scholarly journals How well are non-communicable disease services being integrated into primary health care in Africa: A review of progress against World Health Organization’s African regional targets

PLoS ONE ◽  
2020 ◽  
Vol 15 (10) ◽  
pp. e0240984
Author(s):  
Azeb Gebresilassie Tesema ◽  
Whenayon Simeon Ajisegiri ◽  
Seye Abimbola ◽  
Christine Balane ◽  
Andre Pascal Kengne ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Communicable Disease ◽  
World Health ◽  
Primary Health ◽  
Non Communicable Disease

Seeking Solutions to the Challenges in Health Services in Developing Nations

2015 ◽  
pp. 1-51
Author(s):  
Jessica McCormack ◽  
Patrick Rawstorne ◽  
Mohamud Sheikh
Keyword(s):  
Infectious Disease ◽  
Health Care ◽  
Primary Health Care ◽  
Cardiovascular Diseases ◽  
Burden Of Disease ◽  
Communicable Disease ◽  
Developing Nations ◽  
Global Burden ◽  
Primary Health ◽  
Non Communicable Disease

The Global Burden of Disease (GBD) study, 2010, confirmed that the world's population is living longer and we are now less likely than a decade earlier to die from an infectious disease but also more likely to live our twilight years with morbidity (Murray et al., 2012). We will also most likely die from a chronic non-communicable disease (NCD) such as cardiovascular diseases, cancers, respiratory diseases, and diabetes (Beaglehole, et al., 2008). However this brief glimpse at the trends in the health of the world's population obscures massive inequalities in the burden of disease as well as variations across the globe. In this piece, we will revisit primary health care, both at its dawn, its contribution to developing nations, and the ills it struggled through over the years. Cuba and Thailand are the key examples of developing nations that have experienced the contribution of primary health care more than most other countries.

scholarly journals Treatment Burden Of Non-Communicable Diseases On Patients Attending Primary Health Care In Bahrain 2020: A Cross-Sectional Study

2021 ◽  
Vol 33 (3) ◽  
pp. 16-23
Author(s):  
Fatema Almousawi ◽  
Zahra Ayoob ◽  
Amna Shehab ◽  
Ismaeel Bakhsh ◽  
Mahmood Alawainati ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Communicable Disease ◽  
Cross Sectional Study ◽  
Treatment Burden ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Non Communicable Disease

Background: Adaptation to chronic disease can be challenging. Compliance with medication, adjusting to lifestyle changes, attending health care facilities, and financial costs are among many obstacles encountered. Treatment burden is defined as the effort required by the patient or caregiver to manage the medical conditions of the patient and the impact that this has on their lives. The aim of this study was to help the health care system in establishing new strategies to address the treatment burden on patients with non-communicable diseases. Methods: A cross-sectional study was conducted among patients attending non-communicable disease clinics and central diabetic clinics in eight different primary health care centers in Bahrain, using the Treatment Burden Questionnaire through structured interviews. A value of 59 and above was considered as an unacceptable burden according to patient acceptable symptom state (PASS). Results: Of the 411 participants, around 18% had an unacceptable burden. Female subjects reported a five times higher treatment burden. The younger population of less than 65 years scored higher treatment burden by three folds. Injectable medications were associated with a two-fold increase in treatment burden compared to other medication modalities. Conclusion: Although treatment burden is an emerging and insufficiently addressed concept in the literature, this study revealed an overall low treatment burden. Further studies should be conducted to assess treatment burden and suggest strategies accordingly. Health care providers are encouraged to integrate all patient aspects in the management. New recommendations to formulate updated guidelines with the aim of minimizing the treatment burden are warranted. Keywords: Bahrain, Chronic disease, Non-communicable disease, Primary health care, Surveys and Questionnaires

scholarly journals Health system capacity and readiness for delivery of integrated non-communicable disease services in primary health care: A qualitative analysis of the Ethiopian experience

2021 ◽  
Vol 1 (10) ◽  
pp. e0000026
Author(s):  
Azeb Gebresilassie Tesema ◽  
Seye Abimbola ◽  
Afework Mulugeta ◽  
Whenayon S. Ajisegiri ◽  
Padmanesan Narasimhan ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Communicable Disease ◽  
Addis Ababa ◽  
System Capacity ◽  
World Health ◽  
Political Commitment ◽  
District Health ◽  
Primary Health

