Implementing a telemedicine and remote-mentoring platform to provide integrated noncommunicable disease and COVID-19 care in primary care facilities in rural Pakistan

As the world struggles to contain the Covid-19 pandemic, the crisis has revealed a great deal about the gaps in global health systems, especially in the low- and middle-income countries (LMICs). Evidence shows that patients with non-communicable diseases (NCDs) are at higher risk of contracting Covid-19 and suffering direct and indirect consequences. Countries are using different digital health strategies and solutions to support the public-health response to COVID-19 worldwide, including virtual clinical care, population surveillance, case identification and contact tracing for management and control of NCDs during the COVID Pandemic. There is an urgent need to strengthen primary care to screen, triage and manage NCDs and at the same time to provide home and community-based solutions to prevent community transmission of COVID-19. All people under care for NCDs are priorities for COVID-19 vaccination education and provision; as well as for identification and care of possible COVID illness. Our study aims to implement an integrated package of care for NCD (mainly hypertension/diabetes) and COVID-19, via telemedicine and tele-mentoring platforms, in primary care facilities in rural Pakistan, and to evaluate its effectiveness using an implementation science framework. Our study is guided by the implementation science RE-AIM framework which tackles health system factors at multiple levels. We will implement the integrated NCD-COVID care in six intervention with six health facilities matched control ones through qualitative and quantitative research methods. The study will improve health services for NCD patients who have high risk to COVID. This study fits into CIHR's Global Health Policy as it aims to improve health equity for vulnerable NCD patients facing immense challenges to accessing quality care during the pandemic.