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

2016 ◽  
Vol 7 (2) ◽  
pp. 1-13 ◽  
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.

scholarly journals Availability and prices of medicines for non-communicable diseases at health facilities and retail drug outlets in Kenya: a cross-sectional survey in eight counties

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035132 ◽  
Author(s):  
Paul G Ashigbie ◽  
Peter C Rockers ◽  
Richard O Laing ◽  
Howard J Cabral ◽  
Monica A Onyango ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Price Ratio ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Non Profit ◽  
For Profit ◽  
The Mean

ObjectivesThe objective of this study was to determine the availability and prices of medicines for non-communicable diseases (NCDs) in health facilities and private for-profit drug outlets in Kenya.DesignCross-sectional study.MethodsAll public and non-profit health facilities in eight counties (Embu, Kakamega, Kwale, Makueni, Narok, Nyeri, Samburu and West Pokot) that purchased medicines from the Mission for Essential Drugs and Supplies, a major wholesaler, were surveyed in September 2016. For each health facility, one nearby private for-profit drug outlet was also surveyed. Data on availability and price were analysed for 24 NCD and 8 acute medicine formulations. Availability was analysed separately for medicines in the national Essential Medicines List (EML) and those in the Standard Treatment Guidelines (STGs). Median price ratios were estimated using the International Medical Products Price Guide as a reference.Results59 public and 78 non-profit facilities and 135 drug outlets were surveyed. Availability of NCD medicines was highest in private for-profit drug outlets (61.7% and 29.3% for medicines on the EML and STGs, respectively). Availability of STG medicines increased with increasing level of care of facilities: 16.1% at dispensaries to 31.7% at secondary referral facilities. The mean proportion of availability for NCD medicines listed in the STGs (0.25) was significantly lower than for acute medicines (0.61), p<0.0001. The proportion of public facilities giving medicines for free (0.47) was significantly higher than the proportion of private non-profit facilities giving medicines for free (0.09) (p<0.0001). The mean price ratio of NCD medicines was significantly higher than for acute medicines in non-profit facilities (4.1 vs 2.0, respectively; p=0.0076), and in private for-profit drug outlets (3.5 vs 1.7; p=0.0013).ConclusionPatients with NCDs in Kenya appear to have limited access to medicines. Increasing access should be a focus of efforts to achieve universal health coverage.

scholarly journals Readiness, Availability and Utilization of Rural Vietnamese Health Facilities for Community Based Primary Care of Non-communicable Diseases: A CrossSectional Survey of 3 Provinces in Northern Vietnam

2018 ◽  
Vol 8 (3) ◽  
pp. 150-157 ◽  
Author(s):  
David B. Duong ◽  
Hoang Van Minh ◽  
Long H. Ngo ◽  
Andrew L. Ellner
Keyword(s):  
Communicable Diseases ◽  
Mental Illnesses ◽  
Government Support ◽  
Service Availability ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Northern Vietnam ◽  
Significant Difference ◽  
Service Readiness

Background: Vietnam’s network of commune health centers (CHCs) have historically managed acute infectious diseases and implemented national disease-specific vertical programs. Vietnam has undergone an epidemiological transition towards non-communicable diseases (NCDs). Limited data exist on Vietnamese CHC capacity to prevent, diagnose, and treat NCDs. In this paper, we assess NCD service readiness, availability, and utilization at rural CHCs in 3 provinces in northern Vietnam. Methods: Between January 2014 and April 2014, we conducted a cross-sectional survey of a representative sample of 89 rural CHCs from 3 provinces. Our study outcomes included service readiness, availability of equipment and medications, and utilization for five NCD conditions: hypertension, diabetes, chronic pulmonary diseases, cancer, and mental illnesses. Results: NCD service availability was limited, except for mental health. Only 25% of CHCs indicated that they conducted activities focused on NCD prevention. Patient utilization of CHCs was approximately 223 visits per month or 8 visits per day. We found a statistically significant difference (P<.05) for NCD service availability, medication availability and CHC utilization among the 3 provinces studied. Conclusion: This is the first multi-site study on NCD service availability in Vietnam and the first study in a mountainous region consisting predominately of ethnic minorities. Despite strong government support for NCD prevention and control, Vietnam’s current network of CHCs has limited NCD service capacity.

scholarly journals Prison primary care and non-communicable diseases: a data-linkage survey of prevalence and associated risk factors

