Complex inner and outer setting interactions determine feasibility and readiness of developing primary care...

Area of Science:

• Health Systems Research
• Implementation Science
• Public Health Policy

Background:

• Small Island Developing States (SIDS) face unique challenges in developing health registries.
• Non-communicable diseases (NCDs) like diabetes and hypertension are high priorities for registry development in SIDS.
• Understanding implementation factors is crucial for successful registry development in resource-limited settings.

Purpose of the Study:

• To assess the feasibility and readiness for health registry development in SIDS.
• To identify factors influencing the implementation of NCD registries within SIDS health systems.
• To inform strategies for overcoming barriers to registry implementation.

Main Methods:

• Online quantitative surveys and focus groups were conducted with health managers in four SIDS.
• The Consolidated Framework for Implementation Research (CFIR) guided the development of survey and focus group tools.
• Thematic content analysis and a systems archetype approach were used for data synthesis.

Main Results:

• Diabetes and hypertension were identified as priority NCDs for registry development.
• Respondents prioritized patient care monitoring over disease burden or outcomes monitoring.
• Key facilitators included mission alignment and external support, while lack of human resources, funding, and poor information systems were major barriers.

Conclusions:

• Infrastructural and human resource capacity limitations pose significant threats to optimal NCD registry implementation in SIDS.
• Greater inter-country collaboration and enhanced regional support are recommended to address these challenges.
• Addressing systemic weaknesses in human and information infrastructure is vital for registry success.