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Readiness of Ugandan health services for the management of outpatients with chronic diseases
OBJECTIVE: Traditionally, health systems in sub‐Saharan Africa have focused on acute conditions. Few data exist on the readiness of African health facilities (HFs) to address the growing burden of chronic diseases (CDs), specifically chronic, non‐communicable diseases (NCDs). METHODS: A stratified r...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4758403/ https://www.ncbi.nlm.nih.gov/pubmed/26095069 http://dx.doi.org/10.1111/tmi.12560 |
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author | Katende, David Mutungi, Gerald Baisley, Kathy Biraro, Samuel Ikoona, Eric Peck, Robert Smeeth, Liam Hayes, Richard Munderi, Paula Grosskurth, Heiner |
author_facet | Katende, David Mutungi, Gerald Baisley, Kathy Biraro, Samuel Ikoona, Eric Peck, Robert Smeeth, Liam Hayes, Richard Munderi, Paula Grosskurth, Heiner |
author_sort | Katende, David |
collection | PubMed |
description | OBJECTIVE: Traditionally, health systems in sub‐Saharan Africa have focused on acute conditions. Few data exist on the readiness of African health facilities (HFs) to address the growing burden of chronic diseases (CDs), specifically chronic, non‐communicable diseases (NCDs). METHODS: A stratified random sample of 28 urban and rural Ugandan HFs was surveyed to document the burden of selected CDs by analysing the service statistics, service availability and service readiness using a modified WHO Service Availability and Readiness Assessment questionnaire. Knowledge, skills and practice in the management of CDs of 222 health workers were assessed through a self‐completed questionnaire. RESULTS: Among adult outpatient visits at hospitals, 33% were for CDs including HIV vs. 14% and 4% at medium‐sized and small health centres, respectively. Many HFs lacked guidelines, diagnostic equipment and essential medicines for the primary management of CDs; training and reporting systems were weak. Lower‐level facilities routinely referred patients with hypertension and diabetes. HIV services accounted for most CD visits and were stronger than NCD services. Systems were weaker in lower‐level HFs. Non‐doctor clinicians and nurses lacked knowledge and experience in NCD care. CONCLUSION: Compared with higher level HFs, lower‐level ones are less prepared and little used for CD care. Health systems in Uganda, particularly lower‐level HFs, urgently need improvement in managing common NCDs to cope with the growing burden. This should include the provision of standard guidelines, essential diagnostic equipment and drugs, training of health workers, supportive supervision and improved referral systems. Substantially better HIV basic service readiness demonstrates that improved NCD care is feasible. |
format | Online Article Text |
id | pubmed-4758403 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-47584032016-02-29 Readiness of Ugandan health services for the management of outpatients with chronic diseases Katende, David Mutungi, Gerald Baisley, Kathy Biraro, Samuel Ikoona, Eric Peck, Robert Smeeth, Liam Hayes, Richard Munderi, Paula Grosskurth, Heiner Trop Med Int Health Original Research Papers OBJECTIVE: Traditionally, health systems in sub‐Saharan Africa have focused on acute conditions. Few data exist on the readiness of African health facilities (HFs) to address the growing burden of chronic diseases (CDs), specifically chronic, non‐communicable diseases (NCDs). METHODS: A stratified random sample of 28 urban and rural Ugandan HFs was surveyed to document the burden of selected CDs by analysing the service statistics, service availability and service readiness using a modified WHO Service Availability and Readiness Assessment questionnaire. Knowledge, skills and practice in the management of CDs of 222 health workers were assessed through a self‐completed questionnaire. RESULTS: Among adult outpatient visits at hospitals, 33% were for CDs including HIV vs. 14% and 4% at medium‐sized and small health centres, respectively. Many HFs lacked guidelines, diagnostic equipment and essential medicines for the primary management of CDs; training and reporting systems were weak. Lower‐level facilities routinely referred patients with hypertension and diabetes. HIV services accounted for most CD visits and were stronger than NCD services. Systems were weaker in lower‐level HFs. Non‐doctor clinicians and nurses lacked knowledge and experience in NCD care. CONCLUSION: Compared with higher level HFs, lower‐level ones are less prepared and little used for CD care. Health systems in Uganda, particularly lower‐level HFs, urgently need improvement in managing common NCDs to cope with the growing burden. This should include the provision of standard guidelines, essential diagnostic equipment and drugs, training of health workers, supportive supervision and improved referral systems. Substantially better HIV basic service readiness demonstrates that improved NCD care is feasible. John Wiley and Sons Inc. 2015-07-08 2015-10 /pmc/articles/PMC4758403/ /pubmed/26095069 http://dx.doi.org/10.1111/tmi.12560 Text en © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Papers Katende, David Mutungi, Gerald Baisley, Kathy Biraro, Samuel Ikoona, Eric Peck, Robert Smeeth, Liam Hayes, Richard Munderi, Paula Grosskurth, Heiner Readiness of Ugandan health services for the management of outpatients with chronic diseases |
title | Readiness of Ugandan health services for the management of outpatients with chronic diseases |
title_full | Readiness of Ugandan health services for the management of outpatients with chronic diseases |
title_fullStr | Readiness of Ugandan health services for the management of outpatients with chronic diseases |
title_full_unstemmed | Readiness of Ugandan health services for the management of outpatients with chronic diseases |
title_short | Readiness of Ugandan health services for the management of outpatients with chronic diseases |
title_sort | readiness of ugandan health services for the management of outpatients with chronic diseases |
topic | Original Research Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4758403/ https://www.ncbi.nlm.nih.gov/pubmed/26095069 http://dx.doi.org/10.1111/tmi.12560 |
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