scholarly journals Non-communicable disease (NCD) corners in public sector health facilities in Bangladesh: a qualitative study assessing challenges and opportunities for improving NCD services at the primary healthcare level

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029562 ◽  
Author(s):  
Lal B Rawal ◽  
Kie Kanda ◽  
Tuhin Biswas ◽  
Md. Imtiaz Tanim ◽  
Prakash Poudel ◽  
...  
Keyword(s):  
News Media ◽  
Primary Healthcare ◽  
Communicable Disease ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Challenges And Opportunities ◽  
The Government ◽  
Non Communicable Disease ◽  
Management Services

ObjectiveTo explore healthcare providers’ perspective on non-communicable disease (NCD) prevention and management services provided through the NCD corners in Bangladesh and to examine challenges and opportunities for strengthening NCD services delivery at the primary healthcare level.DesignWe used a grounded theory approach involving in-depth qualitative interviews with healthcare providers. We also used a health facility observation checklist to assess the NCD corners’ service readiness. Furthermore, a stakeholder meeting with participants from the government, non-government organisations (NGOs), private sector, universities and news media was conducted.SettingTwelve subdistrict health facilities, locally known as upazila health complex (UHC), across four administrative divisions.ParticipantsParticipants for the in-depth qualitative interviews were health service providers, namely upazila health and family planning officers (n=4), resident medical officers (n=6), medical doctors (n=4) and civil surgeons (n=1). Participants for the stakeholder meeting were health policy makers, health programme managers, researchers, academicians, NGO workers, private health practitioners and news media reporters.ResultsParticipants reported that diabetes, hypertension and chronic obstructive pulmonary disease were the major NCD-related problems. All participants acknowledged the governments’ initiative to establish the NCD corners to support NCD service delivery. Participants thought the NCD corners have contributed substantially to increase NCD awareness, deliver NCD care and provide referral services. However, participants identified challenges including lack of specific guidelines and standard operating procedures; lack of trained human resources; inadequate laboratory facilities, logistics and medications; and poor recording and reporting systems.ConclusionThe initiative taken by the Government of Bangladesh to set up the NCD corners at the primary healthcare level is appreciative. However, the NCD corners are still at nascent stage to provide prevention and management services for common NCDs. These findings need to be taken into consideration while expanding the NCD corners in other UHCs throughout the country.

scholarly journals Tele-sleep Medicine: An Opportunity in a Crisis

2020 ◽  
Vol 8 ◽  
Author(s):  
Nagarajan Ramakrishnan ◽  
Pon Thelac ◽  
Nileena Mana
Keyword(s):  
Inpatient Care ◽  
Sleep Problems ◽  
Communicable Disease ◽  
Healthcare Providers ◽  
Signs And Symptoms ◽  
Sleep Medicine ◽  
Attractive Option ◽  
The Government ◽  
The City ◽  
Non Communicable Disease

The countrywide lockdown in India has necessitated healthcare providers consider alternate options for providing care during the COVID-19 pandemic. While there has been a tremendous focus in coping with emergency and inpatient care for COVID-19 related illness, there is also an increasing need to address management of non-communicable disease. The pandemic and the associated lockdown have witnessed the onset or worsening of sleep disorders often related to changing lifestyle, including inactivity, fear of the disease, and generalised anxiety caused by the uncertainty of the future. We propose the term ‘Lockdown Sleep Syndrome’ to describe this grouping of signs and symptoms. The wide coverage and extensive use of smartphones and more importantly, the appropriately timed Telemedicine Practice Guidelines from the Government of India, have made telehealth an attractive option, particularly in specialities such as Sleep Medicine which involves minimal physical examination. The experience of restricting personal visits to the clinic and promoting teleconsultation during the initial fifty days of lockdown is described. It was observed that two thirds of consultations shifted to a telehealth platform, and this was effective in giving satisfactory care and valid prescriptions, including to those outside the city of Chennai. Telemedicine not only helped provide uncompromised care to existing patients but also helped in identifying and managing the onset of new sleep problems with a pattern of signs and symptoms which are described as “Lockdown Sleep Syndrome”.

scholarly journals Management of Diabetes Mellitus in Refugee and Migrant Patients in a Primary Healthcare Setting in Greece: A Pilot Intervention

Epidemiologia ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 14-26
Author(s):  
Anastasia I Kolomvotsou ◽  
Elena Riza
Keyword(s):  
Primary Healthcare ◽  
Communicable Disease ◽  
Diabetes Education ◽  
Healthcare Setting ◽  
The Past ◽  
Large Numbers ◽  
Nutritional Needs ◽  
Pilot Intervention ◽  
Global Health Problem ◽  
Non Communicable Disease

