Despite this, use of BP lowering treatments for CVD risk reduction in rural India & Indonesia is limited, even when low-cost medications are available in the primary healthcare formularies. This is where the SMART (Systematic Medical Appraisal Referral and Treatment) health, an android-based technology platform, aims to deliver low-cost, high-quality healthcare through the existing government-funded primary healthcare system. SMARThealth Extend proposes to test an innovative, multifaceted intervention that draws on three elements: capacity strengthening of primary care doctors and non-physician health workers (NPHW); development of a mobile device-based clinical decision support system (CDSS) for use by these healthcare providers; and integration of this system within the existing public primary healthcare sector. The study tries to address the existing gaps (both manpower and technology) in the primary health care system by using an android application for measuring the CVD risk of adults between 40-85 years of age through household screening by trained non-physician healthcare workers (ASHAs in India and Cadres in Indonesia).
Based on the analysis of patient data by the app, the NPHW can recommend preventive measures, such as behavioural changes relating to tobacco use, physical activity and diet, as well as refer those at high risk to physicians at the primary healthcare facility. The physician at the facility also manages high risk patients with the support of the CDSS, by reinforcing behavioural change messages and prescribing preventive medications. The prime objective of the intervention is the risk reduction for CVD through optimal management of risk factors, utilizing methods to strengthen the existing public healthcare system.
The aim of this demonstration project is to determine whether the SMARThealth platform can be appropriately and rapidly customized and implemented in two large rural communities (in the Indonesian province of East Java and the northern Indian state of Haryana). Mixed methods evaluation will be used to assess feasibility, acceptability, scalability and sustainability in both the sites while in Indonesia, an additional evaluation of effectiveness will be undertaken.
The Pfizer Foundation, provided grant funding to support The George Institute for Global Health’s implementation of this program. The Pfizer Foundation is a charitable organization established by Pfizer Inc. It is a separate legal entity from Pfizer Inc. with distinct legal restrictions.
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