SCUBY · SCale Up an integrated care package for diaBetes and hYpertension for vulnerable people in Cambodia, Slovenia and Belgium

Background. Diabetes and hypertension are increasingly dominant in the global burden of disease. Effective interventions for prevention, detection, treatment and control of both conditions are available, but do not reach all people in need. Countries are struggling how to scale-up interventions sustainably and effectively. There is an urgent need to develop and document strategies on how to do so. Method. This project examines the scale-up of existing evidence-based packages for control of diabetes and/or hypertension with five components: (a) identification of people with HT and/or T2D and (b) treatment in primary care services, (c) health education and (d) self-management support to patients and caregivers, and (e) collaboration among caregivers. The project develops, implements and evaluates roadmaps for the national scale-up of this package, in three different types of countries: a low-middle income country with a developing health system (Cambodia), a former socialist country with a centralised health system (Slovenia), and a Western European country with a decentralised system (Belgium).The research objectives are: 1) to analyse the organisational capacity to scale-up the integrated care package and to assess contextual barriers and facilitators; 2) to develop and implement roadmaps for a national scale-up strategy in each country; 3) to evaluate the impact of scale-up on health outcomes and costs; and 4) to generate lessons for other countries. Outcomes. The project will result in comprehensive scale-up strategies and increased diabetes and hypertension control in each country. The involvement of policy-makers, professionals and patients will ensure the local relevance and impact. The project is innovative in applying the conceptual insights from scale-up science to the field of noncommunicable diseases. The lessons on scale-up will benefit policy-makers in other countries with similar contexts.