Assessment of capacity to prevent and manage major non-communicable diseases (NCDs) in primary care centres in Zambia: A health systems approach

摘要 关于非洲非传染性疾病的国别数据很少，现有的大多数数据都是基于 估计值。赞比亚的情况也是如此，因此很难评估非传染性疾病和 卫生系统应对非传染性疾病负担的能力。在这方面有明显的差距 在初级卫生保健中成功实施非传染性疾病干预措施的证据 在撒哈拉以南非洲，尽管世卫组织通过 世卫组织应对非传染性疾病的基本非传染性疾病干预措施(世卫组织PEN一揽子计划)。 我们提出了一种混合方法来评估卫生系统提供非传染性疾病的能力 通过在赞比亚采用和改编世卫组织推荐的非传染性疾病工具提供相关服务 背景。这项初步工作将为设计一项全面的长期研究提供信息，该研究将 通过R01机制提供支持，该机制将采用世卫组织PEN一揽子计划，以改进 赞比亚境内初级保健中的非传染性疾病服务。 为了实现这些目标，我们组建了一支强大的多学科团队，代表 范德比尔特大学和赞比亚大学。完成这项研究和后续行动 审判不仅将使赞比亚的卫生系统受益，而且还将提供关于如何重新 指导撒哈拉以南非洲的卫生系统，以应对日益增长的非传染性疾病负担。致我们的 知识这将是第一项关于卫生系统应对 非传染性疾病在赞比亚的威胁越来越大。

Abstract Country-specific data on NCDs in Africa are scarce and most of the available data are based on estimations. This is true for Zambia, making it difficult to assess the burden of NCDs and the capacity of the health system to respond to the burden of NCDs. There are clear gaps in the evidence of successful implementation of NCD interventions within the primary health care setting in Sub-Saharan Africa, despite WHO putting forward recommendations through the WHO Essential Non communicable Disease Interventions (WHO PEN package) to tackle NCDs. We propose a mixed-methods approach to assess health systems capacity to provide NCD related services by adopting and adapting a WHO recommended NCD tool in the Zambian context. This preliminary work will inform the design of a comprehensive long-term study to be supported through an R01 mechanism, which will adopt the WHO PEN package to improve NCD services in primary care within Zambia. To accomplish these aims we have assembled a strong multidisciplinary team representing Vanderbilt University and the University of Zambia. Completion of this study and the follow-up trial will not only benefit the health system in Zambia but will also provide evidence on how to re- orient health systems in Sub-Saharan Africa, to address the growing NCD burden. To our knowledge this will be the first study to address health systems’ capacity to respond to the growing threat of NCD in Zambia.