Effect of the Community-based SPARSH Program on Control of Selected NCDs: Mixed Methods Evaluation.

Area of Science:

• Public Health
• Health Services Research
• Noncommunicable Disease Management

Background:

• Community-based noncommunicable disease (NCD) management faces challenges like poor treatment adherence, high costs, and limited care access.
• Understanding patient perspectives on low treatment adherence is crucial for improving NCD outcomes.

Purpose of the Study:

• To evaluate the effect of the community-based SPARSH program on NCD treatment adherence, expenditure, and disease control.
• To identify patient-reported reasons for low treatment adherence.

Main Methods:

• A mixed-methods evaluation design combining quantitative (cross-sectional survey of 850 NCD patients) and qualitative (free list) components.
• Path analysis was used to assess the SPARSH program's impact on treatment adherence and NCD control (hypertension, diabetes).
• Qualitative data explored reasons for low treatment adherence among patients.

Main Results:

• Patients enrolled in the SPARSH program demonstrated significantly better treatment adherence.
• High treatment adherence (90%) was associated with improved control of hypertension and diabetes (90%).
• Key reasons for low adherence included forgetting medication, cost, and perceived improvement in health status.

Conclusions:

• The SPARSH program effectively improves treatment adherence and NCD control, particularly for hypertension and diabetes.
• Program strategies like home visits, counseling, and doorstep medication delivery are vital for enhancing adherence.
• Community-based interventions are essential for overcoming barriers in NCD management.