Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia.
Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia.
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DOI：
10.1186/s12992-016-0163-y
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发表时间：
2016-06-02
影响因子：
10.8
通讯作者：
Shiferaw F
中科院分区：
文献类型：
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作者：
Letebo M;Shiferaw F
慢性非传染性疾病（NCD）已成为发展中国家巨大的公共卫生问题。然而，许多资源匮乏的国家面临这种日益严重的流行病，缺乏有组织和全面应对非传染性疾病的系统。缺乏非传染性疾病国家政策、战略、治疗指南以及监测和监测系统是许多发展中国家卫生系统的特点。成功应对这一问题需要各国采取一系列行动，包括制定适合具体情况的慢性病护理模式和计划以及患者和计划监测工具的标准化。在这项横断面定性研究中，我们评估了埃塞俄比亚用于非传染性疾病服务的现有监测和评估 (M&E) 工具。由于艾滋病毒护理和治疗计划是该国唯一的大规模慢性病护理计划，我们探索了该计划中使用的监测和评估工具，并分析了如何调整这些工具来支持该国的非传染性疾病服务。文件审查和深入访谈是主要的数据收集方法。访谈对象是专门从艾滋病毒和非传染性疾病患者数量较多的四个卫生机构中挑选的卫生工作者和参与数据管理的工作人员。采用主题分析来理解数据。我们的研究结果表明，非传染性疾病服务明显缺乏信息系统，包括缺乏支持服务的标准化患者和项目监测工具。我们确定了目前正在使用的几种艾滋病毒护理和治疗患者和项目监测工具，以促进接收过程、登记、随访、队列监测、预约、分析和报告。分析了用于艾滋病毒患者和项目监测的每种工具如何适应支持非传染性疾病服务。鉴于艾滋病毒护理和治疗与非传染性疾病服务之间的相似性，以及已经为实施艾滋病毒护理和治疗计划标准化工具进行了大量投资，调整和使用艾滋病毒患者和非传染性疾病服务项目监测工具可以通过构建服务、标准化患者护理和治疗、支持循证规划以及提供干预措施有效性信息，改善埃塞俄比亚的非传染性疾病应对措施。
Chronic non-communicable diseases (NCDs) have become a huge public health concern in developing countries. Many resource-poor countries facing this growing epidemic, however, lack systems for an organized and comprehensive response to NCDs. Lack of NCD national policy, strategies, treatment guidelines and surveillance and monitoring systems are features of health systems in many developing countries. Successfully responding to the problem requires a number of actions by the countries, including developing context-appropriate chronic care models and programs and standardization of patient and program monitoring tools. In this cross-sectional qualitative study we assessed existing monitoring and evaluation (M&E) tools used for NCD services in Ethiopia. Since HIV care and treatment program is the only large-scale chronic care program in the country, we explored the M&E tools being used in the program and analyzed how these tools might be adapted to support NCD services in the country. Document review and in-depth interviews were the main data collection methods used. The interviews were held with health workers and staff involved in data management purposively selected from four health facilities with high HIV and NCD patient load. Thematic analysis was employed to make sense of the data. Our findings indicate the apparent lack of information systems for NCD services, including the absence of standardized patient and program monitoring tools to support the services. We identified several HIV care and treatment patient and program monitoring tools currently being used to facilitate intake process, enrolment, follow up, cohort monitoring, appointment keeping, analysis and reporting. Analysis of how each tool being used for HIV patient and program monitoring can be adapted for supporting NCD services is presented. Given the similarity between HIV care and treatment and NCD services and the huge investment already made to implement standardized tools for HIV care and treatment program, adaptation and use of HIV patient and program monitoring tools for NCD services can improve NCD response in Ethiopia through structuring services, standardizing patient care and treatment, supporting evidence-based planning and providing information on effectiveness of interventions.