O-21 Feasibility and readiness assessment of small island developing states for development and strengthening of primary care registries

Methods: We used a sequential mixed methods design to conduct this study in four SIDS. We  examined  feasibility and readiness, focusing particularly on resource availability (human, financial, technolgical), headership and team engagement and access to knowledge and information resources relevant to registry development. We sent an online survey to NCD stakeholders identified through snowball sampling and followed this with four in-depth focus groups (4–8 persons each) which sought to clarify and con- textualize the responses to the quantitative survey. Questionnaire development and qualitative analysis were both guided by the consolidated framework for implementation research (CFIR). Focus groups with each of four countries were recorded, transcribed verbatim and analyzed using thematic content analysis guided by theory-based deductively derived coding framework.

Results:  Feasibility scores ranged  from  13 to  19  (maximum =28); readiness scores ranged from 3 to 9 (maximum=9). Respondents reported there was verbal support from the outer setting (political political directorate) for the establishment of registries in territories. The inner setting (ministries  and clinics) of several territories had structural deficits including the presence of paper-based health information systems, lack of unique identifiers, lack of registry science knowledge and insufficient number of human resources. Individuals interviewed currently  conducted many roles and  thus it was unclear from several territories who would constitute the registry team. Despite these challenges, leadership engagement was generally high and respondents described that success of these ventures usually relied on the high value/level of relational connectedness that existed.

Conclusion: There was high interest at central government levels in NCD registry development but infrastructural and human resource capacity barriers likely contribute to implementation deficit in all territories.