What are the barriers to the diagnosis and management of chronic respiratory disease in sub-Saharan Africa? A qualitative study with healthcare workers, national and regional policy stakeholders in five countries.
What are the barriers to the diagnosis and management of chronic respiratory disease in sub-Saharan Africa? A qualitative study with healthcare workers, national and regional policy stakeholders in five countries.
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DOI：
10.1136/bmjopen-2021-052105
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发表时间：
2022-07-29
期刊：
影响因子：
2.9
通讯作者：
Taegtmeyer, Miriam
中科院分区：
文献类型：
--
作者：
Mulupi, Stephen;Ayakaka, Irene;Tolhurst, Rachel;Kozak, Nicole;Shayo, Elizabeth Henry;Abdalla, Elhafiz;Osman, Rashid;Egere, Uzochukwu;Mpagama, Stellah G.;Chinouya, Martha;Chikaphupha, Kingsley Rex;ElSony, Asma;Meme, Helen;Oronje, Rose;Ntinginya, Nyanda Elias;Obasi, Angela;Taegtmeyer, Miriam
关键词：
慢性呼吸道疾病是全球四大非传染性疾病之一。它们与健康状况不佳和每年约400万人死亡有关。低收入/中等收入国家日益加重的慢性疾病负担将使本已薄弱的卫生系统不堪重负。本研究旨在探讨肯尼亚、马拉维、苏丹、坦桑尼亚和乌干达的卫生保健工作者和其他卫生政策利益相关者对有效诊断和管理CRD障碍的看法。定性描述性研究。撒哈拉以南非洲五个国家的初级、二级和三级保健设施、政府机构和民间社会组织。2018年至2019年，我们根据政策决策或卫生服务提供中的角色，有目的地选择了60名国家和区级政策利益相关者，以及49名卫生保健工作者，并分别进行了关键线人访谈和深度访谈。采用框架法对数据进行分析。我们确定了在战略政策和医疗机构层面忽视CRD的交叉恶性循环。由于信息系统和诊断能力薄弱，缺乏关于疾病负担的可靠数据，对纳入政策产生不利影响；这又反映在诊断设备、培训和药品的预算拨款较低。在保健设施一级，预算拨款不足限制了诊断能力、服务质量和适当数据的收集，使疾病负担的常规数据更加缺乏。这五个国家的卫生系统没有足够的能力应对慢性腹泻病，随着各国计划应对covid -19后的肺部疾病，这一问题已成为人们关注的焦点。慢性疾病诊断不足、报告不足和资金不足，导致了忽视和忽视的恶性循环。适当的诊断和管理需要加强卫生系统，特别是在初级卫生保健一级。
Chronic respiratory diseases (CRD) are among the top four non-communicable diseases globally. They are associated with poor health and approximately 4 million deaths every year. The rising burden of CRD in low/middle-income countries will strain already weak health systems. This study aimed to explore the perspectives of healthcare workers and other health policy stakeholders on the barriers to effective diagnosis and management of CRD in Kenya, Malawi, Sudan, Tanzania and Uganda. Qualitative descriptive study. Primary, secondary and tertiary health facilities, government agencies and civil society organisations in five sub-Saharan African countries. We purposively selected 60 national and district-level policy stakeholders, and 49 healthcare workers, based on their roles in policy decision-making or health provision, and conducted key informant interviews and in-depth interviews, respectively, between 2018 and 2019. Data were analysed through framework approach. We identified intersecting vicious cycles of neglect of CRD at strategic policy and healthcare facility levels. Lack of reliable data on burden of disease, due to weak information systems and diagnostic capacity, negatively affected inclusion in policy; this, in turn, was reflected by low budgetary allocations for diagnostic equipment, training and medicines. At the healthcare facility level, inadequate budgetary allocations constrained diagnostic capacity, quality of service delivery and collection of appropriate data, compounding the lack of routine data on burden of disease. Health systems in the five countries are ill-equipped to respond to CRD, an issue that has been brought into sharp focus as countries plan for post-COVID-19 lung diseases. CRD are underdiagnosed, under-reported and underfunded, leading to a vicious cycle of invisibility and neglect. Appropriate diagnosis and management require health systems strengthening, particularly at the primary healthcare level.
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DOI：
10.1183/13993003.02325-2014
发表时间：
2015-10
期刊：
The European respiratory journal
影响因子：
--
作者：
Amaral AF;Coton S;Kato B;Tan WC;Studnicka M;Janson C;Gislason T;Mannino D;Bateman ED;Buist S;Burney PG;BOLD Collaborative Research Group
通讯作者：
BOLD Collaborative Research Group
影响因子：
2.9
作者：
Mulupi, Stephen;Ayakaka, Irene;Tolhurst, Rachel;Kozak, Nicole;Shayo, Elizabeth Henry;Abdalla, Elhafiz;Osman, Rashid;Egere, Uzochukwu;Mpagama, Stellah G.;Chinouya, Martha;Chikaphupha, Kingsley Rex;ElSony, Asma;Meme, Helen;Oronje, Rose;Ntinginya, Nyanda Elias;Obasi, Angela;Taegtmeyer, Miriam
通讯作者：
Taegtmeyer, Miriam
影响因子：
2.8
作者：
Barasa, Edwine W.;Cleary, Susan;Molyneux, Sassy
通讯作者：
Molyneux, Sassy
DOI：
10.3390/ijerph6082258
发表时间：
2009-08
影响因子：
--
作者：
Bischoff A;Ekoe T;Perone N;Slama S;Loutan L
通讯作者：
Loutan L
影响因子：
3.3
作者：
Rabkin, Miriam;El-Sadr, Wafaa M.
通讯作者：
El-Sadr, Wafaa M.