Cascade Analysis: An Adaptable Implementation Strategy Across HIV and Non-HIV Delivery Platforms.

摘要: BACKGROUND Cascades have been used to characterize sequential steps within a complex health system and are in diverse disease areas across prevention, testing, treatment. Routine data great potential inform prioritization system, but often inaccessible frontline care workers (HCWs) who may the greatest opportunity innovate improvement. METHODS The cascade analysis tool (CAT) is an Excel-based, simple simulation model with optimization function. It identifies step that could most improve system. original CAT was developed for HIV treatment prevention of mother-to-child transmission HIV. RESULTS has adapted 7 times: mobile application transmission; hypertension screening management mental outpatient services Mozambique; pediatric adolescent testing treatment, family planning, cervical cancer Kenya; naloxone distribution opioid overdose reversal United States. main domains adaptation technical-estimating denominators structuring be binary steps-as well as logistical-identifying acceptable approaches abstraction aggregation, not overburdening HCW. DISCUSSION allows prompt feedback HCWs, increases HCW autonomy, managers allocate resources time equitable manner. effective, feasible, implementation strategy prioritize requiring improvement systems, although adaptations being currently evaluated.