Biswas Tuhin, Haider M Moinuddin, Das Gupta Rajat, Uddin Jasim
Universal Health Coverage, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Initiative for Climate Change and Health, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
BMJ Open. 2018 Oct 31;8(10):e022817. doi: 10.1136/bmjopen-2018-022817.
The objective of this study was to assess the readiness of health facilities for diabetes and cardiovascular services in Bangladesh.
This study was a cross-sectional survey.
This study used data from a nationwide Bangladesh Health Facility Survey conducted by the Ministry of Health and Social Welfare in 2014.
A total of 319 health facilities delivering services focused on diabetes and cardiovascular diseases (CVD) were included in the survey. Some of these facilities were run by the public sector while others were managed by the private sector and non-governmental organisations. It was a mix of primary and secondary care facilities.
The primary outcome was readiness of health facilities for diabetes and cardiovascular services. We analysed relevant data following the Service Availability and Readiness Assessment manual of the WHO to assess the readiness of selected health facilities towards services for diabetes and CVD.
58% and 24.1% of the facilities had diagnosis and treatment services for diabetes and CVD, respectively. Shortage of trained staff (18.8% and 14.7%) and lack of adequate medicine supply (23.5% and 43.9%) were identified to be factors responsible for inadequate services for diabetes and CVD. Among the facilities that offer services for diabetes and CVD, only 0.4% and 0.9% had all the four service readiness factors (guideline, trained staff, equipment and medicine).
The study suggests that health facilities suffered from numerous drawbacks, such as shortage of trained staff and required medicine. Most importantly, they lack effective guidelines on the diagnosis and treatment for diabetes and CVD. It is, therefore, essential now to ensure that there are trained staff, adequate medicine supply, and appropriate guidelines on the diagnosis and treatment for diabetes and CVD in Bangladesh.
本研究的目的是评估孟加拉国医疗机构提供糖尿病和心血管疾病服务的准备情况。
本研究为横断面调查。
本研究使用了2014年由卫生和社会福利部开展的全国性孟加拉国医疗机构调查的数据。
共有319家提供糖尿病和心血管疾病服务的医疗机构纳入调查。其中一些机构由公共部门运营，而其他机构由私营部门和非政府组织管理。这是初级和二级保健机构的混合体。
主要结局是医疗机构提供糖尿病和心血管疾病服务的准备情况。我们按照世界卫生组织的服务可用性和准备情况评估手册分析相关数据，以评估选定医疗机构提供糖尿病和心血管疾病服务的准备情况。
分别有58%和24.1%的机构具备糖尿病和心血管疾病的诊断和治疗服务。经培训的工作人员短缺（分别为18.8%和14.7%）以及药品供应不足（分别为23.5%和43.9%）被确定为导致糖尿病和心血管疾病服务不足的因素。在提供糖尿病和心血管疾病服务的机构中，只有0.4%和0.9%具备所有四个服务准备因素（指南、经培训的工作人员、设备和药品）。
该研究表明，医疗机构存在诸多缺陷，如经培训的工作人员短缺和所需药品不足。最重要的是，它们缺乏关于糖尿病和心血管疾病诊断和治疗的有效指南。因此，现在必须确保孟加拉国有经培训的工作人员、充足的药品供应以及关于糖尿病和心血管疾病诊断和治疗的适当指南。
