Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
National Tuberculosis Control Program, Manzini, Eswatini.
Int J Public Health. 2023 Mar 30;68:1605551. doi: 10.3389/ijph.2023.1605551. eCollection 2023.
This study describes the availability of basic services, equipment, and commodities for integrated DM-TB services, best practices by healthcare workers, and opportunities for better integration of DM-TB care in Eswatini. A qualitative design was used. Twenty-three healthcare workers participated in a survey and key informant interview. Most respondents indicated DM and TB care are integrated and clients access blood pressure and fasting/random blood glucose assessment. Few respondents indicated they provide visual assessment, hearing assessment, and HbA1c testing. Respondents experienced stockouts of urinalysis strips, antihypertensive drugs, insulin, glucometer strips, and DM drugs in the previous 6 months before the interview. Four main themes emerged from the qualitative interviews-quality and current standards of care, best practices, opportunities, and recommendations to improve integrated services delivery. While DM care is provided for TB patients, the implementation of integrated DM-TB services is suboptimal as the quality and current standards of care vary across health facilities due to different patient-level and health system challenges. Some identified opportunities must be utilized for a successful DM-TB integration.
本研究描述了在斯威士兰，基本服务、设备和商品的提供情况，卫生保健工作者的最佳做法，以及更好地整合糖尿病-结核病护理的机会。本研究采用定性设计。23 名卫生保健工作者参与了一项调查和关键知情人访谈。大多数受访者表示，糖尿病和结核病的护理是整合在一起的，患者可以接受血压和空腹/随机血糖评估。很少有受访者表示他们提供视力评估、听力评估和 HbA1c 检测。在访谈前的 6 个月内，受访者经历了尿液分析条、抗高血压药物、胰岛素、血糖仪条和糖尿病药物的库存短缺。从定性访谈中出现了四个主题——护理的质量和当前标准、最佳做法、机会和改进综合服务提供的建议。虽然为结核病患者提供了糖尿病护理，但由于不同患者层面和卫生系统挑战导致各卫生机构的护理质量和当前标准不同，因此，综合糖尿病-结核病服务的实施并不理想。必须利用一些已确定的机会，以成功地整合糖尿病-结核病护理。
