Capacity assessment of selected health care facilities for the pilot implementation of Package for Essential Non-communicable Diseases (PEN) intervention in Ghana

Abstract

IntroductionNon-communicable diseases (NCDs) continue to pose threats to human health and development worldwide. Though preventable, NCDs kill more people annually than all other diseases combined. The four major NCDs namely cardiovascular diseases, chronic respiratory diseases, diabetes and cancers share common modifiable risk factors. In order to prevent and control NCDs, Ghana has adopted the World Health Organisation Package for Essential NCD (WHO-PEN) intervention, to be piloted in selected districts before a nationwide scale-up. We assessed the capacity of these facilities for the implementation of the WHO-PEN pilot.MethodsWe conducted a cross-sectional health facility-based survey using a multistage sampling technique. We collected data on human resource, equipment, service utilization, medicines availability and health financing through interviews and observation. Descriptive data analysis was performed and expressed in frequencies and relative frequencies.ResultsIn all, 23 health facilities comprising two regional hospitals, three district hospitals, nine health centres and nine Community-based Health Planning and Services (CHPS) compounds from three regions were surveyed. All the hospitals had medical officers whilst 4 (44.4%) of the health centres had physician assistants. Health financing is mainly by the National Health Insurance Scheme (NHIS). None of the health facilities had spacers and only one health centre had oxygen cylinder, glucometer and nebulizer.ConclusionGaps exist in the human resource capacity and service delivery at the primary care levels, the focus of WHO-PEN intervention. Adequately equipping the primary health care level with trained health workers, basic equipment, medications and diagnostics will optimize the performance of WHO-PEN intervention when implemented.

Experiences from the pilot implementation of the Package of Essential Non-communicable Disease Interventions (PEN) in Myanmar, 2017-18: A mixed methods study

“…Qualitative interviews with providers also revealed interrupted supply of drugs as one of the major hindrance to the appropriate management of patients with DM and hypertension. This is supported by findings from other countries in similar settings [21,22,[24][25][26][27]. Non-availability of medicines forces patients to purchase medicines from the private sector or forego treatment if they cannot afford it.…”

“…A similar nation-wide Service Availability and Readiness Assessment (SARA) in Myanmar in 2015 highlighted lack of trained staff at various levels of care. [20] This happens to be a common finding across studies in Africa and India [21][22][23][24][25][26].…”

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

“…Among the 19 studies conducted in one region of SSA, the majority were from the Eastern region (n = 11, 58%) [11][12][13][14][15][16][17][18][19][20][21]. About 26% (n = 5) [22][23][24][25][26]and 16% (n = 3) [27][28][29] of the remaining studies were conducted in the Southern and Western region respectively. Two studies were conducted in more than one region of SSA [30,31].…”

An integrated intervention for chronic care management in rural Nepal: protocol of a type 2 hybrid effectiveness-implementation study

“…In response to the growing need for evidence-based NCD service delivery, the World Health Organization has compiled a set of protocols within the Package of Essential Noncommunicable Disease Interventions (WHO-PEN) for primary health care in low-resource settings [30,31]. These protocols constitute simple decisionmaking algorithms for the screening, diagnosis, and management of major NCDs, helping to ensure quality care provision in primary care settings, especially in areas already struggling with workforce shortages.…”