{
  "abstract": "Introduction Community-based healthcare approaches can improve outcomes and reduce costs for long-term physical and mental health conditions. To design, evaluate and implement such interventions, it is essential to explore the existing resources of community and healthcare institutions, understand stakeholder perspectives and identify potential barriers and facilitators to community-based care for non-communicable diseases. Our aim was to conduct a situation analysis to better understand and contextualise community-based care for long-term physical and mental health conditions in Bolivia, Colombia and Guatemala.Methods A multimethod approach was used, incorporating three data sources: (1) sociodemographic and morbidity indicators from selected regions and healthcare centres; (1) quantitative surveys completed by health centre management staff and (2) semistructured interviews with healthcare workers, patients, caregivers and community leaders. These tools helped assess the capacity of health centres, as well as barriers and facilitators for community-based care. Data were analysed using descriptive statistics and thematic framework analysis.Results 25 health centres across the three countries were included: 12 were of low complexity, 21 in urban areas and 20 used electronic medical records. Daily seen patients ranged from 1 to 270. Most of the centres had general practitioners and nursing staff, with 72% having psychologists, 24% psychiatrists and 50% specialists in cardiovascular or metabolic conditions. Barriers to community-based care included duration and frequency of appointments, a shortage of both administrative and clinical staff, a lack of continuity in treatment, long distances for patients to travel, inadequate facilities and mental health stigma.Conclusion Community interventions aim to manage long-term physical and mental health conditions; however, identified barriers may limit their implementation within the existing healthcare infrastructure and should be addressed when introducing new approaches.",
  "authors": [
    {
      "affiliations": [
        "Department of Clinical Epidemiology and Bioestatistics, Pontificia Universidad Javeriana, Bogotá, Colombia"
      ],
      "name": "Juan Camilo Marin-Urrego"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology and Bioestatistics, Pontificia Universidad Javeriana, Bogotá, Colombia"
      ],
      "name": "Adriana Buitrago-Lopez"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology and Bioestatistics, Pontificia Universidad Javeriana, Bogotá, Colombia",
        "Hospital Universitario San Ignacio, Bogotá, Colombia",
        "Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia"
      ],
      "name": "Carlos Gomez-Restrepo"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud, Universidad Rafael Landivar, Guatemala City, Guatemala"
      ],
      "name": "Edgar Lopez Alvarez"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud Santa Cruz, Universidad Privada Franz Tamayo, Santa Cruz de la Sierra, Bolivia"
      ],
      "name": "Ronald Fernando Tapia Pijuan"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud Santa Cruz, Universidad Privada Franz Tamayo, Santa Cruz de la Sierra, Bolivia"
      ],
      "name": "Lucia Elena Alvarado-Arnez"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud Santa Cruz, Universidad Privada Franz Tamayo, Santa Cruz de la Sierra, Bolivia"
      ],
      "name": "Estela Tango-Camargo"
    },
    {
      "affiliations": [
        "Department of Preventive and Social Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia"
      ],
      "name": "Yazmin Cadena-Camargo"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology and Bioestatistics, Pontificia Universidad Javeriana, Bogotá, Colombia"
      ],
      "name": "David Niño-Torres"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology and Bioestatistics, Pontificia Universidad Javeriana, Bogotá, Colombia"
      ],
      "name": "Nelcy Rodriguez-Malagon"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology and Bioestatistics, Pontificia Universidad Javeriana, Bogotá, Colombia"
      ],
      "name": "Isabela Osorio Jaramillo"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud Santa Cruz, Universidad Privada Franz Tamayo, Santa Cruz de la Sierra, Bolivia"
      ],
      "name": "Shirley Nicole Andrade Azcui"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud Santa Cruz, Universidad Privada Franz Tamayo, Santa Cruz de la Sierra, Bolivia"
      ],
      "name": "Patricia Cabaleiro"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud Santa Cruz, Universidad Privada Franz Tamayo, Santa Cruz de la Sierra, Bolivia"
      ],
      "name": "James Yhon Robles Pinto"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud Santa Cruz, Universidad Privada Franz Tamayo, Santa Cruz de la Sierra, Bolivia"
      ],
      "name": "Luis Felipe Osinaga Robles"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud, Universidad Rafael Landivar, Guatemala City, Guatemala"
      ],
      "name": "Luis Padilla-Vassaux"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud, Universidad Rafael Landivar, Guatemala City, Guatemala"
      ],
      "name": "Carmen Maria Sanchez-Nochez"
    },
    {
      "affiliations": [
        "Facultad de Ciencias de la Salud, Universidad Rafael Landivar, Guatemala City, Guatemala"
      ],
      "name": "Candelaria Letona"
    },
    {
      "affiliations": [
        "Institute of Public Health and Wellbeing, University of Essex, Colchester, UK",
        "Wolfson Institute of Population Health, Queen Mary University of London, London, UK"
      ],
      "name": "Victoria Jane Bird"
    }
  ],
  "title": "Understanding the community management of long-term physical and mental health conditions in Bolivia, Colombia and Guatemala: a situational analysis",
  "uid": "0dd90831-0e36-5c39-97df-ac15c6fdf6a2"
}