Over the past years there is a substantial wave of migrants and refugees all over the world. Europe accepts approximately one-third of the international migrant population with Greece, in particular, having received large numbers of refugees and migrants by land and sea since the beginning of the civil war in Syria. Diabetes, a non-communicable disease, is a global health problem, affecting people in developing countries, refugees and migrants, and its basic treatment tool includes self-management and education. In this pilot study, we organized educational, interactive group sessions for diabetic refugees, based on culture, health, and nutritional needs according to a questionnaire developed for the study. The sessions were weekly, for two months, in the context of primary healthcare, organized by a dietitian. Nine individuals completed the sessions, five of nine were diagnosed in Greece and seven of nine needed diabetes education. Their waist circumference was above normal and they were all cooking at home. Their nutritional habits improved by attending the sessions and the interaction helped their social integration. They all found the sessions useful, and felt more self-confident regarding diabetes control and healthier.

scholarly journals Assesssment of Health Facilities for Implementation of Package of Essential Non-communicable Disease in Nepal: Baseline Study in Kailali and Ilam District

2018 ◽  
Vol 16 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Binod Kumar Aryal ◽  
Mohammad Daud ◽  
Ambika Thapa ◽  
Anita Mahotra ◽  
Sudip Ale Magar ◽  
...  
Keyword(s):  
Health Workers ◽  
Communicable Disease ◽  
Action Plan ◽  
Descriptive Analysis ◽  
Health Facilities ◽  
Essential Medicines ◽  
World Health ◽  
Cross Sectional ◽  
Baseline Study ◽  
Non Communicable Disease

Background: Non-communicable Diseases are an alarming public health emergency in Nepal. Owing to the risk of NCD’s in Nepal, Government of Nepal has developed a Multisectoral Action Plan for Non-communicable Disease 2014-2020 and has adopted the World Health Organization Package of Essential Non-communicable Disease protocol. Prior for its implementation in Nepal, baseline study has been carried out to assess the status of health facilities in Nepal.Methods: A descriptive cross-sectional study was carried out in Kailali and Ilam district encompassing a total of 92 health facilities. A set of structured questionnaire and interview guideline was used to obtain the data. Collected data was transferred to Microsoft Excel, cleaned and analyzed in SPSS 16.0. Descriptive analysis was performed to express the frequencies and relative frequencies Results: Of the total health facilities, 49 and 43 health facilities of Ilam and Kailali were interviewed. The hospital of Ilam consisted all the procedure, equipment and medicine for the management of NCDs whilst, health posts lacked Oxygen services. Only 592 posts were fulfilled out of 704 sanctioned post in both the districts of which only 161 were trained in management of NCDs. Atotal of 231 patients were diagnosed with NCDs before the day of study in all the health facilities of both districts. Conclusions: Study reveals the gaps in capacity of health institution and system in terms of training, supply, equipments, and diagnostics. However, training of health workers, supply of essential medicines and improvising the service delivery would supplement the effective implementation of PEN in Nepal.

Making primary healthcare responsive to non-communicable diseases in sub-Saharan Africa

2020 ◽  
Vol 114 (4) ◽  
pp. 229-231 ◽  
Author(s):  
Frank Baiden
Keyword(s):  
Primary Healthcare ◽  
Communicable Disease ◽  
Premature Mortality ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Non Communicable Diseases ◽  
Formal Integration ◽  
Sub Saharan ◽  
Non Communicable Disease

Abstract Primary healthcare (PHC) meets the needs of people's health throughout their lives and empowers individuals and communities to oversee their own health. Most of the community-based activities currently undertaken in PHC in sub-Saharan Africa (SSA) address child and maternal health. Non-communicable diseases are now major causes of morbidity and premature mortality in SSA. In this paper, I propose the formal integration of community-based, non-communicable disease prevention and early detection into PHC activities. I offer practical suggestions on how this can be achieved to ensure a continuum of care.

scholarly journals You can treat my HIV – But can you treat my blood pressure? Availability of integrated HIV and non-communicable disease care in northern Malawi

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Colin Pfaff ◽  
Vera Scott ◽  
Risa Hoffman ◽  
Beatrice Mwagomba
Keyword(s):  
Blood Pressure ◽  
Communicable Disease ◽  
Qualitative Interviews ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rural Districts ◽  
Health Centres ◽  
Treatment Of Hypertension ◽  
The Status ◽  
Non Communicable Disease

