scholarly journals Challenges to primary healthcare services in the management of non-communicable diseases in marginalised populations on the Thailand–Myanmar border: a pilot survey

2018 ◽  
Vol 48 (4) ◽  
pp. 273-277 ◽  
Author(s):  
Makoto Saito ◽  
Arunrot Keereevijit ◽  
Thi Dar San ◽  
Yin Yin Thein ◽  
Mary Ellen Gilder ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Low Cost ◽  
Healthcare Services ◽  
Communicable Diseases ◽  
Retention Rates ◽  
Non Communicable Diseases ◽  
Pilot Survey ◽  
Retrospective Audit ◽  
Lost To Follow Up

Non-communicable diseases (NCDs) are emerging rapidly. This manuscript reports on a pilot survey of NCDs at a primary healthcare level in a marginalised migrant population on the Thailand–Myanmar border in the face of declining rates of malaria. A retrospective audit of routine clinic (2004–2016) and NCD patient survey data (2014–2016) was conducted. The length of follow-up was assessed by Kaplan–Meier analysis. From July 2014 to July 2016, 238 migrant patients were on the NCD register. Hypertension (n = 80) and diabetes mellitus (n = 51) were the most common diagnoses. After the first consultation, 41% (95% confidence interval = 35–47%) were lost to follow-up by 30 days. NCD retention rates were low: 50% of registered patients were lost to follow-up by 80 (95% CI = 49–132) days. After this survey, a novel low-cost insurance scheme for the migrant community has been launched in this area. Development of new schemes involving patients, healthcare providers and funding support are required for improved and sustainable NCD care for marginalised populations.

scholarly journals Early detection and management of major non-communicable diseases in urban primary healthcare facilities in Ethiopia: a study protocol for a type-3 hybrid implementation-effectiveness design

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040564
Author(s):  
Helen Yifter ◽  
Afrah Omer ◽  
Seid Gugsa ◽  
Abebaw Fekadu ◽  
Abraham Kebede ◽  
...  
Keyword(s):  
Early Detection ◽  
Primary Healthcare ◽  
Addis Ababa ◽  
Communicable Diseases ◽  
Barriers And Facilitators ◽  
Non Communicable Diseases ◽  
Implementation Effectiveness ◽  
Evaluation Phase ◽  
Intervention Protocol ◽  
Type 3

IntroductionIntegrating early detection and management of non-communicable diseases in primary healthcare has an unprecedented role in making healthcare more accessible particularly in low- and middle-income countries such as Ethiopia. This study aims to design, implement and evaluate an evidence-based intervention guided by the HEARTS technical package and implementation guide to address barriers and facilitators of integrating early detection and management of hypertension, diabetes mellitus and cardiovascular diseases in primary healthcare settings of Addis Ababa.MethodologyWe will employ a type-3 hybrid implementation-effectiveness study from November 2020 to May 2022. This study will target patients ≥40 years of age. Ten health centres will be randomly selected from each subcity of Addis Ababa. The study will have four phases: (1) Baseline situational analysis (PEN facility-capacity assessment, 150 observations of patient healthcare provider interactions and 697 patient medical record reviews), (2) Consolidated Framework for Implementation Research (CFIR) inspired qualitative assessment of barriers and facilitators (20 in-depth interviews of key stakeholders), (3) Design of intervention protocol. The intervention will have capacity enhancement components including training of non-communicabledisease (NCDservice providers, provision of essential equipment/supporting materials and monthly monitoring and feedback and (4) Implementation monitoring and evaluation phase using the RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework. Outcomes on early detection and management of NCDs will be assessed to examine the effectiveness of the study.Ethics and dissemination planEthical clearance was obtained from the Addis Ababa University, College of Health Sciences Institutional Review Board and Addis Ababa Health Bureau. We plan to present the findings from this research in conferences and publish them in peer-reviewed journals.

scholarly journals Communicative health literacy in patients with non-communicable diseases in Ethiopia: a cross-sectional study

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Desalew Tilahun ◽  
Abebe Abera ◽  
Gugsa Nemera
Keyword(s):  
Health Literacy ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Source Population ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Health Literacy Level ◽  
Literacy Level

