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Readiness of Ugandan health services for the management of outpatients with chronic diseases.
- Source :
-
Tropical medicine & international health : TM & IH [Trop Med Int Health] 2015 Oct; Vol. 20 (10), pp. 1385-95. Date of Electronic Publication: 2015 Jul 08. - Publication Year :
- 2015
-
Abstract
- 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).<br />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.<br />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.<br />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.<br /> (© 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.)
- Subjects :
- Attitude of Health Personnel
Chronic Disease
Health Knowledge, Attitudes, Practice
Health Personnel
Health Services standards
Humans
Outpatients
Rural Health
Surveys and Questionnaires
Uganda
Urban Health
Cardiovascular Diseases diagnosis
Cardiovascular Diseases therapy
Delivery of Health Care organization & administration
Diabetes Mellitus diagnosis
Diabetes Mellitus therapy
Epilepsy diagnosis
Epilepsy therapy
HIV Infections diagnosis
HIV Infections therapy
Respiratory Tract Diseases diagnosis
Respiratory Tract Diseases therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1365-3156
- Volume :
- 20
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Tropical medicine & international health : TM & IH
- Publication Type :
- Academic Journal
- Accession number :
- 26095069
- Full Text :
- https://doi.org/10.1111/tmi.12560