Background: Many patients on antiretroviral therapy (ART) in Malawi have or will develop non-communicable diseases (NCDs). The current capacity of ART sites to provide care for NCDs is not known.Aim: This study aimed to assess the capacity of ART sites to provide care for hypertension and diabetes in rural Malawi.Setting: Twenty-five health centres and five hospitals in two rural districts in northern Malawi.Methods: A cross-sectional survey was performed between March and May 2014 at all facilities. Qualitative interviews were held with three NCD coordinators.Results: Treatment of hypertension and diabetes was predominantly hospital-based. Sixty percent of hospitals had at least one clinician and one nurse trained in NCD care, whereas 5% of health centres had a clinician and 8% had a nurse trained in NCD care. Hundred percent of hospitals and 92% of health centres had uninterrupted supply of hydrochlorothiazide in the previous 6 months, but only 40% of hospitals and no health centres had uninterrupted supply of metformin. Hundred percent of hospitals and 80% of health centres had at least one blood pressure machine, and 80% of hospitals and 32% of health centres had one glucometer. Screening for hypertension amongst ART patients was only conducted at one hospital and no health centres. At health centres, integrated NCD and ART care was more common, with 48% (12/25) providing ART and NCD treatment in the same consultation.Conclusions: The results reflect the status of the initial stages of the Malawi NCD programme at sites currently providing ART care. 

scholarly journals Barriers to Integrate Physical Exercise Into the Ethiopian Healthcare System to Treat Non-Communicable Diseases

2018 ◽  
Vol 10 (10) ◽  
pp. 123 ◽  
Author(s):  
Melkamu D. Kassa ◽  
Jeanne Grace
Keyword(s):  
Physical Exercise ◽  
Built Environment ◽  
Healthcare System ◽  
Healthcare Professionals ◽  
Communicable Disease ◽  
Healthcare Providers ◽  
Healthcare Organizations ◽  
Exercise Participation ◽  
Referral Hospitals ◽  
Non Communicable Disease

Introduction: Physical exercise is recognized as one component of non-communicable disease prevention, but little attention has been devoted to integrating physical exercise into the Ethiopian healthcare system, with the barriers to its inclusion being unclear. Objectives: The present study explores the bottlenecks to integrate physical exercise into the Ethiopian healthcare system to treat non-communicable disease. Design: A mixed method sequential explanatory design. Setting: Public referral hospitals in Ethiopia. Methodology: Data was collected in two phases among 312 (195 males and 117 females) healthcare professionals. The participants were selected proportionately and randomly from 13 public referral hospitals. Results: Lack of: national coordination to promote physical exercise (t (311) = 69.20, p < .0005), trained physical exercise professionals (t (311) = 14.42, p < .0005); physical exercise guidelines (t (311) = 33.25, p < .0005); training how to prescribe physical exercise by healthcare providers (t (311) = 62.94, p < .0005); information on the health benefits of physical exercise to give to their patients (t (311) = 65.62, p < .0005); and built environment that encourages physical exercise participation (t (311) = 59.64, p < .0005) were identified as barriers. Additionally, built environment, policy, healthcare professionals' lifestyle, demography of healthcare professionals, health information coverage of physical exercise and the hospital physical building were also identified as barriers. Conclusions: Physical exercise appears marginalized from the Ethiopian healthcare system. Healthcare organizations and policy makers could take the cited barriers into consideration to plan, design and integrate physical exercise into the healthcare system to prevent NCDs in Ethiopia.

Qualitative appraisal of stakeholders’ perspective on diabetes mellitus policy in Jakarta, Indonesia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Bachtiar ◽  
A Edward ◽  
C Candi ◽  
A Sarena
Keyword(s):  
Primary Healthcare ◽  
Health Workers ◽  
Healthcare Providers ◽  
Routine Data ◽  
District Level ◽  
Capital City ◽  
Care Seeking ◽  
Diabetes Screening ◽  
External Threats ◽  
The Government

Abstract Background Diabetes prevalence in Indonesia increased from 6.9% to 8.5% between 2013 and 2017.1 It was the third-leading cause of death in 2017. The government responded by introducing the Health Minimum Service Standard Policy (HMSS) in 2016. This study aims to perform a rapid qualitative appraisal of strategic stakeholders and capture their perspective on policy implementation. Methods We used a qualitative approach by interviewing stakeholders from the Ministry of Health, provincial and district-level governments, and 12 primary healthcare providers in Jakarta. The interview was performed from December 2019 to January 2020. Policy dissemination, implementation, and evaluation were also assessed during the interview. Triangulation was done with direct observation and routine data review at primary healthcare. Results The policy was disseminated from the MoH to state and district-level governments through workshops. It improved the coverage of screening, from 7.13% to 26.92% between 2017 and 2019 in Jakarta. Most stakeholders concerned about the problem with people's awareness and multisectoral collaboration to improve the coverage of diabetes services. PHC managers expressed internal threats (limited health workers, ineffective teamwork, and limited budget) and external threats (poor care-seeking, people's awareness, and commitment from across stakeholders) in implementing the policy. Conclusions Diabetes screening coverage in PHC has increased since the implementation of the policy, but below far from reaching a universal target. The government should collaborate with PHC to address the issues of internal and external threats. Key messages The 'SPM' policy introduced in 2016 has provided guidance for state and district-level government to assist the efforts on improving diabetes screening by PHCs in Indonesia. Coverage for diabetes screening in Jakarta, the capital city of Indonesia, has not reached the target. Further exploration of external and internal threats at PHC level is needed.

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