Background Non-communicable diseases (NCDs) now account for about 71% and 32% of all the deaths globally and in Ethiopia. Primary health care (PHC) is a vital instrument to address the ever-increasing burden of NCDs and is the best strategy for delivering integrated and equitable NCD care. We explored the capacity and readiness of Ethiopia’s PHC system to deliver integrated, people-centred NCD services. Methods A qualitative study was conducted in two regions and Federal Ministry of Health, Addis Ababa, Ethiopia. We carried out twenty-two key informant interviews with national and regional policymakers, officials from a partner organisation, woreda/district health office managers and coordinators, and PHC workers. Data were coded and thematically analysed using the World Health Organization (WHO) Operational Framework for PHC. Results Although the rising NCD burden is well recognised in Ethiopia, and the country has NCD-specific strategies and some interventions in place, we identified critical gaps in several levers of the WHO Operational Framework. Many compared the under-investment in NCDs contrasted with Ethiopia’s successful PHC models established for maternal and child health and communicable disease programs. Insufficient political commitment and leadership required to integrate NCD services at the PHC level and weaknesses in governance structures, inter-sectoral coordination, and funding for NCDs were identified as significant barriers to strengthening PHC capacity to address NCDs. Among the operational-focussed levers, fragmented information management systems and inadequate equipment and medicines were identified as critical bottlenecks. The PHC workforce was also considered insufficiently skilled and supported to provide NCD services in PHC facilities. Conclusion Strengthening NCD prevention and control through PHC in Ethiopia requires greater political commitment and investment at all health system levels. Prior success strategies with other PHC programs could be adapted and applied to NCD policies and practice, giving due consideration for the unique nature of the NCD program.

scholarly journals Primary Health Care: a strategic framework for the prevention and control of chronic non-communicable disease

2014 ◽  
Vol 7 (1) ◽  
pp. 24504 ◽  
Author(s):  
Alessandro R. Demaio ◽  
Karoline Kragelund Nielsen ◽  
Britt Pinkowski Tersbøl ◽  
Per Kallestrup ◽  
Dan W. Meyrowitsch
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Prevention And Control ◽  
Communicable Disease ◽  
Strategic Framework ◽  
Primary Health ◽  
And Control ◽  
Non Communicable Disease

scholarly journals Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tiina Laatikainen ◽  
Anastasiya Dumcheva ◽  
Tetiana Kiriazova ◽  
Oleksandr Zeziulin ◽  
Laura Inglin ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Capacity Building ◽  
Health Care Professionals ◽  
Communicable Disease ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Primary Health ◽  
Prescription Rates ◽  
Non Communicable Disease

Abstract Background Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in prevention and care. The aim of this study was to evaluate the effect of an interprofessional capacity building intervention carried out in Ukraine to improve the management non-communicable diseases in primary health care. Methods A mixed-methods evaluation study was performed in 2018 to analyse the effect of a capacity building intervention carried out for over 10,000 primary care professionals in Ukraine in 2018. Quantitative data were collected from primary health care records of intervention and control areas preceding the intervention and 1.5 to 2 years after the intervention. Altogether 2798 patient records before and 2795 after the intervention were reviewed. In control areas, 1202 patient records were reviewed. Qualitative data were collected carrying out focus group interviews for health professionals, clinic managers and patients. Also, observations of clinical practice and patient pathways were performed. Results The capacity building intervention improved the capacity of professionals in detection and management of non-communicable disease risk factors. Significant improvement was seen in detection rates of both behavioural and biological risk factors and in medication prescription rates in the intervention areas. However, almost similar improvement in prescription rates was also observed in control clinics. Improvements in control of blood pressure, blood glucose and cholesterol were not seen during the evaluated implementation period. Qualitative analyses highlighted the improved knowledge and skills but challenges in changing the current practice. Conclusions A large scale capacity building intervention improved primary health care professionals’ knowledge, skills and clinical practice on NCD risk detection and reduction. We were not able to detect improvements in treatment outcomes - at least within 1.5 to 2 years follow-up. Improvement of treatment outcomes would most likely need more comprehensive systems change.

Nursing Profession’s Contribution to Person- and People-Centered Primary Health Care

2015 ◽  
Vol 5 (4) ◽  
pp. 197-203
Author(s):  
Yukiko Kusano ◽  
Erica Ehrhardt
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Policy Development ◽  
Workforce Planning ◽  
Policy Decision ◽  
Well Being ◽  
World Health ◽  
Integration Of Care ◽  
Primary Health ◽  
Strategic Role

Background: Equity and access to primary health care (PHC) services, particularly nursing services, are key to improving the health and well-being of all people. Nurses, as the largest group of healthcare professionals delivering services wherever people are, have a unique opportunity to put people at the centre of care, making services more effective, efficient and equitable.Objectives: To assess contributions of nurses to person and people-centered PHC. Methods: Analysis of nursing contributions under each of the four sets of the PHC reforms set by the World Health Organization.Results: Evidence and examples of nursing contributions are found in all of the four PHC reform areas. These include: expanding access;addressing problems through prevention; coordination and integration of care; and supporting the development of appropriate, effective and healthy public policies; and linking field-based innovations and policy development to inform evidence-based policy decision making.Conclusions:Nurses have significant contributions in each of the four PHC reform areas. The focus of nursing care on people-centeredness, continuity of care, comprehensiveness and integration of services, which are fundamental to holistic care, is an essential contribution of nurses to people-centered PHC. Nurses’ contributions can be optimised through positive practice environments, appropriate workforce planning and implementation andadequate education and quality control though strong regulatory principles and frameworks. People-centered approaches need to be considered both in health and non-health sectors as part of people-centered society. A strategic role of nurses as partners in services planning and decision-making is one of the key elements to achieve people-centered PHC.

scholarly journals Desempenho e Importância da Atenção Básica na Prevenção e Controle da Tuberculose: Revisão de Literatura

