Development of a transdisciplinary people centred intervention plan to reduce the burden of cardiometabolic diseases in local food chain actors in Sacaba, Bolivia

Summary

The prevalence of cardiometabolic (CM) diseases in Bolivia has risen over the last decades. Although, this burden is unevenly distributed, as demonstrated in a prior project conducted by the local team, identifying double the prevalence of CM risk factors, compared with the departmental average, in market sellers in Sacaba, a mixed peri-urban rural municipality of Cochabamba. Many of the market sellers are also family farmers. Since the COVID-19 pandemic, poverty and informal work has grown, while recently introduced health policies such as the free universal health security (SUS, March 2019) lack effective implementation. The participative market action research on which this project builds, focused on the mitigation of COVID-19 in food markets and included a general health assessment. This assessment created awareness in market sellers on the need to access both the health care system and safe and nutritious foods. They identified a knowledge gap, beside organizational and economic barriers, to access health care and a healthy diet at a cost they can afford to maintain. The region of Sacaba, which is the focus of this project, includes 3 urban districts, where a large part of the population works as informal food sellers or transport drivers, and 5 rural districts where most families are small scale farmers. To know what is needed and available to improve the CM health in this region, a comprehensive transdisciplinary population level assessment will be conducted, supported by a transdisciplinary learning community in the fields of health and food systems. (1) At population level, the cardiometabolic health status, including physical and biochemical measures; behavioural and genetic risk factors, social determinants of health, and health literacy will be assessed. (2) At the level of the 14 primary health care centres in this region, the functionality of the health committees as well as the capacity to prevent and manage CM diseases will be assessed and strengthened. (3) Additionally, the local food system will be mapped to understand the local production, availability, access and consumption of foods, and the underlying economic and socio-cultural reasons. All activities will be planned, organized, monitored, and evaluated by the regional social and territorial organizations, supported by the municipal authorities and local health network. The results of the assessment will be shared with all stakeholders, who will co-develop the intervention plan.

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