College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany.
Front Public Health. 2022 Jul 1;10:882033. doi: 10.3389/fpubh.2022.882033. eCollection 2022.
Eighty percent (80%) of global Non-Communicable Diseases attributed deaths occur in low- and middle-income countries (LMIC) with hypertension and diabetes being key contributors. The overall prevalence of hypertension was 15.3% the national prevalence of diabetes in rural and urban was 7.5 and 9.7%, respectively among 15-64 years. Hypertension represents a leading cause of death (43%) among hospitalized patients at the University teaching hospital of Kigali. This study aimed to identify ongoing population-level interventions targeting risk factors for diabetes and hypertension and to explore perceived barriers and facilitators for their implementation in Rwanda.
This situational analysis comprised a desk review, key informant interviews, and stakeholders' consultation. Ongoing population-level interventions were identified through searches of government websites, complemented by one-on-one consultations with 60 individuals nominated by their respective organizations involved with prevention efforts. Semi-structured interviews with purposively selected key informants sought to identify perceived barriers and facilitators for the implementation of population-level interventions. A consultative workshop with stakeholders was organized to validate and consolidate the findings.
We identified a range of policies in the areas of food and nutrition, physical activity promotion, and tobacco control. Supporting program and environment interventions were mainly awareness campaigns to improve knowledge, attitudes, and practices toward healthy eating, physical activity, and alcohol and tobacco use reduction, healthy food production, physical activity infrastructure, smoke-free areas, limits on tobacco production and bans on non-standardized alcohol production. Perceived barriers included limited stakeholder involvement, misbeliefs about ongoing interventions, insufficient funding, inconsistency in intervention implementation, weak policy enforcement, and conflicts between commercial and public health interests. Perceived facilitators were strengthened multi-sectoral collaboration and involvement in ongoing interventions, enhanced community awareness of ongoing interventions, special attention paid to the elderly, and increased funds for population-level interventions and policy enforcement.
There are many ongoing population-level interventions in Rwanda targeting risk factors for diabetes and hypertension. Identified gaps, perceived barriers, and facilitators provide a useful starting point for strengthening efforts to address the significant burden of disease attributable to diabetes and hypertension.
全球 80%的非传染性疾病死亡归因于中低收入国家（LMIC），其中高血压和糖尿病是主要致病因素。15-64 岁人群中，高血压的总体患病率为 15.3%，农村和城市地区的糖尿病患病率分别为 7.5%和 9.7%。在基加利教学医院住院的患者中，高血压是导致死亡的主要原因（43%）。本研究旨在确定针对糖尿病和高血压危险因素的正在进行的人群干预措施，并探讨其在卢旺达实施的障碍和促进因素。
本情况分析包括桌面审查、关键知情人访谈和利益相关者协商。通过政府网站搜索，以及与各自组织中参与预防工作的 60 人进行一对一咨询，确定正在进行的人群干预措施。对有针对性选择的关键知情人进行半结构化访谈，以确定实施人群干预措施的障碍和促进因素。与利益相关者组织了一次磋商研讨会，以验证和整合研究结果。
我们确定了一系列食品和营养、促进身体活动和控制烟草的政策。支持方案和环境干预措施主要是提高知识、态度和健康饮食、身体活动以及减少酒精和烟草使用、健康食品生产、身体活动基础设施、无烟区、限制烟草生产和禁止非标准化酒精生产等方面的实践意识运动。障碍包括利益相关者参与有限、对正在进行的干预措施的误解、资金不足、干预措施实施不一致、政策执行不力以及商业和公共卫生利益之间的冲突。促进因素包括加强多部门合作和参与正在进行的干预措施、提高社区对正在进行的干预措施的认识、特别关注老年人、增加人群干预措施和政策执行的资金。
卢旺达有许多针对糖尿病和高血压危险因素的正在进行的人群干预措施。确定的差距、障碍和促进因素为加强努力应对归因于糖尿病和高血压的重大疾病负担提供了一个有用的起点。
