abstract: 'Objective

  Design and build a strategy construction and evaluation software system

  to help stakeholders to develop viable strategies to expand (and adapt)

  the Chagas Platform healthcare model through the primary healthcare

  system in Bolivia.

  Methods

  The software was built based on a ranking of medical Interventions and

  Actions (needed to support Interventions'' implementation) needed for

  comprehensive management of Chagas Disease in Bolivia. The ranking was

  performed using a Multi Criteria Decision Analysis (MCDA) methodology

  adapted to the WHO''s building blocks framework. Data regarding the

  criteria and the rankings was obtained through surveys and interviews

  with health care professionals working on Chagas disease. The Analytical

  Hierarchy Process was used to construct the decision criteria weights.

  Data Envelopment Analysis was used to identify the Interventions that

  lay on the efficiency frontier of outcomes and the complexity of

  associated Actions. These techniques were combined with integer

  programing tools using the open-source software R to build a

  decision-making tool to assess the outcomes and complexity of any

  combination of Interventions and Actions. This model and tool were

  applied to data concerning the care of Chagas disease in Bolivia

  collected through surveys of experts. The tool works by loading the data

  from each specific context.

  Results

  The initial set of Interventions and Actions recommended after analysis

  of the survey data was further refined through face-to-face interviews

  with field experts in Bolivia, resulting in a strategy of 18

  Interventions and 15 Actions. Within the WHO model the Leadership and

  Governance building block came up as the one needing more support with

  Actions such as the inclusion of Chagas into Annual Municipal

  Operational Plans by appointing local and provincial coordinators.

  Conclusion

  This project established the suitability of the model for constructing

  healthcare strategies. The model could be developed further resulting in

  a decision-making tool for program managers in a wide range of

  healthcare related issues, including neglected and/ or prevalent

  diseases. The tool has the potential to be used at different stages of

  decision making by diverse stakeholders in order to coordinate

  activities needed to address a health problem.

  Author summary

  This manuscript presents a strategy construction tool to generate viable

  strategies to expand the Chagas platforms for healthcare pilot through

  the primary healthcare system in Bolivia. Relevance of this work resides

  in the need for performing a rational planification to address Neglected

  Diseases in low- and middle-income countries, by prioritizing

  Interventions and Actions. After gathering and loading the data from

  each specific context and problem, policy makers can use the tool for

  construction or evaluation of strategies using the WHO Building Block

  model. The main comparative advantage is that the model does not only

  include the identification and evaluation of Interventions for the

  comprehensive care of Chagas, but also includes the necessary activities

  in the health system to support the large-scale implementation of them.

  The tool has the potential to be used at different stages of decision

  making to coordinate activities to address a health problem. The tool

  could be adapted for its use in other neglected and/ or prevalent

  diseases or in other locations.'
affiliation: 'Pinazo, MJ (Corresponding Author), Hosp Clin Univ Barcelona, Barcelona
  Inst Global Hlth ISGlobal, Barcelona, Spain.

  Pinazo, Maria-Jesus; Gascon, Joaquim, Hosp Clin Univ Barcelona, Barcelona Inst Global
  Hlth ISGlobal, Barcelona, Spain.

  Cidoncha, Ainize; Gopal, Gurram, IIT, Chicago, IL 60616 USA.

  Cidoncha, Ainize, Univ Politecn Cataluna, Barcelona, Spain.

  Moriana, Silvia, Chagas Dis Global Coalit, Barcelona, Spain.

  Saravia, Ruth; Torrico, Faustino, Fdn CEADES, Cochabamba, Bolivia.'
article-number: e0009249
author: Pinazo, Maria-Jesus and Cidoncha, Ainize and Gopal, Gurram and Moriana, Silvia
  and Saravia, Ruth and Torrico, Faustino and Gascon, Joaquim
author-email: mariajesus.pinazo@isglobal.org
author_list:
- family: Pinazo
  given: Maria-Jesus
- family: Cidoncha
  given: Ainize
- family: Gopal
  given: Gurram
- family: Moriana
  given: Silvia
- family: Saravia
  given: Ruth
- family: Torrico
  given: Faustino
- family: Gascon
  given: Joaquim
da: '2023-09-28'
doi: 10.1371/journal.pntd.0009249
files: []
issn: 1935-2735
journal: PLOS NEGLECTED TROPICAL DISEASES
language: English
month: MAR
number: '3'
number-of-cited-references: '18'
orcid-numbers: 'Gascon, Joaquim/0000-0002-5045-1585

  Delgado, Maria Jesús Pinazo/0000-0002-4237-1075'
papis_id: 82ec225746c01a697d7572f17ea2ef8b
ref: Pinazo2021multicriteriadecisio
researcherid-numbers: 'Gascon, Joaquim/M-3598-2015

  Delgado, Maria Jesús Pinazo/X-6093-2018'
times-cited: '3'
title: Multi-criteria decision analysis approach for strategy scale-up with application
  to Chagas disease management in Bolivia
type: article
unique-id: WOS:000634795100003
usage-count-last-180-days: '0'
usage-count-since-2013: '2'
volume: '15'
web-of-science-categories: Infectious Diseases; Parasitology; Tropical Medicine
year: '2021'