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坦桑尼亚初级卫生保健服务的可及性差异及管理糖尿病准备情况的预测。

Disparities in availability of services and prediction of the readiness of primary healthcare to manage diabetes in Tanzania.

机构信息

Department of Community Medicine, The University of Dodoma, Dodoma, Tanzania.

Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.

出版信息

Prim Care Diabetes. 2021 Apr;15(2):365-371. doi: 10.1016/j.pcd.2020.11.007. Epub 2020 Nov 28.

Abstract

BACKGROUND

The burdens of Non-communicable Diseases have overstretched health systems in developing countries. The study explores disparities in the availability of services and predicts the readiness of primary healthcare facilities to manage diabetes in Tanzania.

METHODS

The study analyzed data from the 2014-2015 Tanzania Service Provision Assessment Survey. A total of 1142 primary healthcare facilities were included in this analysis. The Negative binomial regression models were fitted to predict each of selected independent variable that is associated with the readiness of primary healthcare to manage diabetes.

RESULTS

The overall availability of services was significantly different across the type of facility and managing authority. In an adjusted model, the following were the predictors for a significant increase in readiness to manage diabetes: health center [β = 0.470], private facilities [β = 0.252], the performance of management meetings [β = 0.446], having source of fund other than government [β = 0.193,], and presence of medical doctors [β = 0.677].

CONCLUSION

The robust primary care systems to manage diabetes could be achieved by improving the readiness of primary healthcare facilities through optimizing the availability of diagnostic tools, basic medicines, medical doctors, and early release of a government fund to publicly-owned facilities.

摘要

背景

非传染性疾病的负担使发展中国家的卫生系统不堪重负。本研究探讨了服务提供方面的差异,并预测了坦桑尼亚初级保健设施管理糖尿病的准备情况。

方法

本研究分析了 2014-2015 年坦桑尼亚服务提供情况评估调查的数据。共有 1142 家初级保健设施纳入本分析。采用负二项回归模型预测与初级保健管理糖尿病准备情况相关的每个选定自变量。

结果

各设施类型和管理机构的整体服务提供情况存在显著差异。在调整后的模型中,以下是提高管理糖尿病准备情况的显著预测因素:卫生中心[β=0.470]、私立机构[β=0.252]、管理会议的执行情况[β=0.446]、有政府以外的资金来源[β=0.193]和有医生[β=0.677]。

结论

通过优化诊断工具、基本药物、医生的可及性,并提前向公有制设施发放政府资金,可改善初级保健设施的准备情况,从而建立健全的初级保健系统来管理糖尿病。

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