Integration and scale-up of a primary healthcare-based chronic wound care package for persons affected by skin-neglected tropical diseases and other conditions in Ethiopia: a protocol for an implementation research study

The profound impact of wounds on the quality of life of those affected is often underestimated. Chronic wounds impose substantial burdens on individuals and communities in terms of disability, mental distress, stigma, and economic productivity losses. To effectively address these challenges, an integrated and comprehensive approach to primary healthcare-based chronic wound care prevention and management is essential. This implementation research study aims to assess the integration and scale-up of a comprehensive package of primary healthcare-based wound care and psychosocial support for persons affected by chronic wounds caused by NTDs and other conditions in selected districts in Ethiopia. The study will be implemented in Central Ethiopia and Amhara Regions in three stages, utilizing a mixed-methods approach to co-develop a comprehensive care package and progressively implement the care package building on learnings from successive stages of implementation. Stage 1 will encompass the co-development of a holistic wound care package and strategies for its integration into routine primary health services. Stage 2 will involve a pilot study in one sub-district, to establish the care package’s adoption, feasibility, acceptability, fidelity, potential effectiveness, readiness for scale-up, and costs. Stage 3 will involve the scale-up of the wound care package and its evaluation in several districts. This implementation research on integration and scale up of chronic wound care within primary health services will substantially improve access to care and support for affected persons in Ethiopia. It will also have critical contribution to the national wound care and integrated early detection, management and reporting of chronic wound due to skin-NTDs and other chronic health conditions government initiative in the primary health care system of Ethiopia. The finding from this embedded implementation research will be disseminated to relevant stakeholders using a variety of channels to inform policymaking and program design. Persons affected by chronic wounds and their family, healthcare providers, and program planners will benefit from this study.