Assessment of health service delivery capacities, health providers’ knowledge and practices related to type 2 diabetes care in Kinshasa primary healthcare network facilities, Democratic Republic of the Congo

Abstract

BackgroundDemocratic Republic of the Congo (DRC) is experiencing an increase in the morbi-mortality related to Non Communicable Diseases (NCD). The reform of DRC health system, based on Health District model, is needed in order to tackle this public issue. This article used 2006 International Diabetes Federation (IDF)’s guidelines to assess the capacities of health facilities belonging to Kinshasa Primary Health Care Network (KPHCN) in terms of equipments, as well as the knowledge, and the practice of their health providers related to type 2 diabetes care.MethodsA multicentric cross-sectional study was carried in 18 Health Facilities (HF) of KPHCN in charge of the follow-up of diabetic patients. The presence of IDF recommended materials and equipment was checked and 28 health providers were interviewed about their theoretical knowledge about patients’ management and therapeutic objectives during recommended visits. Chi square test or Fisher exact test was used to compare proportions and the Student t-test to compare means.ResultsThe integration of NCD healthcare in the KPHC network is feasible. The majority of HF possessed IDF recommended materials except for the clinical practice guidelines, urinary test strips, and monofilament, available in only one, two and four HF, respectively. KPHCN referral facilities had required materials for biochemical analyses, the ECG and for the fundus oculi test. Patients’ management is characterized by a lack of attention on the impairment of renal function during the first visits and a poor respect of recommended practices during quarterly and annual visits. A poor knowledge of the reduction of cardiovascular risk factors-related therapeutic objectives has been also reported.ConclusionThe capacities, knowledge, and practice of T2D care were poor among HF of KPHCN. The lack of equipment and training of healthcare professionals should be supplied even to those who are not medical doctors. Special attention must to be put on the clinical practice guidelines formulation and sensitization and on supervision.

Estratos de risco e qualidade do cuidado à pessoa idosa na Atenção Primária à Saúde

“…Even with different methods, which limit the comparison between the data obtained, other national and international studies also emphasized the incipience of the use of the clinical protocol of DM and hypertension recommended for the improvement of the assistance by physicians and nurses working in PHC 10 - 11 , 22 - 23 .…”

Predictors of non-adherence to antihypertensive medication in Kinshasa, Democratic Republic of Congo: a cross-sectional study

“…From October 2013 to November 2013, a cross-sectional study was carried out at Kinshasa Primary Health-care (KPHC) network facilities. This network consists of 51 facilities that allows for follow-up of patients with NCDs like hypertension and diabetes, living in Kinshasa [ 16 ].…”

Assessment of hypertension management in primary health care settings in Kinshasa, Democratic Republic of Congo

“…The KPHC network facilities comprise a constellation of confessional health centers organized around referral hospitals. The KPHC network facilities have worked using an integrated approach in order to improve diabetes and hypertension care as previously described [ 26 ]. The non-KPHC network facilities are the other health-care facilities which do not belong to this network.…”