SMARThealth is a technology-enabled ecosystem that aims to improve the delivery of high-quality essential primary healthcare to communities. A controlled demonstration project of SMARThealth in 4 villages of the Malang district in Indonesia, involving over 20,000 adults, provided evidence that the intervention had acceptable reach, was effective in improving CVD risk screening and management, and was adopted widely with good implementation fidelity.
In the 4 intervention villages, demand for ongoing provision for SMARThealth was strong, from both the community and the district health authority. There is now a unique opportunity to scale-up this intervention more widely in the Malang district, funded by the Malang District Health Authority and Badan Penyelenggara Jaminan Sosial, with technical support and evaluation provided by a research consortium comprised of The George Institute for Global Health, Brawijaya University, and the University of Manchester. This scale-up process will be staged, with an initial “proof of concept” commitment to 100 villages in the Malang District; this application will support the activities of the research consortium through 4 phases – Phase 1 will be a 9-12 month development phase using implementation science methods to ensure “institutionalisation” of critical intervention components; Phase 2 will be a “test of scale-up” vanguard phase in ~20 villages, to help understand how localised adaptions can facilitate scale-up; Phase 3 will be a 24-month implementation phase at scale; and Phase 4 will be a 6-month evaluation period where all the continuously accumulated quantitative and qualitative data will be triangulated to provide evidence on both the process and effectiveness of scale-up.
The research consortium will also take the opportunity to evaluate the process of scale-up to contribute to more generalisable knowledge in the field.
- National Health and Medical Research Council, Australia