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Mapping stages, barriers and facilitators to the implementation of HEARTS in the Americas initiative in 12 countries. A qualitative study

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dc.contributor.authorGiraldo, Gloria P.
dc.contributor.authorJoseph, Kristy T.
dc.contributor.authorAngell, Sonia Y.
dc.contributor.authorCampbell, Norm R. C.
dc.contributor.authorConnell, Kenneth
dc.contributor.authorDiPette, Donald J.
dc.contributor.authorEscobar, Maria C.
dc.contributor.authorValdés-Gonzalez, Yamile
dc.contributor.authorJaffe, Marc G.
dc.contributor.authorMalcolm, Taraleen
dc.contributor.authorMaldonado, Javier
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorOlsen, Michael H.
dc.contributor.authorOrdunez, Pedro
dc.contributor.researchgroupMasiraspa
dc.date.accessioned2022-02-18T16:53:28Z
dc.date.available2022-02-18T16:53:28Z
dc.date.issued2021-03-18
dc.descriptionDigitalspa
dc.description.abstractThe World Health Organization (WHO) Global Hearts Initiative offers technical packages to reduce the burden of cardiovascular diseases through population-wide and targeted health services interventions. The Pan American Health Organization (PAHO) has led implementation of the HEARTS in the Americas Initiative since 2016. The authors mapped the developmental stages, barriers, and facilitators to implemen-tation among the 371 primary health care centers in the participating 12 countries. The authors used the qualitative method of document review to examine cumula-tive country reports, technical meeting notes, and reports to regional stakeholders. Common implementation barriers include segmentation of health systems, overcom-ing health care professionals' scope of practice legal restrictions, and lack of health information systems limiting operational evaluation and quality improvement mecha-nisms. Main implementation facilitators include political support from ministries of health and leading scientific societies, PAHO's role as a regional catalyst to implemen-tation, stakeholder endorsement demonstrated by incorporating HEARTS into official documents, and having a health system oriented to primary health care. Key lessons include the need for political commitment and cultivating on-the-ground leadership to initiate a shift in hypertension care delivery, accompanied by specific progress in the development of standardized treatment protocols and a set of high-quality medicines. By systematizing an implementation strategy to ease integration of interventions into delivery processes, the program strengthened technical leadership and ensured sus-tainability. These study findings will aid the regional approach by providing a staged planning model that incorporates lessons learned. A systematic approach to imple-mentation will enhance equity, efficiency, scale-up, and sustainability, and ultimately improve population hypertension control.spa
dc.description.researchareaCiencias Médicas y de la Saludspa
dc.format.extent11 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doi10.1111/jch.14157
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/6054
dc.language.isoengspa
dc.publisherThe JCH The Journal of Clinical Hypertensionspa
dc.publisher.placeUSAspa
dc.relation.citationendpage765spa
dc.relation.citationissue4spa
dc.relation.citationstartpage755spa
dc.relation.citationvolume23spa
dc.relation.citesGiraldo GP, Joseph KT, Angell SY, et al. Mapping stages, barriers and facilitators to the implementation of HEARTS in the Americas initiative in 12 countries: A qualitative study. J Clin Hypertens. 2021;23:755–765. https://doi.org/10.1111/jch.14157
dc.relation.indexedScopusspa
dc.relation.ispartofjournalJournal of Clinical Hypertensionspa
dc.rights© 2021 Pan American Health Organization. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://onlinelibrary.wiley.com/doi/10.1111/jch.14157spa
dc.titleMapping stages, barriers and facilitators to the implementation of HEARTS in the Americas initiative in 12 countries. A qualitative studyspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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