Assessing the readiness of health facilities for diabetes and cardiovascular services in Bangladesh: a cross-sectional survey

Abstract

ObjectiveThe objective of this study was to assess the readiness of health facilities for diabetes and cardiovascular services in Bangladesh.DesignThis study was a cross-sectional survey.SettingThis study used data from a nationwide Bangladesh Health Facility Survey conducted by the Ministry of Health and Social Welfare in 2014.ParticipantsA total of 319 health facilities delivering services focused on diabetes and cardiovascular diseases (CVD) were included in the survey. Some of these facilities were run by the public sector while others were managed by the private sector and non-governmental organisations. It was a mix of primary and secondary care facilities.Primary and secondary outcome measuresThe primary outcome was readiness of health facilities for diabetes and cardiovascular services. We analysed relevant data following the Service Availability and Readiness Assessment manual of the WHO to assess the readiness of selected health facilities towards services for diabetes and CVD.Results58% and 24.1% of the facilities had diagnosis and treatment services for diabetes and CVD, respectively. Shortage of trained staff (18.8% and 14.7%) and lack of adequate medicine supply (23.5% and 43.9%) were identified to be factors responsible for inadequate services for diabetes and CVD. Among the facilities that offer services for diabetes and CVD, only 0.4% and 0.9% had all the four service readiness factors (guideline, trained staff, equipment and medicine).ConclusionsThe study suggests that health facilities suffered from numerous drawbacks, such as shortage of trained staff and required medicine. Most importantly, they lack effective guidelines on the diagnosis and treatment for diabetes and CVD. It is, therefore, essential now to ensure that there are trained staff, adequate medicine supply, and appropriate guidelines on the diagnosis and treatment for diabetes and CVD in Bangladesh.

Quality and barriers of outpatient diabetes care in rural health facilities in Uganda – a mixed methods study

“…The readiness of the health facilities in this study to offer DM services was less than optimal due to shortage of trained health workers, poor availability of supplies and medicines, inadequate guidelines and support systems for diabetes services. This finding is similar to what was reported by other, mostly cross-sectional studies, that assessed readiness and quality of diabetes care in Ethiopia [17], Bangladesh [18], Brazil [28] and Malawi [19]; where provision of diabetes services was greatly affected by lack of effective guidelines for diagnosis and management of diabetes, shortage of trained health workers and inadequate availability of medicines and equipment. In addition to these, a facility capacity assessment survey in Uganda [16] also found gaps in the availability of essential services and inadequate diagnostic capacity in most of the public sector facilities assessed.…”

“…However, care for chronic diseases is persistently affected by poor availability of equipment and essential medicines, limited diagnostic capacity, inadequate essential services and lack of standard guidelines [15, 16]. Similar gaps affect readiness of health systems in other developing countries like Ethiopia [17], Bangladesh [18] and Malawi [19].…”

Health system’s readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey

“…For instance, year round availability of essential medicines in Nepal was 16.6% in health facilities from the Mountains, 57.1% in the Hills, and 52.2% in the Terai [ 46 ]. A study in Bangladesh reported that the poor supply chain management for essential medicines affected the management of NCDs in the rural settings [ 47 ].…”

Availability and price changes of potential medicines and equipment for the prevention and treatment of COVID-19 among pharmacy and drug stores in Bangladesh; findings and implications

“…This is a concern as Kasonde et al (2019) recently ascertained that several purchased medicines to manage non-communicable diseases (NCDs) in Bangladesh were expensive by international standards, with the least affordable being bisoprolol (for hypertension), metformin and atorvastatin, adding to concerns with affordability to treat family members with T2DM 28 . We are aware of ongoing plans in Bangladesh to reduce the prevalence and burden of NCDs; however, there are concerns with their implementation [29][30][31][32] . There are also currently high rates of smoking in Bangladesh, up to 35% of the adult population, highest among the South East Asian countries 11,[33][34][35] , adding to the cost and burden of NCDs 35,36 , which also needs to be addressed.…”