consultative workshop. This methodology was applied in a standardized manner in two African countries. Following the analysis, the authors held iterative team consultations to reflect on challenges and lessons learnt during this process. Results Key challenges and lessons learnt relate to i) stakeholder recruitment, engagement and retainment; ii) utilization and triangulation of multiple sources of data; and iii) evolving circumstances, particularly related to the Covid-19 pandemic. It proved challenging to recruit stakeholders outside the health sector and in the private sector, as they often do not consider themselves as making or influencing policies and thus were reluctant to engage. The difficulties with responsiveness were often overcome through face-to-face visits, an opportunity to explain the relevance of their participation. With regards to health sector stakeholders and all other stakeholders, continued engagement over prolonged periods of time also turned out to be challenging. Covid-19 restrictions were preserved to be an impediment throughout the conduct of the situational analysis, specifically in South Africa. The use of multi-stage mixed methods was found to be appropriate for addressing the study objectives, as each step yielded unique data, concepts, and perspectives that complemented the other data. Conclusion Conducting a situational analysis is crucial for understanding the current state of interventions and identifying opportunities for new interventions. The multi-component methodology used in two African countries was found to be feasible, appropriate, and informative. Others planning to conduct situational analysis may follow, adapt and improve upon our approach, reacting to the challenges encountered. |
| first_indexed | 2024-03-10T16:54:11Z |
| format | Article |
| id | doaj.art-aa9dd6f2141a483ab3b55ea1587573b6 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-10T16:54:11Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-aa9dd6f2141a483ab3b55ea1587573b62023-11-20T11:11:59ZengBMCBMC Public Health1471-24582023-08-012311810.1186/s12889-023-16537-3Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysisUwimana Nicol J0Nganabashaka JP1Tumusiime KD2Young T3Rehfuess E4Burns J5Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch UniversityCollege of Medicine and Health Sciences, University of RwandaCollege of Medicine and Health Sciences, University of RwandaDivision of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch UniversityInstitute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, LMU MunichInstitute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, LMU MunichAbstract Background Hypertension and diabetes are on the rise both in Rwanda and South Africa. The responsibility for NCD risk factors cut across different sectors, which makes it complex to effectively manage. Policy-relevant intervention research is thus critical for addressing the NCD challenge. We conducted a situational analysis in both countries to identify and describe current population-level interventions targeting risk factors for diabetes and hypertension. This paper presents this methodology and shares challenges encountered, and lessons learnt in applying the methodology. Methods We describe a multi-component methodology for conducting a situational analysis, which included a desk review, stakeholder mapping, survey, key informant interviews, and a consultative workshop. This methodology was applied in a standardized manner in two African countries. Following the analysis, the authors held iterative team consultations to reflect on challenges and lessons learnt during this process. Results Key challenges and lessons learnt relate to i) stakeholder recruitment, engagement and retainment; ii) utilization and triangulation of multiple sources of data; and iii) evolving circumstances, particularly related to the Covid-19 pandemic. It proved challenging to recruit stakeholders outside the health sector and in the private sector, as they often do not consider themselves as making or influencing policies and thus were reluctant to engage. The difficulties with responsiveness were often overcome through face-to-face visits, an opportunity to explain the relevance of their participation. With regards to health sector stakeholders and all other stakeholders, continued engagement over prolonged periods of time also turned out to be challenging. Covid-19 restrictions were preserved to be an impediment throughout the conduct of the situational analysis, specifically in South Africa. The use of multi-stage mixed methods was found to be appropriate for addressing the study objectives, as each step yielded unique data, concepts, and perspectives that complemented the other data. Conclusion Conducting a situational analysis is crucial for understanding the current state of interventions and identifying opportunities for new interventions. The multi-component methodology used in two African countries was found to be feasible, appropriate, and informative. Others planning to conduct situational analysis may follow, adapt and improve upon our approach, reacting to the challenges encountered.https://doi.org/10.1186/s12889-023-16537-3Situational analysisPopulation level interventionsDiabetesHypertensionNon-communicable diseasesMethodology |
| spellingShingle | Uwimana Nicol J Nganabashaka JP Tumusiime KD Young T Rehfuess E Burns J Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysis BMC Public Health Situational analysis Population level interventions Diabetes Hypertension Non-communicable diseases Methodology |
| title | Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysis |
| title_full | Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysis |
| title_fullStr | Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysis |
| title_full_unstemmed | Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysis |
| title_short | Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysis |
| title_sort | taking stock of population level interventions targeting risk factors for hypertension and diabetes in rwanda and south africa methodological reflections and lessons learnt from conducting a multi component situational analysis |
| topic | Situational analysis Population level interventions Diabetes Hypertension Non-communicable diseases Methodology |
| url | https://doi.org/10.1186/s12889-023-16537-3 |
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