Capacity of Ugandan public sector health facilities to prevent and control non-communicable diseases: an assessment based upon WHO-PEN standards

Abstract Objective: To examine the barriers and facilitators to engaging Community Health Workers (CHWs) for Non-communicable Diseases (NCDs) prevention and control in Bangladesh.Design: We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection, and data were analysed thematically.Setting: Data were collected from health facilities across three districts in Bangladesh, and two stakeholder consultative meetings were conducted at the central level.Participants: We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n=4); key informant interviews with central level health policymakers/ managers (n=15) and focus group discussions with CHWs (4 FGDs; total n=29). Participants in a stakeholder consultative meeting included members from the government (n=4), non-government organisations (n=2), private sector (n=1) and universities (n=2).Results: The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispatching of basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. The facilitating factors to engage CHWs included government commitment and program priority, development of NCD related policies and strategies, the establishment of NCD corners, community support systems, social recognition and staff motivation.Conclusion: Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for capacity building of CHWs, systems-level support and maximizing CHWs engagement to prevention and control of NCDs in Bangladesh.

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Non-Communicable Diseases and Global Health Politics

The Oxford Handbook of Global Health Politics ◽

10.1093/oxfordhb/9780190456818.013.35 ◽

2019 ◽

pp. 626-659

Author(s):

Roger Magnusson

Keyword(s):

Respiratory Diseases ◽

Communicable Diseases ◽

World Health ◽

Global Response ◽

Non Communicable Diseases ◽

Health Politics ◽

Chronic Respiratory Diseases ◽

Health Organization ◽

High Level ◽

And Control

Non-communicable diseases (NCDs), including cardiovascular disease, cancer, chronic respiratory diseases, and diabetes, are responsible for around 70 percent of global deaths each year. This chapter describes how NCDs have become prevalent and critically evaluates global efforts to address NCDs and their risk factors, with a particular focus on the World Health Organization (WHO) and United Nations (UN) system. It explores the factors that have prevented those addressing NCDs from achieving access to resources and a priority commensurate with their impact on people’s lives. The chapter evaluates the global response to NCDs both prior to and since the UN High-Level Meeting on Prevention and Control of Non-communicable Diseases, held in 2011, and considers opportunities for strengthening that response in future.

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A Study on Service Availability and Readiness Assessment of Non-Communicable Diseases Using the WHO Tool for Gazipur District in Bangladesh

Bangladesh Journal of Bioethics ◽

10.3329/bioethics.v7i2.30785 ◽

2016 ◽

Vol 7 (2) ◽

pp. 1-13 ◽

Cited By ~ 5

Author(s):

Mohammad Rashemdul Islam ◽

Shamima Parvin Laskar ◽

Darryl Macer

Keyword(s):

Respiratory Disease ◽

Chronic Respiratory Disease ◽

Communicable Diseases ◽

Health Facilities ◽

Essential Medicines ◽

Service Availability ◽

Diabetes Diagnosis ◽

Cross Sectional ◽

Non Communicable Diseases ◽

Service Readiness

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets. A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.

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Protocol for establishing an Adaptive Diseases control Expert Programme in Tanzania (ADEPT) for integrating care of communicable and non-communicable diseases using tuberculosis and diabetes as a case study

BMJ Open ◽

10.1136/bmjopen-2020-041521 ◽

2021 ◽

Vol 11 (4) ◽

pp. e041521

Author(s):

Stellah G Mpagama ◽

Kaushik Ramaiya ◽

Troels Lillebæk ◽

Blandina T Mmbaga ◽

Marion Sumari-de Boer ◽

...

Keyword(s):

Operational Research ◽

Communicable Diseases ◽

Health Facilities ◽

Learning System ◽

Management Approach ◽

African Countries ◽

Non Communicable Diseases ◽

Research Outcomes ◽

The Government

IntroductionMost sub-Saharan African countries endure a high burden of communicable infections but also face a rise of non-communicable diseases (NCDs). Interventions targeting particular epidemics are often executed within vertical programmes. We establish an Adaptive Diseases control Expert Programme in Tanzania (ADEPT) model with three domains; stepwise training approach, integration of communicable and NCDs and a learning system. The model aims to shift traditional vertical programmes to an adaptive diseases management approach through integrating communicable and NCDs using the tuberculosis (TB) and diabetes mellitus (DM) dual epidemic as a case study. We aim to describe the ADEPT protocol with underpinned implementation and operational research on TB/DM.Methods and analysisThe model implement a collaborative TB and DM services protocol as endorsed by WHO in Tanzania. Evaluation of the process and outcomes will follow the logic framework. A mixed research design with both qualitative and quantitative approaches will be used in applied research action. Anticipated implementation research outcomes include at the health facilities level for organising TB/DM services, pathways of patients with TB/DM seeking care in different health facilities, factors in service delivery that need deimplementation and the ADEPT model implementation feasibility, acceptability and fidelity. Expected operational research outcomes include additional identified patients with dual TB/DM, the prevalence of comorbidities like hypertension in patients with TB/DM and final treatment outcomes of TB/DM including treatment-related complications. Findings will inform the future policies and practices for integrating communicable and NCDs services.Ethics and disseminationEthical approval was granted by The National Research Health Ethical Committee (Ref-No. NIMR/HQ/R.8a/Vol.IX/2988) and the implementation endorsed by the government authorities. Findings will be proactively disseminated through multiple mechanisms including peer-reviewed journals, and engagement with various stakeholders’ example in conferences and social media.

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The Empowerment of Integrated Development Post of Non-Communicable Diseases in Efforts to Prevent and Control Non- Communicable Diseases

International Journal of Public Health Science (IJPHS) ◽

10.11591/ijphs.v5i3.4799 ◽

2016 ◽

Vol 5 (3) ◽

pp. 294

Author(s):

Yandrizal Yandrizal ◽

Rizanda Machmud ◽

Melinda Noer ◽

Hardisman Hardisman ◽

Afrizal Afrizal ◽

...

Keyword(s):

Public Health ◽

Infectious Disease ◽

Early Detection ◽

Communicable Disease ◽

Communicable Diseases ◽

Combination Method ◽

Integrated Development ◽

Non Communicable Diseases ◽

And Control ◽

Non Communicable Disease

Non-Communicable disease has already been the main cause of death in many countries, as many as 57 million death in the world in 2008, 36 million (63 percent) is because of un-infectious disease, specifically heart illness, diabetes, cancer, and chronic respiratory diseases. Prevention and controlling efforts of un-infectious diseases developing in Indonesia is non-communicable disease integrated development post (Pospindu PTM). This research used combination method approach with exploratory design. Exploratory design with sequential procedure used combination consecutively, the first is qualitative and the second is quantitative method. Public Health Center formed Posbindu PTM has not disseminate yet to all stakeholders. Posbindu PTM members felt benefit by following this activity. Some of them did not know follow the activity because of unknown about it. There was connection between coming behavior to Posbindu PTM to preventing behavior of non-communicable disease.Percentage for high blood pressure risk indicated 20-25 percent from all visitors. Formulation of its policy implementation started with stakeholder analysis; head of sub district, head of urban village, head of health department in regency/city, head of public health service, head of neighborhood Association, and the head of family welfare development. Analysis of perception, power and authority found that every stakeholder had authority to manage the member directly or indirectly. It was not implemented because of the lack knowledge of stakeholders about the Posbindu PTM function.They would play a role after knowing the aim and advantage of the post by motivate the people to do early detection, prevention and control the non-communicable disease. The members were given wide knowledge about early detection, preventing and control the un-infectious disease, measuring and checking up their healthy continuously so that keep feeling the advantage of coming to the post.

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