2019 ◽  
Vol 23 (2) ◽  
pp. 80
Author(s):  
Mikaela Lopes de Caldas ◽  
Francisco Das Chagas Cardoso Filho
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mycobacterium Tuberculosis ◽  
Primary Health Care ◽  
Communicable Disease ◽  
Control Measures ◽  
Historical Period ◽  
Tuberculosis Control ◽  
Treatment And Prevention ◽  
Primary Health

A tuberculose (TB) é uma doença infecciosa e transmissível, causada pelo Mycobacterium tuberculosis. A detecção de casos figura entre as principais medidas de controle da tuberculose, embora grandes avanços tenham ocorrido no que se relaciona ao diagnóstico, tratamento e prevenção da doença, a mesma ainda requer atenção especial, por parte dos profissionais da saúde (equipe multiprofissional) e da sociedade como um todo. A Atenção Básica se caracteriza como ferramenta primordial na suspeição e na detecção dos casos de tuberculose na comunidade. O objetivo geral do presente trabalho é identificar produções científicas que avaliem o desempenho da Atenção Básica no controle da tuberculose. Os objetivos específicos foram: ressaltar a importância da Atenção Básica na detecção dos casos suspeitos; expor a relevância da Atenção Básica como fator indispensável no controle da tuberculose. Caracteriza-se como uma pesquisa bibliográfica explicativa e explorativa, realizada no recorte histórico de 1998 a 2011, período esse definidor para a implementação de medidas de controle da tuberculose. Encontraram-se 29 referências, das quais 19 obedeciam aos critérios de inclusão. Portanto, a Atenção Básica caracterizada como principal porta de entrada ao acesso à saúde, proporciona a aproximação do cidadão às medidas de controle da tuberculose, assim como promove a educação em saúde, que visa a prevenção dos agravos e proporcionam autonomia e autoconhecimento que são indispensáveis para a manutenção da saúde frente às doenças preveníveis como a tuberculose, porém que se configuram como problemas de saúde pública. Palavras-chave: Tuberculose. Atenção Básica. Controle. AbstractTuberculosis (TB) is an infectious and communicable disease caused by mycobacterium tuberculosis. The case detection is one of the main control  measures of tuberculosis, although major advances have occurred regarding the diagnosis, treatment and prevention of the disease, the same still requires special attention on the part of health professionals (multidisciplinary team) and society as a whole. The primary care is characterized as a primary tool in suspicion and detection of tuberculosis cases in the community. The overall objective of this study is to identify scientific production to assess the performance of primary health care in tuberculosis control. The specific objectives were to highlight the importance of primary care in the detection of suspected cases; expose the relevance of primary health care as an essential factor in tuberculosis control. It is characterized as an explanatory and exploratory literature survey, conducted in historical period from 1998 to 2011, a period defined for the implementation of tb control measures. It was found 29 references, 19 of which obeyed the inclusion criteria. Therefore, the primary care characterized as the main gateway to access to health, provides the citizen’s approach to tuberculosis control measures and promotes health education aimed at prevention of injuries and provides autonomy and self-knowledge that are essential for maintenance health against preventable diseases such as tuberculosis, but which are seen as  the main  public health problems. Keywords: Tuberculosis. Primary Care. Control. 

scholarly journals The origins of Ethiopia's primary health care expansion: The politics of state building and health system strengthening

2020 ◽  
Author(s):  
Kevin Croke
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Developmental State ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
World Health ◽  
Director General ◽  
Central Feature ◽  
Primary Health ◽  
Health Programmes

Abstract Ethiopia’s expansion of primary health care over the past 15 years has been hailed as a model in sub-Saharan Africa. A leader closely associated with the programme, Tedros Adhanom Gebreyesus, is now Director-General of the World Health Organization, and the global movement for expansion of primary health care often cites Ethiopia as a model. Starting in 2004, over 30 000 Health Extension Workers were trained and deployed in Ethiopia and over 2500 health centres and 15 000 village-level health posts were constructed. Ethiopia’s reforms are widely attributed to strong leadership and ‘political will’, but underlying factors that enabled adoption of these policies and implementation at scale are rarely analysed. This article uses a political economy lens to identify factors that enabled Ethiopia to surmount the challenges that have caused the failure of similar primary health programmes in other developing countries. The decision to focus on primary health care was rooted in the ruling party’s political strategy of prioritizing rural interests, which had enabled them to govern territory successfully as an insurgency. This wartime rural governance strategy included a primary healthcare programme, providing a model for the later national programme. After taking power, the ruling party created a centralized coalition of regional parties and prioritized extending state and party structures into rural areas. After a party split in 2001, Prime Minister Meles Zenawi consolidated power and implemented a ‘developmental state’ strategy. In the health sector, this included appointment of a series of dynamic Ministers of Health and the mobilization of significant resources for primary health care from donors. The ruling party’s ideology also emphasized mass participation in development activities, which became a central feature of health programmes. Attempts to translate this model to different circumstances should consider the distinctive features of the Ethiopian case, including both the benefits and costs of these strategies.

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