Test

Once the roadmap is defined and approved by the Steering Committee, the Operational Committee – potentially supported by Implementation Working Groups (step 2) – can start with implementation. The interventions in CARDIO4Cities in Practice have been validated in other CARDIO cities and could be considered for immediate city-wide roll-out. However, to ensure the best possible implementation in a new city, a stepwise approach may be preferrable:

• Initial implementation should target high-priority areas with the highest potential impact to demonstrate value and evaluate interventions in a subset of health facilities and their catchment areas, or in a certain subpopulation.
• Assess the effectiveness, feasibility, and impact of the interventions through continuous monitoring and data collection of the set of minimum essential data.
• If needed, conduct additional rounds of stakeholder consultations and workshops to refine the interventions. Host “pause and reflect” sessions to evaluate large-scale impact and make necessary adjustments. Use the insights gained to iterate and develop an optimal final solution package.

When selecting pilot health facilities for cardiovascular intervention implementation, factors such as cardiovascular disease-specific services, catchment area, patient volume, patient eligibility criteria, and availability of an on-site pharmacy should be considered. As importantly, commitment of local stakeholders can significantly enhance the success of interventions.

Engage the community through listening and outreach to foster participation and support. Ensure efficient resource allocation and budget management to maximize impact. Lastly, maintain flexibility to adapt to unforeseen challenges and continuously improve strategies based on feedback and outcomes.