BJGP Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. bjgpopen19X101643 ◽  
Author(s):  
Nat MJ Wright ◽  
Philippa Hearty ◽  
Victoria Allgar
Keyword(s):  
Risk Factors ◽  
Physical Health ◽  
Respiratory Disease ◽  
Prison Population ◽  
Communicable Diseases ◽  
Self Report ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Clinical Records

BackgroundThe size and mean age of the prison population has increased rapidly in recent years. Prisoners are a vulnerable group who, compared with the general population, experience poorer health outcomes. However, there is a dearth of research quantifying the prevalence of non-communicable diseases (NCDs) among prisoner populations.AimTo explore both the prevalence of NCDs and their risk factors.Design & settingA cross-sectional survey was undertaken that was compared with clinical records in two male prisons in the north of England.MethodSelf-report surveys were completed by 199 prisoners to assess sociodemographic characteristics, general health, NCD prevalence, and risk factor prevalence. Data were checked against that retrieved from prison clinical records.ResultsIt was found that 46% reported at least one NCD and 26% reported at least one physical health NCD. The most common self-reported NCD was 'anxiety and depression' (34%), followed by 'respiratory disease' (17%), and 'hypertension' (10%). Having a physical health NCD was independently associated with increasing age or drug dependence.The level of agreement between clinical records and self-report ranged from 'fair' for alcohol dependence (kappa 0.38; P<0.001) to 'very good' for diabetes (kappa 0.86; P<0.001).ConclusionCompared with mainstream populations and despite high prevalence of risk factors for NCDs physical illness NCDs, with the exception of respiratory disease, are less common. However, poor mental health is more common. These differences are possibly owing to the younger average age of prison populations, since prevalence of risk factors was reported as high.Secondary data analysis of clinical records is a more methodologically robust way of monitoring trends in prisoner population disease prevalence.

scholarly journals Health system's readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey

2020 ◽  
Author(s):  
Umesh Ghimire ◽  
Nipun Shrestha ◽  
Bipin Adhikari ◽  
Suresh Meheta ◽  
Yashashwi Pokharel ◽  
...  
Keyword(s):  
Health Facility ◽  
Respiratory Disease ◽  
Chronic Respiratory Disease ◽  
Health Facilities ◽  
World Health ◽  
Related Services ◽  
Public Facilities ◽  
Health Facility Survey ◽  
Service Readiness ◽  
Facility Survey

Abstract Background: The burgeoning rise of non-communicable diseases is posing a serious challenge in resource constrained health facilities of Nepal. The main objective of this study was to assess the readiness of health facilities for cardiovascular, diabetes and chronic respiratory disease services in Nepal. Methods: This study utilized data from the Nepal Health Facility Survey 2015. General readiness of 940 health facilities along with disease specific readiness for cardiovascular diseases (CVDs), diabetes and cardiorespiratory diseases (CRDs) were assessed using service availability and readiness assessment manual of the World Health Organization (WHO). Health facilities were categorized into public and private facilities.Results: Out of a total of 940 health facilities assessed, private facilities showed higher availability of items of general service readiness, except for standard precautions for infection prevention, compared to public facilities. The multivariable adjusted regression coefficients for CVDs (β=2.87, 95%CI: 2.42-3.39), diabetes (β =3.02, 95%CI: 2.03-4.49) and CRDs (β=15.95, 95%CI: 4.61-55.13) at private facilities were higher than public hospitals. Health facilities located in hills had higher readiness index for CVDs (β=1.99, 95%CI: 1.02 - 1.39). Service readiness for CVDs (β=1.13, 95%CI: 1.04-1.23) and diabetes (β=1.78, 95%CI: 1.23-2.59) were higher in the urban municipalities than in rural municipalities. Finally, disease related services readiness index was sub-optimal with some degree of variation at the province level in Nepal. Province 2 for CVDs (β=0.83, 95%CI: 0.73-0.95), and province 4 (β =1.24, 95%CI: 1.07-1.43) and province 5 (β =1.17, 95%CI: 1.02-1.34) had higher readiness index compared to province 1.Conclusions: This study found a sub-optimal readiness of services related to three NCDs at the public facilities in Nepal. Compared to public facilities, private facilities showed higher readiness score for CVDs, diabetes and CRDs. To cope up with the growing burden of NCDs, urgent improvement in health services, particularly in public facilities are critical to manage common NCDs.

scholarly journals Disparities in availability of essential medicines to treat non-communicable diseases in Uganda: A Poisson analysis using the Service Availability and Readiness Assessment

