School of Nutrition, Food Science and Technology, Department of Human Nutrition Hawassa University, Hawassa, Ethiopia.
School of Public Health, Department of Public Health Hawassa University, Hawassa, Ethiopia.
PeerJ. 2022 Aug 25;10:e13797. doi: 10.7717/peerj.13797. eCollection 2022.
In low-income nations such as Ethiopia, noncommunicable diseases (NCDs) are becoming more common. The Ethiopian Ministry of Health has prioritized NCD prevention, early diagnosis, and management. However, research on the readiness of public health facilities to address NCDs, particularly hypertension and type II diabetes mellitus, is limited.
The study used a multistage cluster sampling method and a health facility-based cross-sectional study design. A total of 83 health facilities were evaluated based on WHO's Service Availability and Readiness Assessment (SARA) tool to investigate the availability of services and the readiness of the primary health care unit (PHCU) to manage type II diabetes and Hypertension. Trained data collectors interviewed with PHCU head or NCD focal persons. The study tried to investigate (1) the availability of basic amenities and the four domains: staff and guidelines, basic equipment, diagnostic materials, and essential medicines used to manage DM and HPN, (2) the readiness of the PHCU to manage DM and HPN. The data were processed by using SPSS version 24. Descriptive statistics, including frequency and percentage, inferential statistics like the chi-square test, and logistic regression models were used to analyze the data.
Of the 82 health facilities, only 29% and 28% of the PHCU identified as ready to manage HPN and DM. Facility type, facility location, presence of guidelines, trained staff, groups of antihypertensive and antidiabetic medicines had a significant impact ( < 0.05) on the readiness of the PHCU to manage HPN and DM at a 0.05 level of significance. Facilities located in urban were 8.2 times more likely to be ready to manage HPN cases than facilities located in rural (AOR = 8.2, 95% CI [2.4-28.5]) and < 0.05.
The results identified comparatively poor and deprived readiness to offer HPN and DM services at lower-level health facilities(health centers). Equipping the lower-level health facilities with screening and diagnostic materials, essential medicines, and provision of basic training for the health care providers and NCD guidelines should be available, especially in the lower health care facilities.
在埃塞俄比亚等低收入国家,非传染性疾病(NCD)的发病率越来越高。埃塞俄比亚卫生部已将 NCD 的预防、早期诊断和管理列为优先事项。然而,针对公共卫生机构应对 NCD(尤其是高血压和 2 型糖尿病)的准备情况的研究有限。
本研究采用多阶段聚类抽样方法和基于卫生设施的横断面研究设计。共评估了 83 家卫生机构,依据世界卫生组织的服务可用性和准备情况评估(SARA)工具,调查服务的可用性以及初级卫生保健单位(PHCU)管理 2 型糖尿病和高血压的准备情况。经过培训的数据收集员采访了 PHCU 负责人或 NCD 重点人员。该研究试图调查:(1)基本设施和四个领域的可用性:人员和指南、基本设备、诊断材料以及用于管理 DM 和 HPN 的基本药物;(2)PHCU 管理 DM 和 HPN 的准备情况。数据使用 SPSS 版本 24 进行处理。使用描述性统计,包括频率和百分比,以及推断性统计,如卡方检验和逻辑回归模型来分析数据。
在 82 家卫生机构中,只有 29%和 28%的 PHCU 被认为有能力管理 HPN 和 DM。设施类型、设施位置、指南的存在、经过培训的人员、抗高血压药物和抗糖尿病药物组对 PHCU 管理 HPN 和 DM 的准备情况有显著影响(<0.05)。位于城市的设施管理 HPN 病例的可能性是位于农村的设施的 8.2 倍(AOR=8.2,95%CI[2.4-28.5]),差异具有统计学意义(<0.05)。
结果表明,较低级别卫生设施(卫生中心)提供 HPN 和 DM 服务的准备情况较差,资源匮乏。应向较低级别的卫生设施提供筛查和诊断材料、基本药物,并为卫生保健提供者和 NCD 指南提供基本培训。