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巴基斯坦旁遮普省不同地区基层医疗保健设施对非传染性疾病管理的提供和准备情况。

Availability and readiness of primary healthcare facilities for the management of non-communicable diseases in different districts of Punjab, Pakistan.

机构信息

Department of Public Health, National University of Medical Sciences (NUMS), Rawalpindi, Punjab, Pakistan.

Department of Public Health, Health Services Academy, Islamabad, Islamabad, Pakistan.

出版信息

Front Public Health. 2023 Mar 10;11:1037946. doi: 10.3389/fpubh.2023.1037946. eCollection 2023.

Abstract

INTRODUCTION

Non-communicable diseases (NCDs) and their effects are rising quickly. NCDs such as cardiovascular illnesses, diabetes, cancer, and chronic lung diseases cause 60% of global deaths; of which, 80% occur in developing countries. In established health systems, primary healthcare handles most of the NCD care.

METHODOLOGY

This is a mixed-method study conducted to analyze the health service availability and readiness toward NCDs using the SARA tool. It included 25 basic health units (BHUs) of Punjab, which were selected through random sampling. Quantitative data were collected using the SARA tools, while qualitative data were collected through in-depth interviews with healthcare providers working at the BHUs.

RESULTS

There was a problem of load shedding of both electricity and water in 52% of the BHUs, which leads to the poor availability of healthcare services. Only eight (32%) out of 25 BHUs provide the diagnosis or management of NCDs. The service availability was the highest for diabetes mellitus (72%), followed by cardiovascular disease (52%) and then chronic respiratory disease (40%). No services were available for cancer at the BHU level.

CONCLUSION

This study raises issues and questions about the primary healthcare system in Punjab in two areas: first, the overall performance system, and second, the readiness of basic healthcare institutions to treat NCDs. The data show that there are many persisting primary healthcare (PHC) deficiencies. The study found a major training and resource deficit (guidelines and promotional materials). Therefore, it is important to include NCD prevention and control training in district training activities. NCDs are underrecognized in primary healthcare (PHC).

摘要

简介

非传染性疾病(NCDs)及其影响迅速增加。心血管疾病、糖尿病、癌症和慢性肺部疾病等 NCD 导致全球 60%的死亡;其中 80%发生在发展中国家。在现有的卫生系统中,初级卫生保健承担了大部分 NCD 护理工作。

方法

这是一项混合方法研究,使用 SARA 工具分析卫生服务的可用性和对 NCD 的准备情况。它包括旁遮普邦的 25 个基本卫生单位(BHUs),这些单位是通过随机抽样选择的。使用 SARA 工具收集定量数据,同时通过对在 BHUs 工作的医疗保健提供者进行深入访谈收集定性数据。

结果

有 52%的 BHUs 存在电力和水的停电问题,这导致医疗服务的可用性较差。只有 25 个 BHUs 中的 8 个(32%)提供 NCD 的诊断或管理服务。糖尿病(72%)的服务可用性最高,其次是心血管疾病(52%),然后是慢性呼吸道疾病(40%)。BHU 级别的癌症没有提供任何服务。

结论

这项研究在两个方面提出了旁遮普邦初级卫生保健系统的问题和疑问:首先是整体绩效系统,其次是基本医疗保健机构治疗 NCD 的准备情况。数据显示存在许多持续存在的初级卫生保健(PHC)缺陷。研究发现了主要的培训和资源不足(指南和宣传材料)。因此,将 NCD 预防和控制培训纳入地区培训活动非常重要。NCD 在初级卫生保健(PHC)中被低估了。

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