PLoS ONE ◽  
2018 ◽  
Vol 13 (2) ◽  
pp. e0192332 ◽  
Author(s):  
Mari Armstrong-Hough ◽  
Sandeep P. Kishore ◽  
Sarah Byakika ◽  
Gerald Mutungi ◽  
Marcella Nunez-Smith ◽  
...  
Keyword(s):  
Communicable Diseases ◽  
Essential Medicines ◽  
Service Availability ◽  
Readiness Assessment ◽  
Non Communicable Diseases

scholarly journals Assessing service availability and readiness to manage Chronic Respiratory Diseases (CRDs) in Bangladesh

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247700
Author(s):  
Progga Paromita ◽  
Hasina Akhter Chowdhury ◽  
Cinderella Akbar Mayaboti ◽  
Shagoofa Rakhshanda ◽  
A. K. M. Fazlur Rahman ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Tertiary Care ◽  
Health Facilities ◽  
Essential Medicines ◽  
World Health ◽  
Service Availability ◽  
Cross Sectional ◽  
Chronic Respiratory Diseases ◽  
District Hospitals ◽  
The Mean

Introduction Chronic Respiratory Diseases (CRDs) are some of the most prevailing non-communicable diseases (NCDs) worldwide and cause three times higher morbidity and mortality in low- and middle-income countries (LMIC) than in developed nations. In Bangladesh, there is a dearth of data about the quality of CRD management in health facilities. This study aims to describe CRD service availability and readiness at all tiers of health facilities using the World Health Organization’s (WHO) Service Availability and Readiness Assessment (SARA) tool. Methods A cross-sectional study was conducted from December 2017 to June 2018 in a total of 262 health facilities in Bangladesh using the WHO SARA Standard Tool. Surveys were conducted with facility management personnel by trained data collectors using REDCap software. Descriptive statistics for the availability of CRD services were calculated. Composite scores for facility readiness (Readiness Index ‘RI’) were created which included four domains: staff and guideline, basic equipment, diagnostic capacity, and essential medicines. RI was calculated for each domain as the mean score of items expressed as a percentage. Indices were compared to a cutoff of70% which means that a facility index above 70% is considered ‘ready’ to manage CRDs at that level. Data analysis was conducted using SPSS Vr 21.0. Results It was found, tertiary hospitals were the only hospitals that surpassed the readiness index cutoff of 70%, indicating that they had adequate capacity and were ready to manage CRDs (RI 78.3%). The mean readiness scores for the other hospital tiers in descending order were District Hospitals (DH): 40.6%, Upazila Health Complexes (UHC): 33.3% and Private NGOs: 39.5%). Conclusion Only tertiary care hospitals, constituting 3.1% of sampled health facilities, were found ready to manage CRD. Inadequate and unequal supplies of medicine as well as a lack of trained staff, guidelines on the diagnosis and treatment of CRDs, equipment, and diagnostic facilities contributed to low readiness index scores in all other tiers of health facilities.

scholarly journals Assessing service availability and readiness to manage cervical cancer in Bangladesh

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shagoofa Rakhshanda ◽  
Koustuv Dalal ◽  
Hasina Akhter Chowdhury ◽  
Cinderella Akbar Mayaboti ◽  
Progga Paromita ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health Facilities ◽  
World Health ◽  
Accurate Information ◽  
Service Availability ◽  
Cross Sectional ◽  
Middle Income ◽  
Primary Level ◽  
Cancer Management ◽  
Service Readiness

Abstract Background The second most common cancer among females in Bangladesh is cervical cancer. The national strategy for cervical cancer needs monitoring to ensure that patients have access to care. In order to provide accurate information to policymakers in Bangladesh and other low and middle income countries, it is vital to assess current service availability and readiness to manage cervical cancer at health facilities in Bangladesh. Methods An interviewer-administered questionnaire adapted from the World Health Organization Service Availability and Readiness Assessment Standard Tool was used to collect cross-sectional data from health administrators of 323 health facilities in Bangladesh. Services provided were categorized into domains and service readiness was determined by mean readiness index (RI) scores. Data analysis was conducted using STATA version 13. Results There were seven tertiary and specialized hospitals, 118 secondary level health facilities, 124 primary level health facilities, and 74 NGO/private hospitals included in the study. Twenty-six per cent of the health facilities provided services to cancer patients. Among the 34 tracer items used to assess cancer management capacity of health facilities, four cervical cancer-specific tracer items were used to determine service readiness for cervical cancer. On average, tertiary and specialized hospitals surpassed the readiness index cutoff of 70% with adequate staff and training (100%), equipment (100%), and diagnostic facilities (85.7%), indicating that they were ready to manage cervical cancer. The mean RI scores for the rest of the health facilities were below the cutoff value, meaning that they were not prepared to provide adequate cervical cancer services. Conclusion The health facilities in Bangladesh (except for some tertiary hospitals) lack readiness in cervical cancer management in terms of guidelines on diagnosis and treatment, training of staff, and shortage of equipment. Given that cervical cancer accounts for more than one-fourth of all female cancers in Bangladesh, management of cervical cancer needs to be available at all levels of health facilities, with primary level facilities focusing on early diagnosis. It is recommended that appropriate standard operating procedures on cervical cancer be developed for each level of health facilities to contribute towards attaining sustainable developmental goals.

