Innovations in Community-Based Health Care for Cardiometabolic Diseases
Authors: Rohina Joshi, Andre Pascal Kengne, Fred Hersch, Mary Beth Weber, Helen McGuire, Anushka Patel
The evidence pertaining to two important strategies for extending health services into communities in low- and middle-income countries (LMICs) for preventing and managing cardiometabolic and chronic lung conditions and risk factors is reviewed in this chapter: (1) focusing on task-shifting, defined as assigning health care management and prevention tasks to nonphysicians; and (2) focusing on self-management, with or without support from family or community-based peers. While the two strategies seek to extend health care delivery into the community, they remain different in that the first involves changing the health workforce structure and delivery of health care, while the second involves educating patients to understand the condition and empowering them to make informed choices in day-to-day management. Two case studies outline examples of initiatives used in communities in LMICs. Innovative approaches to extending the care of people with cardiometabolic and chronic lung conditions into the community will likely prove crucial components of any suite of strategies to reduce the burden of disease in LMICs.