Research, Chagas

How to Take Decisions that Will Have a Higher Health Impact

ISGlobal develops a tool to improve comprehensive care strategies for Chagas disease

Healthcare Unit in Cochabamba, Bolivia. Photo by Ana Ferreira.
Photo: Ana Ferreira

A tool that helps improve strategies for the comprehensive care of Chagas and other neglected tropical diseases? Its name is Xtrategy and it has been developed by ISGlobal, an institution supported by “la Caixa” Foundation, and the Illinois Institute of Technology. The tool has been tested in Bolivia with help from partners of the Chagas Coalition, and partners from the Chagas Coalition. The results have just been published in PLoS NTDs

Based on the WHO’s ‘building blocks’ model of healthcare systems, Xtrategy is a software tool that enables better decision-making by health authorities, from the local to the national level. This easy-to-use software provides a strong support to people responsible for planning strategies for the comprehensive care of Chagas disease, since it will allow them to increase the impact of their decisions. One of the advantages of the tool is that it can be adapted for planning interventions for any disease.

“To develop Xtrategy, we used a mathematical analysis approach adapted by Ainize Cidoncha, which uses a decision model based on multiple criteria,” explains Maria Jesús Pinazo, director of the Chagas Initiative at ISGlobal-Hospital Clinic and lead author of the study, conducted together with Faustino Torrico from the CEADES foundation in Bolivia and other project partners.

The added value of this project is that it responds to the need of developing a rational planification to address neglected tropical diseases in low- and middle-income countries, by prioritizing the necessary interventions and actions.

A key element for this project were the data provided, through interviews and surveys, by experts and authorities in six areas of the country where the tool was tested throughout 2019. Xtrategy is designed to give support particularly when planning and designing strategies that expand and adapt comprehensive healthcare.

The advantage of this model is that it not only includes the identification and evaluation of interventions for comprehensive Chagas care, but also the activities the health system must undertake in order to implement them at a larger scale. Thanks to an established classification of actions and interventions, the tool predicts how much impact a decision will have and how complex it will be to implement, depending on the setting where it is taken.  

“Our plan, from the moment we started developing Xtrategy, was to apply the model and evaluate it in different areas of Bolivia, in the context of Chagas disease.  But we have seen that it can be adapted to other countries and other neglected or prevalent diseases,” says Pinazo.

The tool was tested in Bolivia with support from the Spanish Cooperation Agency (AECID) and the collaboration of the Global Chagas Coalition, ISGlobal, Ayuda en Acción, the CEADES foundation, and the Nor Sud Intercultural Foundation.    

Xtrategy is publicly available on the website of the Chagas Coalition.  


Pinazo MJ, Cidoncha A, Gopal G, et al. Multi-criteria decision analysis approach for strategy scale-up with application to Chagas disease management in Bolivia. PLoS Negl Trop Dis. 2021 Mar 26;15(3):e0009249