Understanding low mobilization for non-communicable diseases among people living with NCDs: A qualitative study on hypertension in urban South India

Abstract Background One of the effective strategies to prevent and control Non- communicable diseases risk factors is to identify priorities and problems of Non-communicable programs. this study was conducted to identify the challenges of non-communicable diseases programs in order to improve programs development. Methods This study was a qualitative study which was carried out in 5 universities of medical sciences and the Ministry of Health in 2019 year. The sampling method was purposive and the participants include specialists in the field of NCD who have executive and research experience in this field. Data were collected through 40 individual interviews with health professionals and care providers. Data were analyzed by content analysis using CIPP model. Results In the present study, problems of non-communicable disease programs were identified in 4 main categories, 12 sub-categories including inadequate participation of all levels of service delivery in program development, needs assessment, budget allocation, data and program evaluation system. Conclusions Some problems of non-communicable diseases programs included inadequacy of needs assessment, lack of prioritization based on local and regional conditions, program evaluation system. Paying attention to the mentioned points will help to solve underlying problems and improve the processes of developing, implementing and evaluating programs.

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The Lived Experience of Nurses on the Role of Continuing Education Programs in Promoting Their Knowledge, Skills, and Attitude Toward Non-Communicable Diseases

10.21203/rs.3.rs-431307/v1 ◽

2021 ◽

Author(s):

Maryam Zarei ◽

Leila Bazrafkan ◽

Sadaf Mojarrab

Keyword(s):

Qualitative Study ◽

Lived Experience ◽

Professional Education ◽

Training Programs ◽

Clinical Skills ◽

Skills Training ◽

Communicable Diseases ◽

Professional Skills ◽

Non Communicable Diseases ◽

Effective Training

Abstract BackgroundContinuing professional education is essential for nurses to provide quality patient care and upgrade their professional skills and competence. The need for continuing medical education (CME) has become more apparent in the face of advances in medical science, the ever-changing healthcare system, and the important role nurses play in improving health care. It is therefore imperative to explore nurses’ experience of CME courses and the extent to which such programs are effective. The present qualitative study aimed to assess the lived experience of nurses on the effect of CE programs in promoting their knowledge, skill, and attitude toward non-communicable diseases.MethodsThis qualitative study was conducted in 2019-2020 at various hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran). The target population was nurses actively working in the chronic wards of these hospitals. The participants were selected using maximum variation sampling, including nursing managers, education and clinical supervisors, and staff nurses. Data were collected through individual, face-to-face, semi-structured interviews and analysed using the conventional content analysis method. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln.ResultsAnalysis of the interview data resulted in 230 primary codes based on which 15 subcategories, 6 categories, and 3 themes were identified. The extracted themes were training to improve knowledge and attitude, training to improve professional skills, and the need for effective training programs. The associated categories weretraining to improve clinical knowledge, training to improve professional attitude, training in clinical skills related to holistic and person‐centred care, communication skills training, incorporate the fundamentals of effective training, and recognize common challenges and barriers to effective training.ConclusionProfessional competence and performance of nurses can be improved through intrinsic motivation stimulation, planning and implementation of training programs based on professional needs, and effective assessment of the teaching/learning process.

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Team-based primary health care for non-communicable diseases: complexities in South India

Health Policy and Planning ◽

10.1093/heapol/czaa121 ◽

2020 ◽

Vol 35 (Supplement_2) ◽

pp. ii22-ii34 ◽

Cited By ~ 1

Author(s):

Dorothy Lall ◽

Nora Engel ◽

Narayanan Devadasan ◽

Klasien Horstman ◽

Bart Criel

Keyword(s):

Primary Care ◽

Quality Improvement ◽

Chronic Care ◽

South India ◽

Health Workers ◽

Communicable Diseases ◽

Non Communicable Diseases ◽

Primary Care Clinics ◽

Primary Health ◽

Team Based Care

Abstract Chronic non-communicable diseases (NCDs), such as diabetes and cardiovascular diseases, have reached epidemic proportions worldwide. Health systems, especially those in low- and middle-income countries, such as India, struggle to deliver quality chronic care. A reorganization of healthcare service delivery is needed to strengthen care for chronic conditions. In this study, we evaluated the implementation of a package of tailored interventions to reorganize care, which were identified following a detailed analysis of gaps in delivering quality NCD care at the primary care level in India. Interventions included a redesign of the workflow at primary care clinics, a redistribution of tasks, the introduction of patient information records and the involvement of community health workers in the follow-up of patients with NCDs. An experimental case study design was chosen to study the implementation of the quality improvement measures. Three public primary care facilities in rural South India were selected. Qualitative methods were used to gain an in-depth understanding of the implementation process and outcomes of implementation. Observations, field notes and semi-structured interviews with staff at these facilities (n = 15) were thematically analysed to identify contextual factors that influenced implementation. Only one of the primary health centres implemented all components of the intervention by the end of 9 months. The main barriers to implementation were hierarchical arrangements that inhibited team-based care, the amount of time required for counselling and staff transfers. Team cohesion, additional staff and staff motivation seem to have facilitated implementation. This quality improvement research highlights the importance of building relational leadership to enable team-based care at primary care clinics in India. Redesigned organization of care and task redistribution is important solutions to deliver quality chronic care. However, implementing these will require capacity building of local primary care teams.

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