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

2017 ◽  
Author(s):  
Mari Armstrong-Hough ◽  
Sandeep Kishore ◽  
Sarah Byakika ◽  
Gerald Mutungi ◽  
Marcella Nunez-Smith ◽  
...  
Keyword(s):  
Health Facility ◽  
Communicable Diseases ◽  
Health Centers ◽  
Essential Medicines ◽  
Hiv Care ◽  
Service Availability ◽  
Readiness Assessment ◽  
Non Communicable Diseases ◽  
Hiv Services ◽  
Facility Type

Objective Although the WHO-developed Service Availability and Readiness Assessment (SARA) tool is a comprehensive and widely applied survey of health facility preparedness, SARA data have not previously been used to model predictors of readiness. We sought to demonstrate that SARA data can be used to model availability of essential medicines for treating non-communicable diseases (EM-NCD). Methods We fit a Poisson regression model using 2013 SARA data from 196 Ugandan health facilities. The outcome was total number of different EM-NCD available. Basic amenities, equipment, region, health facility type, managing authority, NCD diagnostic capacity, and range of HIV services were tested as predictor variables. Findings In multivariate models, we found significant associations between EM-NCD availability and region, managing authority, facility type, and range of HIV services. For-profit facilities’ EM-NCD counts were 98% higher than public facilities (p<.001). General hospitals and referral health centers had 98% (p=.004) and 105% (p=.002) higher counts compared to primary health centers. Facilities in the North and East had significantly lower counts than those in the capital region (p=0.015; p=0.003). Offering HIV care was associated with 35% lower EM-NCD counts (p=0.006). Offering HIV counseling and testing was associated with 57% higher counts (p=0.048). Conclusion We identified multiple within-country disparities in availability of EM-NCD in Uganda. Our findings can be used to identify gaps and guide distribution of limited resources. While the primary purpose of SARA is to assess and monitor health services readiness, we show that it can also be an important resource for answering complex research and policy questions requiring multivariate analysis.

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

2017 ◽  
Author(s):  
Mari Armstrong-Hough ◽  
Sandeep Kishore ◽  
Sarah Byakika ◽  
Gerald Mutungi ◽  
Marcella Nunez-Smith ◽  
...  
Keyword(s):  
Health Facility ◽  
Communicable Diseases ◽  
Health Centers ◽  
Essential Medicines ◽  
Hiv Care ◽  
Service Availability ◽  
Readiness Assessment ◽  
Non Communicable Diseases ◽  
Hiv Services ◽  
Facility Type

Objective Although the WHO-developed Service Availability and Readiness Assessment (SARA) tool is a comprehensive and widely applied survey of health facility preparedness, SARA data have not previously been used to model predictors of readiness. We sought to demonstrate that SARA data can be used to model availability of essential medicines for treating non-communicable diseases (EM-NCD). Methods We fit a Poisson regression model using 2013 SARA data from 196 Ugandan health facilities. The outcome was total number of different EM-NCD available. Basic amenities, equipment, region, health facility type, managing authority, NCD diagnostic capacity, and range of HIV services were tested as predictor variables. Findings In multivariate models, we found significant associations between EM-NCD availability and region, managing authority, facility type, and range of HIV services. For-profit facilities’ EM-NCD counts were 98% higher than public facilities (p<.001). General hospitals and referral health centers had 98% (p=.004) and 105% (p=.002) higher counts compared to primary health centers. Facilities in the North and East had significantly lower counts than those in the capital region (p=0.015; p=0.003). Offering HIV care was associated with 35% lower EM-NCD counts (p=0.006). Offering HIV counseling and testing was associated with 57% higher counts (p=0.048). Conclusion We identified multiple within-country disparities in availability of EM-NCD in Uganda. Our findings can be used to identify gaps and guide distribution of limited resources. While the primary purpose of SARA is to assess and monitor health services readiness, we show that it can also be an important resource for answering complex research and policy questions requiring multivariate analysis.

