Effectiveness of community-based diabetes and hypertension prevention and management programmes in Indonesia and Viet Nam

A quasi-experimental study

Bibliographic Data

ID21878951
AuthorsManuela Fritz (0000-0002-6507-644X, University of Groningen, corresponding author), Michael Grimm (0000-0002-1310-7435, University of Passau), Hoang Thi My Hanh (0000-0002-3818-6061, Health Strategy and Policy Institute), Jaap Koot (0000-0002-6933-0302, University Medical Center Groningen), Giang Hoang Nguyen (Health Strategy and Policy Institute, Hanoi, Viet Nam), Nguyễn Hoàng Giang (0000-0003-4766-7243, Health Strategy and Policy Institute), Thi-Phuong-Lan Nguyen (0000-0001-5266-1765, Thai Nguyen University), Ari Probandari (0000-0003-3171-5271, Sebelas Maret University), Vitri Widyaningsih (0000-0003-0116-7120, Sebelas Maret University), Robert Lensink (0000-0001-6448-5164, University of Groningen)
Year2024
Volume9
Issue5
Pagese015053
Publication date2024-05-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-015053
PMID38777393
OpenAlexW4398224739
LanguageEN
Citations received1
References cited32

Introduction Non-communicable diseases (NCDs) have surpassed infectious diseases as the leading global cause of death, with the Southeast Asian region experiencing a significant rise in NCD prevalence over the past decades. Despite the escalating burden, screening for NCDs remains at very low levels, resulting in undetected cases, premature mortality and high public healthcare costs. We investigate whether community-based NCD prevention and management programmes are an effective solution. Methods In Indonesia, we compare participants in the community-based NCD screening and management programme Pos Pembinaan Terpadu-Penyakit Tidak Menular with matched non-participants with respect to their uptake of screening activities, health-related behaviour and knowledge and metabolic risk factors. We use statistical matching to redress a possible selection bias (n=1669). In Viet Nam, we compare members of Intergenerational Self-Help Clubs , which were offered similar NCD health services, with members of other community groups, where such services were not offered. We can rely on two waves of data and use a double-difference approach to redress a possible selection bias and to measure the impacts of participation (n=1710). We discuss strengths and weaknesses of the two approaches in Indonesia and Viet Nam. Results In Indonesia, participants have significantly higher uptake of screening for hypertension and diabetes (+13% from a control mean of 88% (95% CI 9% to 17%); +93% from a control mean of 48% (95% CI 79% to 108%)). In both countries, participants show a higher knowledge about risk factors, symptoms and complications of NCDs (Indonesia: +0.29 SD (0.13–0.45), Viet Nam: +0.17 SD (0.03–0.30)). Yet, the improved knowledge is only partly reflected in improved health behaviour (Viet Nam: fruit consumption +0.33 SD (0.15–0.51), vegetable consumption +0.27 SD (0.04–0.50)), body mass index (BMI) (Viet Nam: BMI −0.07 SD (−0.13 to −0.00)) or metabolic risk factors (Indonesia: systolic blood pressure: −0.13 SD (−0.26 to −0.00)). Conclusion Community-based NCD programmes are well suited to increase screening and to transmit health knowledge. Due to their extensive outreach within the community, they can serve as a valuable complement to the screening services provided at the primary healthcare level. Yet, limited coverage, insufficient resources and a high staff turnover remain a problem. Trial registration number NCT05239572

Environmental health · Political science · Public health · Redress · Viet nam · Diabetes, Cardiovascular Risks, and Lipoproteins · Global Public Health Policies and Epidemiology · Health Promotion and Cardiovascular Prevention · Medicine · Nursing · Gerontology

Tools

Open DOIOpen Access