scholarly journals Readiness of health facilities for the outpatient management of non-communicable diseases in a low-resource setting: an example from a facility-based cross-sectional survey in Tanzania

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040908
Author(s):  
Deogratius Bintabara ◽  
Dorothy Ngajilo
Keyword(s):  
Treatment Guidelines ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Outpatient Management ◽  
Diagnostic Equipment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Chronic Respiratory Diseases ◽  
Low Resource

ObjectiveThis study assessed the readiness of health facilities to provide outpatient management of non-communicable diseases using a nationally representative sample of health facilities from Tanzania as an example of a low-resource country.DesignFacility-based cross-sectional survey.SettingThis study analysed data collected from public and private-owned dispensaries/clinics, health centres and hospitals during the 2014–2015 Tanzania Service Provision Assessment survey.Primary outcome measuresThree outcome variables are included in this study, namely readiness of facilities to provide outpatient management for diabetes, hypertension and chronic respiratory diseases. These were composite variables measured based on availability of indicators identified in the WHO-Service Availability and Readiness Assessment manual. These indicators were grouped into three domains, viz staff training and guidelines, basic diagnostic equipment and basic medicines. Readiness was measured by assessing the presence of required indicators in each of these domains.ResultsOut of 1188 health facilities assessed, 52.1%, 64.8% and 60.9% reported providing services related to diabetes, hypertension and chronic respiratory diseases, respectively. A few facilities reported having treatment guidelines (33.2%) or staff trained to provide non-communicable disease services (10.4%). The availability of basic diagnostic equipment and medicines for these diseases was significantly lower in public lower level facilities than in their private counterparts (p<0.05). Facilities located in urban settings as well as higher level (health centre and hospitals) and publicly owned facilities were significantly associated with increased service readiness index for providing outpatient management of non-communicable diseases.ConclusionA fair distribution of resources through the ‘push’ system of refresher training, treatment guidelines, medicines and diagnostic equipment from higher authorities or other agencies may be one way of strengthening the readiness of lower level and public facilities to cope with the increasing burden of non-communicable diseases in low-resource countries such as Tanzania.

scholarly journals Variation in the Availability and Cost of Essential Medicines for Non-Communicable Diseases in Uganda: a descriptive time series analysis

2020 ◽  
Author(s):  
Mari Armstrong-Hough ◽  
Srish Sharma ◽  
Sandeep P. Kishore ◽  
Ann R Akiteng ◽  
Jeremy I. Schwartz
Keyword(s):  
Descriptive Analysis ◽  
Communicable Diseases ◽  
Essential Medicines ◽  
Cross Sectional ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
For Profit ◽  
Middle Income Countries ◽  
The Cost ◽  
Over Time

AbstractBackgroundAvailability of essential medicines for non-communicable diseases (NCDs) is poor in low- and middle-income countries. Availability and cost are conventionally assessed using cross-sectional data. However, these characteristics may vary over time.MethodsWe carried out a prospective, descriptive analysis of the availability and cost of essential medicines in 23 Ugandan health facilities over a five-week period. We surveyed facility pharmacies in-person up to five times, recording availability and cost of 19 essential medicines for NCDs and four essential medicines for communicable diseases.ResultsAvailability of medicines varied substantially over time, especially among public facilities. Among private-for-profit facilities, the cost of the same medicine varied from week to week. Private-not-for-profit facilities experienced less dramatic fluctuations in price.ConclusionsWe conclude that there is a need for standardized, continuous monitoring to better characterize the availability and cost of essential medicines, understand demand for these medicines, and reduce uncertainty for patients.

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