Availability and affordability of essential medicines and diagnostic tests for diabetes mellitus in sub-Saharan Africa: A systematic review.

Kibirige, Davis; Sanya, Richard E.; Sekitoleko, Isaac; Katende, David; Atuhe, David; Milln, Jack; Schwartz, Jeremy I.; Nyirenda, Moffat

doi:10.21203/rs.3.rs-16103/v1

Cited by 2 publications

(3 citation statements)

References 30 publications

(60 reference statements)

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“… 22 The results of the current review consistent with other studies conducted in LMIC demonstrated sub-optimal availability of basic technologies (diagnostic tests, basic equipment) for NCDs, there are many LMIC does not able to provide basic NCDs interventions. 5 , 23 , 24 A possible explanation of sub-optimal availability of basic technologies is in the present period of global fiscal restraint, governments are seeking ways of decreasing expenditures on social sectors, including health. 24 Enhancing the access to essential medicines and basic technologies is important for the accomplishment of the Millennium Development Goals.…”

Section: Discussionmentioning

confidence: 99%

“… 24 Inadequate financial resources, one of the major reason for gaps identified, the next stage that could be taken as the remedial stage encourages the efficiency of NCDs services delivery, which can be done throughput priorities for NCDs interventions based on equity, safety, and cost-effectiveness, healthcare providers must be adherence to prescription and investigations requests based on evidence-based and cost-effectiveness. 5 , 23 , 28 If these prioritized interventions are delivered validly, it will enhance the chances of prevention and control of NCDs, and reducing health care budgets. 29 - 31 The study demonstrated that the international community should assist the low-middle-income countries to NCDs control, including increasing access to essential medicines and basic technologies, and support local production of essential medicines.…”

Section: Discussionmentioning

confidence: 99%

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Public Sector Capacity to Prevent and Control of Noncommunicable Diseases in Twelve Low- and Middle-Income Countries Based on WHO-PEN Standards: A Systematic Review

Albelbeisi

Albelbeisi²,

Bilbeisi

et al. 2021

Health�Serv�Insights

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This review was conducted to assess the capacity of the public sector to prevent and control noncommunicable diseases (NCDs) in low-and middle-income countries (LMIC) based on WHO-PEN standards. A PRISMA systematic search appraisal of PubMed, Scopus, and Embase was conducted during May-2020 for original articles conducted in LMIC and reported the capacity of the public sector to prevent and control NCDs. The country readiness score was calculated as the mean score of items for each domain. The indices were compared to an agreed cutoff at 80% the WHO optimal target of availability of affordable essential medicines and basic technologies required to treat NCDs. The literature search yielded 5 original studies, conducted in twelve countries, and surveyed 304 public health facilities. All countries failed to reach the WHO optimal target of availability of affordable essential medicines and basic technologies. The readiness index score according to WHO-PEN standards among countries in terms of essential medicines, diagnostic investigations, and basic equipment were range from 13.5% to 51%, 0.0% to 59.4%, and 29.2% to 51.2% respectively. This review revealed critical gaps in the twelve LMIC public sector capacity to prevent and control of NCDs in terms of essential medicines, basic equipment, and diagnostic investigations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Public Sector Capacity to Prevent and Control of Noncommunicable Diseases in Twelve Low- and Middle-Income Countries Based on WHO-PEN Standards: A Systematic Review

Albelbeisi

Albelbeisi²,

Bilbeisi

et al. 2021

Health�Serv�Insights

View full text Add to dashboard Cite

show abstract

“…It is estimated that nearly half (46%) of all deaths in the region will be attributable to NCDs by 2030, representing a two-fold increase from 25% in 2004 [4]. However, national health systems in SSA appear largely ill-prepared to meet this challenge [5][6][7][8]. Continuity of care across the lifespan and care settings is one of the critical elements of chronic diseases programs [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Linkage to HIV care and hypertension and diabetes control in rural South Africa: Results from the population-based Vukuzazi Study

Magodoro

Olivier²,

Gareta³

et al. 2022

PLOS Glob Public Health

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Non-communicable diseases (NCDs) account for half of all deaths in South Africa, partly reflecting unmet NCDs healthcare needs. Leveraging existing HIV infrastructure is touted as a strategy to alleviate this chronic care gap. We evaluated whether HIV care platforms are associated with improved NCDs care. We conducted a community-based screening of adults in rural KwaZulu-Natal, collecting BP, HbA1c, and health services utilization data. Care cascade indicators for hypertension and diabetes mellitus were defined as: 1) aware, if previously diagnosed, 2) in care, if seeing a provider within last 6 months; 3) treated, if reporting medication use within preceding 2 weeks; and 4) controlled, if BP<140/90mmHg or HbA1c<6.5%. We fit multivariable adjusted logistic regression models to compare successful completion of each step of the care cascade for hypertension and diabetes between people with virally suppressed HIV and HIV-negative comparators. Inverse probability sampling weights were applied to derive population-level estimates. The analytic sample included 4,933 individuals [mean age 58.4 years; 77% female]. Compared to being HIV-negative, having suppressed HIV was associated with lower adjusted prevalence of being aware (-6.0% [95% CI: -11.0, -1.1%]), in care (-5.7% [-10.6, -0.8%]), and in treatment (-4.8% [-9.7, 0.1%]) for diabetes; but higher adjusted prevalence of controlled diabetes (3.2% [0.2–6.2%]). In contrast, having suppressed HIV was associated with higher adjusted prevalence of being aware (7.4% [5.3–9.6%]), in care (8.0% [5.9–10.2%]), in treatment (8.4% [6.1–10.6%]) and controlled (9.0% [6.2–11.8%]), for hypertension. Overall, disease control was achieved for 40.0% (38.6–40.8%) and 6.8% (5.9–7.8%) of individuals with hypertension and diabetes, respectively. Engagement in HIV care in rural KwaZulu-Natal was generally associated with worse diabetes care and improved hypertension care. While further work should explore how success of HIV programs can be translated to NCD care, strengthening of primary healthcare will also be needed to respond to the growing NCDs epidemic.

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Availability and affordability of essential medicines and diagnostic tests for diabetes mellitus in sub-Saharan Africa: A systematic review.

Cited by 2 publications

References 30 publications

Public Sector Capacity to Prevent and Control of Noncommunicable Diseases in Twelve Low- and Middle-Income Countries Based on WHO-PEN Standards: A Systematic Review

Public Sector Capacity to Prevent and Control of Noncommunicable Diseases in Twelve Low- and Middle-Income Countries Based on WHO-PEN Standards: A Systematic Review

Linkage to HIV care and hypertension and diabetes control in rural South Africa: Results from the population-based Vukuzazi Study

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