Abstract Background Health literacy plays a prominent role in empowering individuals for prevention as well as management of non-communicable diseases (NCDs). However, there is paucity of information on the health literacy of patients with non-communicable diseases in Ethiopia. Therefore, this study aimed to assess communicative health literacy and associated factors in patients with NCDs on follow-up at Jimma Medical Center (JMC), Ethiopia. Methods A cross-sectional study was conducted from 4 May 2020 to 4 July 2020 with 408 randomly selected adult patients, attending outpatient department of JMC in Ethiopia. The final sample size was obtained by using single population proportion formula. All patients with NCDs who were on follow-up at chronic illness clinic, JMC, were used as a source population. All eligible patients with NCDs who fulfilled the inclusion criteria were included in this study. A simple random sampling technique was used to recruit study participants. Data were collected through structured interviewer administered questionnaires on the six of nine health literacy domains using Health Literacy Questionnaire (HLQ) containing 30 items, socio-demographic and socio-economic characteristics, disease-related factors, and health information sources. Multivariable logistic regression was executed to determine the associations. Result Descriptive analysis shows more than half of the respondents in four of the six health literacy domains had high communicative health literacy level (CHLL). The proportion of people with high CHLL across each of the domains was as follows: health care provider support (56.1%), social support for health (53.7%), active engagement with a healthcare provider (56.1%), and navigating healthcare system (53.4%). We found educational status was significantly associated with five of six health literacy domains whereas number of sources was associated with four of six health literacy domains. Conclusion The overall findings of the current study indicate that health literacy levels vary according to socio-demographic and disease characteristics of patients. Thus, healthcare professionals should assess patients’ health literacy level and tailor information and support to the health literacy skills and personal context of their patients.

scholarly journals Ayushman Bharat Yojana: a memorable health initiative for Indians

2018 ◽  
Vol 5 (8) ◽  
pp. 3152 ◽  
Author(s):  
Rohit Dhaka ◽  
Ramesh Verma ◽  
Ginni Agrawal ◽  
Gopal Kumar
Keyword(s):  
Health Centre ◽  
Tertiary Care ◽  
Poverty Line ◽  
Healthcare Services ◽  
Communicable Diseases ◽  
Health And Wellness ◽  
Non Communicable Diseases ◽  
Protection Scheme ◽  
Insurance Cover ◽  
The Government

India in a state of epidemiological health transition i.e shifting from communicable to non-communicable diseases. The annually 3.2% Indians falling below the poverty line and three forth Indians spending their entire income on health care and purchasing drugs. The government of India announced a Ayushman Bharat Yojana- National Health Protection Scheme (AB-NHPM) in the year 2018.  The aim of this programme is to providing a service to create a healthy, capable and content new India and two goals are to creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services and to provide health insurance cover to at least 40% of India's population which is deprived of secondary and tertiary care services. This Yojana will be implemented through Health and Wellness Centres that are to be developed in the primary health centre or sub-centre in the village and that will provide preventive, promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc. These centres would be equipped with basic medical tests for hypertension, diabetic and cancer and they are connected to the district hospital for advanced tele-medical consultations. The government has aims to set up 1,50,000 health and wellness centres across the country by the year 2022.

scholarly journals Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

2021 ◽  
Author(s):  
Bo Burström
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Healthcare System ◽  
Health Equity ◽  
Social Determinants ◽  
Primary Healthcare ◽  
Communicable Diseases ◽  
Determinants Of Health ◽  
Non Communicable Diseases

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.

scholarly journals Study protocol: a prospective cohort on non-communicable diseases among primary healthcare users living in Kosovo (KOSCO)

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038889
Author(s):  
Katrina Ann Obas ◽  
Jana Gerold ◽  
Ariana Bytyçi-Katanolli ◽  
Naim Jerliu ◽  
Marek Kwiatkowski ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Healthcare ◽  
Health Sector ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Lifestyle Changes ◽  
Epidemiological Evidence ◽  
Non Communicable Diseases ◽  
The Balkans ◽  
Central Switzerland