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 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 Variation in Price of Medicines and Free Medicine Availability for Treatment of Non-communicable Diseases in Public Sector of Eastern Nepal

2018 ◽  
Vol 16 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Amrit Devkota ◽  
Anubhav Paudel ◽  
Bhawesh Koirala ◽  
Dharanidhar Baral ◽  
Swotantra Gautam ◽  
...  
Keyword(s):  
Public Health ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Communicable Diseases ◽  
Health Centers ◽  
Essential Medicines ◽  
Essential Drug ◽  
Price Variation ◽  
Non Communicable Diseases ◽  
Medicine Availability

Background: Nepal is witnessing rise in non-communicable chronic diseases. Costs of the medicine, availability of the medicine for free in public health sectors and variation of price of medicines may play an important role in the management of chronic disease. The study was undertaken to find out the variation in price of drugs used for treating non communicable diseases among private pharmacies and availability of free essential medicines in public facilities.Methods: Randomly selected 33 public health centers and 13 pharmacies were included for the study. Availability of free essential medicines for treating selected chronic diseases was assessed in public health centers and percentage price variation in various branded drugs used for treating these diseases was assessed at the consumer level.Results: Out of 89 different formulations, variations between maximum and minimum priced brands of more than 100% were observed in 37 formulations and that of > 200% in 22 formulations. Thirty-seven formulations had more than 100% inter-pharmacy variation. The most commonly available free essential medicines was 4 mg salbutamol (88.57%) while the least available free essential drug was levothyroxine 5 mg (9.0%).Conclusions: Considerable variation in prices is seen among similar drugs and in prices of same drug in different pharmacies. These factors may have implications in the management of chronic disease in Nepal offsetting the government’s effort to control chronic diseases.

scholarly journals Constructing a malaria-related health service readiness index and assessing its association with child malaria mortality: an analysis of the Burkina Faso 2014 SARA data

2020 ◽  
Author(s):  
Ourohiré Millogo ◽  
Jean Edouard Odilon Doamba ◽  
Ali Sié ◽  
Juerg Utzinger ◽  
penelope vounatsou
Keyword(s):  
Mortality Rate ◽  
Burkina Faso ◽  
Mortality Rates ◽  
Essential Medicines ◽  
Service Availability ◽  
Readiness Assessment ◽  
Malaria Mortality ◽  
Health Centres ◽  
Geostatistical Models ◽  
Facility Readiness

Abstract Abstract Background: The Service Availability and Readiness Assessment (SARA) surveys generate data on the readiness of health facility services. We constructed a readiness index related to malaria services and determined the association between health facility malaria readiness and malaria mortality in children under the age of 5 years in Burkina Faso. Methods: Data on inpatients visits and malaria-related deaths in under 5-year-old children were extracted from the national Health Management Information System (HMIS) in Burkina Faso. Bayesian geostatistical models with variable selection were fitted to malaria mortality data. The most important facility readiness indicators related to general and malaria-specific services were determined. Multiple correspondence analysis (MCA) was used to construct a composite facility readiness score based on multiple factorial axes. The analysis was carried out separately for 112 medical centres and 546 peripheral health centres. Results: Malaria mortality rate in medical centres was 4.8 times higher than that of peripheral health centres (3.46% vs. 0.72%, p<0.0001). Essential medicines was the domain with the lowest readiness (only 0.1% of medical centres and 0% of peripheral health centres had the whole set of tracer items of essential medicines). Basic equipment readiness was the highest. The composite readiness score explained 30% and 53% of the original set of items for medical centres and peripheral health centres, respectively. Mortality rate ratio (MRR) was by 59% (MRR = 0.41, 95% Bayesian credible interval (BCI): 0.19-0.91) lower in the high readiness group of peripheral health centres, compared to the low readiness group. Medical centres readiness was not related to malaria mortality. The geographical distribution of malaria mortality rate indicate that regions with health facilities with high readiness show lower mortality rates. Conclusion: Performant health services in Burkina Faso are associated with lower malaria mortality rates. Health system readiness should be strengthened in the regions of Sahel, Sud-Ouest and Boucle du Mouhoun. Emphasis should be given to improving the management of essential medicines and to reducing delays of emergency transportation between the different levels of the health system. Keywords: Bayesian geostatistical models, Burkina Faso, Composite readiness index, Malaria, Service Availability and Readiness Assessment

Characterization of smoking as a risk factor for chronic non-communicable diseases from the data of an analysis of the activities of Tomsk health centers

2015 ◽  
Vol 18 (1) ◽  
pp. 21 ◽  
Author(s):  
O. S. Kobyakova ◽  
E. S. Kulikov ◽  
I. A. Deev ◽  
E. A. Starovoitova ◽  
N. V. Selivanova ◽  
...  
Keyword(s):  
Risk Factor ◽  
Communicable Diseases ◽  
Health Centers ◽  
Non Communicable Diseases

scholarly journals Non-communicable diseases and HIV care and treatment: models of integrated service delivery

