A health system approach to improve NCD outcomes and reduce inequalities in the Republic of Moldova

Skarphedinsdottir, Maria; Smith, Blaine; Ferrario, Alessandra; Zues, Olga; Ciobanu, Angela; Tirdeau, M; Domente, Silviu; Habicht, Jarno; Jakab, Mátyás G.

doi:10.1093/eurpub/cku161.024

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“…Many of these countries, like the Republic of Moldova, struggle to achieve the Sustainable Development Goal target 3.4, which aims to reduce premature NCD mortality by a third between 2015 and 2030 [ 2 ]. In Moldova, NCDs account for nearly 90% of all deaths, with cardiovascular diseases causing 55% [ 3 , 4 ]. Men and rural population are disproportionately affected by NCDs, making them key groups for public health interventions [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Does training on the WHO package of essential noncommunicable (PEN) disease interventions enhance consultation quality? A real-world assessment of adherence to PEN protocol in primary health centres in the Republic of Moldova

Kempers,

Rotaru,

Topa

et al. 2023

Global Health Action

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Background Noncommunicable diseases (NCDs) pose a significant global health challenge. Primary health centres are pivotal in addressing this challenge by providing essential care to NCD patients. The WHO Package of Essential Noncommunicable (PEN) disease interventions has been designed to enhance the quality of NCD consultations and ensure adherence to the protocol. This study investigates the effects of PEN training in Moldova. Objectives The primary objective of this study is to assess the effects of training on WHO PEN on the quality of NCD consultations and adherence to the PEN protocol in a real -world setting in primary health centres in Moldova. Methods An observational, cross-sectional study was conducted, comparing primary health centres where health personnel received PEN training, provided by the Healthy Life project, to those where such training was not provided. In total, 24 family doctors and 24 medical assistants were observed for 233 workdays and covering 2,166 NCD consultations. Results Intervention primary health centres (PHCs) showed longer NCD consultation durations, with family doctors and medical assistants spending an added 1 minute 43 seconds and 3 minutes 10 seconds, respectively. These PHCs also reported a higher proportion of primary NCD consultations, indicating better screening for new NCD patients. Medical assistants in the intervention group took on a more pronounced role in NCD care. However, the findings also highlight the necessity to refine aspects of the PEN training, especially concerning follow-up consultations, risk assessments, and task delegation. Conclusions The findings suggest that the PEN training contributed to improvement of both the quality of NCD consultations and adherence to the PEN protocol. Yet, there is a need for enhancing the identified aspects of the PEN training. The findings highlight the potential of PEN training in primary healthcare settings for improved NCD management.

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Section: Introductionmentioning

confidence: 99%