’Padayon’: a new digital health model for diabetes and hypertension in rural Philippines

© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Noncommunicable diseases (NCDs) account for 41 million global deaths every year, equating to 71% of global deaths overall. Of the 41 million deaths, 29 million occur in lowincome and middleincome countries (LMICs). However, health system services for prevention, education, screening and treatment of NCDs remain inaccessible to billions of people living in rural regions in LMICs. The WHO has reported that over half the world’s population lack access to the basic health services they need. Digital health has the potential to address the gaps and weaknesses of traditional health systems. Unfortunately, many digital health services do not work in regions with low internet connectivity and low digital literacy. Approximately 3 billion people lack internet connectivity at all. The growth in virtual healthcare during the COVID19 pandemic has been primarily in affluent, metropolitan areas. Digital health needs to better serve the lowincome, rural populations at risk of NCDs. A new digital health model, Padayon, for diabetes and hypertension was designed to address this challenge across LMICs. The focus was the municipality of Pototan, Western Visayas, in rural Philippines. The prevalence of type 2 diabetes among adults in the Philippines is estimated at 7%, comprising almost 4 million cases and accounting for 6.5% of mortality across total deaths in 2020. Cardiovascular disease is the single largest cause of mortality in the Philippines, accounting for 33% of total deaths. There are significant health system weaknesses in Pototan, where residents live on an average income of $3–7 per day and over an hour from healthcare providers. There is a lack of access to basic screening such as random blood sugar (RBS) testing, with a comprehensive panel for diabetes at a private clinic costing 10 times the residents’ daily wage. Residents must travel over an hour Summary box