Readiness of health facilities for the outpatient management of non-communicable diseases in a low-resource setting: an example from a facility-based cross-sectional survey in Tanzania.
Readiness of health facilities for the outpatient management of non-communicable diseases in a low-resource setting: an example from a facility-based cross-sectional survey in Tanzania.
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DOI：
10.1136/bmjopen-2020-040908
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发表时间：
2020-11-11
期刊：
影响因子：
2.9
通讯作者：
Ngajilo D
中科院分区：
文献类型：
--
作者：
Bintabara D;Ngajilo D
本研究以坦桑尼亚作为资源匮乏国家的一个具有全国代表性的卫生机构样本，评估了卫生机构提供非传染性疾病门诊管理的准备情况。基于设施的横断面调查。本研究分析了 2014 年至 2015 年坦桑尼亚服务提供评估调查期间从公立和私营药房/诊所、保健中心和医院收集的数据。本研究包括三个结果变量，即为糖尿病、高血压和慢性呼吸道疾病提供门诊治疗的设施的准备情况。这些是根据世卫组织服务可用性和准备情况评估手册中确定的指标的可用性进行测量的综合变量。这些指标分为三个领域，即人员培训和指南、基本诊断设备和基本药物。通过评估每个领域中所需指标的存在来衡量准备情况。在接受评估的 1188 个医疗机构中，分别有 52.1%、64.8% 和 60.9% 报告提供与糖尿病、高血压和慢性呼吸道疾病相关的服务。一些机构报告拥有治疗指南（33.2%）或接受过提供非传染性疾病服务培训的工作人员（10.4%）。公共较低级别设施中这些疾病的基本诊断设备和药物的供应量明显低于私营设施（p<0.05）。位于城市和更高级别的设施（卫生中心和医院）和公立设施与提供非传染性疾病门诊管理的服务准备指数的提高显着相关。通过来自上级当局或其他机构的进修培训、治疗指南、药品和诊断设备的“推动”系统公平分配资源，可能是加强下级和公共设施准备程度的一种方式，以应对坦桑尼亚等资源匮乏国家日益增加的非传染性疾病负担。
This study assessed the readiness of health facilities to provide outpatient management of non-communicable diseases using a nationally representative sample of health facilities from Tanzania as an example of a low-resource country. Facility-based cross-sectional survey. This study analysed data collected from public and private-owned dispensaries/clinics, health centres and hospitals during the 2014–2015 Tanzania Service Provision Assessment survey. Three outcome variables are included in this study, namely readiness of facilities to provide outpatient management for diabetes, hypertension and chronic respiratory diseases. These were composite variables measured based on availability of indicators identified in the WHO-Service Availability and Readiness Assessment manual. These indicators were grouped into three domains, viz staff training and guidelines, basic diagnostic equipment and basic medicines. Readiness was measured by assessing the presence of required indicators in each of these domains. Out of 1188 health facilities assessed, 52.1%, 64.8% and 60.9% reported providing services related to diabetes, hypertension and chronic respiratory diseases, respectively. A few facilities reported having treatment guidelines (33.2%) or staff trained to provide non-communicable disease services (10.4%). The availability of basic diagnostic equipment and medicines for these diseases was significantly lower in public lower level facilities than in their private counterparts (p<0.05). Facilities located in urban settings as well as higher level (health centre and hospitals) and publicly owned facilities were significantly associated with increased service readiness index for providing outpatient management of non-communicable diseases. A fair distribution of resources through the ‘push’ system of refresher training, treatment guidelines, medicines and diagnostic equipment from higher authorities or other agencies may be one way of strengthening the readiness of lower level and public facilities to cope with the increasing burden of non-communicable diseases in low-resource countries such as Tanzania.
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影响因子：
0.9
作者：
Hajia, Ali M.;Mohammed, Farida A. K.;El-Shazly, Medhat K.
通讯作者：
El-Shazly, Medhat K.
影响因子：
2.7
作者：
Hoang Van Minh;Do, Young Kyung;Tran Tuan Anh
通讯作者：
Tran Tuan Anh
影响因子：
4.9
作者：
Afridi, I;Canny, J;Whitworth, J
通讯作者：
Whitworth, J
DOI：
10.5588/ijtld.15.0734
发表时间：
2016-06-01
影响因子：
4
作者：
Bissell, K.;Perrin, C.;Beran, D.
通讯作者：
Beran, D.
影响因子：
168.9
作者：
Cameron, A.;Ewen, M.;Laing, R.
通讯作者：
Laing, R.