Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa

BACKGROUND: Chronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop interventions to improve management of chronic diseases in the form of...

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Autores principales: Maimela, Eric, Alberts, Marianne, Bastiaens, Hilde, Fraeyman, Jesicca, Meulemans, Herman, Wens, Johan, Van Geertruyden, Jeane Pierre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5935929/
https://www.ncbi.nlm.nih.gov/pubmed/29728147
http://dx.doi.org/10.1186/s12913-018-3085-y
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author Maimela, Eric
Alberts, Marianne
Bastiaens, Hilde
Fraeyman, Jesicca
Meulemans, Herman
Wens, Johan
Van Geertruyden, Jeane Pierre
author_facet Maimela, Eric
Alberts, Marianne
Bastiaens, Hilde
Fraeyman, Jesicca
Meulemans, Herman
Wens, Johan
Van Geertruyden, Jeane Pierre
author_sort Maimela, Eric
collection PubMed
description BACKGROUND: Chronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop interventions to improve management of chronic diseases in the form of an integrated, evidence-based chronic disease management model in Dikgale, a rural area of Limpopo Province in South Africa. METHODS: A multifaceted intervention, called ‘quality circles’ (QCs) was developed to improve the quality and the management of chronic diseases in the Dikgale Health and Demographic Surveillance System (HDSS). These QCs used the findings from previous studies which formed part of the larger project in the study area, namely, the quantitative study using STEPwise survey and qualitative studies using focus group discussions and semi-structured interviews. RESULTS: The findings from previous studies in Dikgale HDSS revealed that an epidemiological transition is occurring. Again, the most widely reported barriers from previous studies in this rural area were: lack of knowledge of NCDs; shortages of medication and shortages of nurses in the clinics, which results in patients having long waiting-time at clinics. Lack of training of health care providers on the management of chronic diseases and the lack of supervision by the district and provincial health managers, together with poor dissemination of guidelines, were contributing factors to the lack of knowledge of non-communicable diseases (NCDs) management among nurses and community health care workers (CHWs). Consideration of all of these findings led to the development of model which focuses on integrating nursing services, CHWs and traditional health practitioners (THPs), including a well-established clinical information system for health care providers. A novel aspect of the model is the inclusion of community ambassadors who are on treatment for NCDs and are, thus, repositories of knowledge who can serve as a bridge between health care workers and community members. CONCLUSION: The model developed highlights the need for health interventions that aim to control risk factors at the population level, the need for availability of NCD-trained nurses, functional equipment and medication and a need to improve the link with traditional healers.
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spelling pubmed-59359292018-05-11 Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa Maimela, Eric Alberts, Marianne Bastiaens, Hilde Fraeyman, Jesicca Meulemans, Herman Wens, Johan Van Geertruyden, Jeane Pierre BMC Health Serv Res Research Article BACKGROUND: Chronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop interventions to improve management of chronic diseases in the form of an integrated, evidence-based chronic disease management model in Dikgale, a rural area of Limpopo Province in South Africa. METHODS: A multifaceted intervention, called ‘quality circles’ (QCs) was developed to improve the quality and the management of chronic diseases in the Dikgale Health and Demographic Surveillance System (HDSS). These QCs used the findings from previous studies which formed part of the larger project in the study area, namely, the quantitative study using STEPwise survey and qualitative studies using focus group discussions and semi-structured interviews. RESULTS: The findings from previous studies in Dikgale HDSS revealed that an epidemiological transition is occurring. Again, the most widely reported barriers from previous studies in this rural area were: lack of knowledge of NCDs; shortages of medication and shortages of nurses in the clinics, which results in patients having long waiting-time at clinics. Lack of training of health care providers on the management of chronic diseases and the lack of supervision by the district and provincial health managers, together with poor dissemination of guidelines, were contributing factors to the lack of knowledge of non-communicable diseases (NCDs) management among nurses and community health care workers (CHWs). Consideration of all of these findings led to the development of model which focuses on integrating nursing services, CHWs and traditional health practitioners (THPs), including a well-established clinical information system for health care providers. A novel aspect of the model is the inclusion of community ambassadors who are on treatment for NCDs and are, thus, repositories of knowledge who can serve as a bridge between health care workers and community members. CONCLUSION: The model developed highlights the need for health interventions that aim to control risk factors at the population level, the need for availability of NCD-trained nurses, functional equipment and medication and a need to improve the link with traditional healers. BioMed Central 2018-05-04 /pmc/articles/PMC5935929/ /pubmed/29728147 http://dx.doi.org/10.1186/s12913-018-3085-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Maimela, Eric
Alberts, Marianne
Bastiaens, Hilde
Fraeyman, Jesicca
Meulemans, Herman
Wens, Johan
Van Geertruyden, Jeane Pierre
Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa
title Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa
title_full Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa
title_fullStr Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa
title_full_unstemmed Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa
title_short Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa
title_sort interventions for improving management of chronic non-communicable diseases in dikgale, a rural area in limpopo province, south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5935929/
https://www.ncbi.nlm.nih.gov/pubmed/29728147
http://dx.doi.org/10.1186/s12913-018-3085-y
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