IntroductionWith the lowest life expectancy in the Balkans, underlying causes of morbidity in Kosovo remain unclear due to limited epidemiological evidence. The goal of this cohort is to contribute epidemiological evidence for the prevention and control of non-communicable diseases such as depression, hypertension, diabetes and chronic respiratory disease in Kosovo as the basis for policy and decision-making, with a spotlight on the relationships between non-experimental primary healthcare (PHC) interventions and lifestyle changes as well as between depression and the course of blood pressure.Methods and analysisPHC users aged 40 years and above were recruited consecutively between March and October 2019 from 12 main family medicine centres across Kosovo. The data collected through interviews and health examinations included: sociodemographic characteristics, social and environmental factors, comorbidities, health system, lifestyle, psychological factors and clinical attributes (blood pressure, height, weight, waist/hip/neck circumferences, peak expiratory flow and HbA1c measurements). Cohort data were collected annually in two phases, approximately 6 months apart, with an expected total follow-up time of 5 years.Ethics and disseminationEthical approvals were obtained from the Ethics Committee Northwest and Central Switzerland (Ref. 2018-00994) and the Kosovo Doctors Chamber (Ref. 11/2019). Cohort results will provide novel epidemiological evidence on non-communicable diseases in Kosovo, which will be published in scientific journals. The study will also examine the health needs of the people of Kosovo and provide evidence for health sector decision-makers to improve service responsiveness, which will be shared with stakeholders through reports and presentations.

scholarly journals 0695 Sleepwell24, A Smartphone Application To Promote PAP Therapy Adherence: Feasibility And Acceptability

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A265-A265
Author(s):  
M E Petrov ◽  
K Hasanaj ◽  
C M Hoffmann ◽  
D R Epstein ◽  
L Krahn ◽  
...  
Keyword(s):  
Real Time ◽  
Smartphone Application ◽  
Sleep Medicine ◽  
Retention Rates ◽  
Activity Levels ◽  
Post Intervention ◽  
Personal Technology ◽  
Lost To Follow Up ◽  
First Time

Abstract Introduction We aimed to test the feasibility and acceptability of SleepWell24, a multicomponent, smartphone-delivered intervention to increase positive airway pressure (PAP) adherence among newly diagnosed OSA patients. Methods SleepWell24 targets PAP adherence along with other health behaviors through education, trouble-shooting, goal-setting, and near real-time biofeedback of PAP machine use, and sleep and physical activity levels (via Fitbit integration), and other chronic disease self-management components. Patients with a first-time diagnosis of OSA (AHI≥5) and prescribed PAP therapy were enrolled from the Centers for Sleep Medicine at Mayo Clinic in Rochester, MN and Phoenix, AZ. Patients were randomized to SleepWell24 or usual care (UC) and assessed for PAP use over 60 consecutive nights. UC patients received a Fitbit monitor to control for non-specific intervention effects related to the introduction of a new personal technology. Feasibility was assessed with recruitment and retention rates and acceptability was assessed post-intervention with the validated, 8-item Treatment Evaluation Questionnaire (TEQ; range:0-4). ANCOVA models, adjusting for age, sex, and AHI severity, compared intervention arms on acceptability ratings. Results OSA patients were consented and randomized (N=111). Before the intervention began 4 participants withdrew, 12 were lost to follow-up, and 5 could not start the trial due to durable medical equipment (DME) vendor barriers. Ninety OSA patients (n=41 SleepWell24, n=49 UC; age M±SD=57.2±12.2; 44.4% female, 61.1% AHI≥15) started the intervention, with 2 participants withdrawing, 1 becoming deceased (unrelated to treatment) and 7 with missing PAP data due to DME vendor barriers. There was no significant between-groups differences on post-treatment acceptability (SleepWell24 M±SD=2.7±1.1 vs. UC M±SD=3.1±0.9, F[1,73]=2.3, p=0.11), and 77% of SleepWell24 participants found the app to be moderately to totally acceptable. Conclusion Overall, SleepWell24 was found to be feasible for delivery in two large clinical sleep medicine centers, and patients found the app to be acceptable. A number of challenges in trial delivery were encountered that have implications for scaled-up efficacy testing: (a) partnerships with DME vendors for near real-time PAP data integration; (b) alignment with clinical practice (i.e., referral, medical record integration); and (c) patient engagement. Support National Institute of Nursing Research / National Institutes of Health: R21NR016046

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.

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