Lupafya Phindile Chitsulo, Mwagomba Beatrice L Matanje, Hosig Kathy, Maseko Lucy M, Chimbali Henry
Family Health International (FHI 360), Lilongwe, Malawi.
Clinical Services Department, Ministry of Health, Lilongwe, Malawi.
Health Educ Behav. 2016 Apr;43(1 Suppl):64S-9S. doi: 10.1177/1090198115614313.
Malawi is a Sub-Saharan African country experiencing the epidemiological transition from predominantly infectious to noncommunicable diseases (NCDs) with dramatically increasing prevalence of lifestyle-related diseases such as obesity, hypertension, and diabetes. Malawi's 2011-2016 Health Sector Strategic Plan included NCDs, and an NCD Control Program was established with subsequent development of a National Action Plan for prevention and management of NCDs launched in 2013. The current study was designed to identify gaps in implementation of NCD control program policies and action plan strategies by describing current efforts toward prevention and management of NCDs in Malawi with emphasis on challenges and opportunities. Semistructured questionnaires were used to collect quantitative and qualitative data from Malawi Ministry of Health personnel (senior officers, service providers, health education officers, and nutritionists) in 10 health districts and 3 central hospitals. Frequencies were generated for quantitative data. Qualitative data were used to generate themes and most common responses. Results showed that current services focus on facility-based NCD screening and clinical services rather than active screening, prevention, and community awareness and outreach, although respondents emphasized the importance of prevention, lifestyle education, and community outreach. Respondents indicated inadequate resources for NCD services including financial capital, human resources, equipment and supplies, and transportation. While Malawi has begun to address NCDs, policy and practice implications include (a) better integration of services within the existing infrastructure with emphasis on capacity building; (b) greater implementation of planned NCD activities; (c) a stronger, more comprehensive data management system; and (d) innovative funding solutions.
马拉维是撒哈拉以南非洲的一个国家，正经历着从以传染病为主向非传染性疾病的流行病学转变，与肥胖、高血压和糖尿病等生活方式相关疾病的患病率急剧上升。马拉维2011 - 2016年卫生部门战略计划纳入了非传染性疾病内容，并设立了非传染性疾病控制项目，随后于2013年制定并发布了预防和管理非传染性疾病的国家行动计划。本研究旨在通过描述马拉维目前在非传染性疾病预防和管理方面的努力，重点关注挑战和机遇，来找出非传染性疾病控制项目政策和行动计划战略实施中的差距。采用半结构化问卷从马拉维卫生部在10个卫生区和3家中心医院的人员（高级官员、服务提供者、健康教育官员和营养师）中收集定量和定性数据。对定量数据进行频次统计。定性数据用于生成主题和最常见的回答。结果显示，目前的服务侧重于基于机构的非传染性疾病筛查和临床服务，而非主动筛查、预防以及社区意识和宣传推广，尽管受访者强调了预防、生活方式教育和社区宣传的重要性。受访者指出非传染性疾病服务资源不足，包括资金、人力资源、设备和物资以及交通方面。虽然马拉维已开始应对非传染性疾病问题，但政策和实践方面的影响包括：(a) 在现有基础设施内更好地整合服务，重点是能力建设；(b) 加大计划中的非传染性疾病活动的实施力度；(c) 建立更强大、更全面的数据管理系统；(d) 创新资金解决方案。