2017 ◽  
Vol 22 (8) ◽  
pp. 926-937 ◽  
Author(s):  
Malia Duffy ◽  
Bisola Ojikutu ◽  
Soa Andrian ◽  
Elaine Sohng ◽  
Thomas Minior ◽  
...  
Keyword(s):  
Service Delivery ◽  
Communicable Diseases ◽  
Hiv Care ◽  
Non Communicable Diseases ◽  
Integrated Service Delivery ◽  
Treatment Models ◽  
Care And Treatment ◽  
Integrated Service

scholarly journals Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa

2021 ◽  
Vol 18 (20) ◽  
pp. 10751
Author(s):  
Marie Brault ◽  
Sten Vermund ◽  
Muktar Aliyu ◽  
Saad Omer ◽  
Dave Clark ◽  
...  
Keyword(s):  
South African ◽  
Communicable Disease ◽  
Low Cost ◽  
Healthcare Delivery ◽  
Strong Support ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Non Communicable Diseases ◽  
Sub Saharan

In Sub-Saharan Africa, communicable and other tropical infectious diseases remain major challenges apart from the continuing HIV/AIDS epidemic. Recognition and prevalence of non-communicable diseases have risen throughout Africa, and the reimagining of healthcare delivery is needed to support communities coping with not only with HIV, tuberculosis, and COVID-19, but also cancer, cardiovascular disease, diabetes, and depression. Many non-communicable diseases can be prevented or treated with low-cost interventions, yet implementation of such care has been limited in the region. In this Perspective piece, we argue that deployment of an integrated service delivery model is an urgent next step, propose a South African model for integration, and conclude with recommendations for next steps in research and implementation. An approach that is inspired by South African experience would build on existing HIV-focused infrastructure that has been developed by Ministries of Health with strong support from the U.S. President’s Emergency Response for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. An integrated chronic healthcare model holds promise to sustainably deliver infectious disease and non-communicable disease care. Integrated care will be especially critical as health systems seek to cope with the unprecedented challenges associated with COVID-19 and future pandemic threats.

scholarly journals Association between malaria-related health service readiness and malaria mortality in under 5-year-old children in Burkina Faso

2020 ◽  
Author(s):  
Ourohiré Millogo ◽  
Jean Edouard Odilon Doamba ◽  
Ali Sié ◽  
Juerg Utzinger ◽  
Penelope Vounatsou
Keyword(s):  
Mortality Rate ◽  
Health System ◽  
Burkina Faso ◽  
Health Facility ◽  
Health Centers ◽  
Essential Medicines ◽  
Malaria Mortality ◽  
Medical Centers ◽  
Health Centres ◽  
Facility Readiness

Abstract Background: The Service Availability and Readiness Assessment (SARA) surveys generate data on the readiness of health facility services. We constructed a readiness index related to malaria services and determined the association between health facility malaria readiness and malaria mortality in children under the age of 5 years in Burkina Faso. Methods: Data on malaria-related visits and deaths in under 5-year-old children were extracted from the national Health Management Information System (HMIS) in Burkina Faso. Bayesian geostatistical models with variable selection were fitted to malaria mortality data. The most important facility readiness indicators related to general and malaria-specific services were determined. Multiple correspondence analysis (MCA) was used to construct a composite facility readiness score based on multiple factorial axes. The analysis was carried out separately for 112 medical centers and 546 peripheral health centers. Results: Malaria mortality rate in medical centres was 4.8 times higher than that of peripheral health centres (3.46 vs 0.72%, p<0.0001). Essential medicines was the domain with the lowest readiness (only 0.1% of medical centres and 0% of peripheral health centres had the whole set of essential medicines tracer indicators). Basic equipment readiness was the highest. The composite readiness score explained 30% and 53% of the original indicators for medical centers and peripheral health centers, respectively. Mortality rate ratio (MRR) was by 59% (MRR = 0.41, 95% Bayesian credible interval (BCI): 0.19-0.91) lower in the high readiness group of peripheral health centers, compared to the low readiness group. Medical centers readiness was not related to malaria mortality. The geographical distribution of malaria mortality rate showed that regions with high mortality rate have also high proportion of health facilities with low readiness and vice versa. Conclusion: Performant health services in Burkina Faso are associated with lower malaria mortality rates. Health system readiness should be strengthened in the regions of Sahel, Sud-Ouest and Boucle du Mouhoun. Emphasis should be given to improving the management of essential medicines and to reducing delays of emergency transportation between the different levels of the health system.

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