2020
DOI: 10.1186/s12889-019-7994-4
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Decentralising NCD management in rural southern Africa: evaluation of a pilot implementation study

Abstract: Background: The prevalence of non-communicable diseases, and associated morbidity and mortality, is increasing rapidly in low and middle-income countries where health systems often have limited access and lower quality of care. The intervention was to decentralise uncomplicated non-communicable disease (NCD) care from a hospital to nurse practitioners in health centres in a poor rural district in Eswatini, southern Africa. The objective of this study was to assess the feasibility and impact of decentralised ca… Show more

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Cited by 19 publications
(33 citation statements)
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“…facilities. Policy changes to enable nurse-led HTN treatment in SSA have been considered [51], and several pilot studies have explored the feasibility of nurse-led delivery models with encouraging results [52][53][54][55]. Should nurse-led models find broad acceptance, steady attention to quality of care remains paramount [51,56].…”
Section: Plos Onementioning
confidence: 99%
“…facilities. Policy changes to enable nurse-led HTN treatment in SSA have been considered [51], and several pilot studies have explored the feasibility of nurse-led delivery models with encouraging results [52][53][54][55]. Should nurse-led models find broad acceptance, steady attention to quality of care remains paramount [51,56].…”
Section: Plos Onementioning
confidence: 99%
“…Using a similar shared care guide for management of diabetes and hypertension care in Eswatini (southern Africa), nurses were able to successfully deliver diabetes and hypertension care with improvements in physiological parameters, although continued training and supervision were required to consolidate change. 14 A similar NCD guideline and training COMDIS-HSD partner initiative in Pakistan was found to be effective in trials and was scaled across the Punjab Province of 110 million population. [16][17][18][19][20] This Nigeria pilot adds evidence for the potential in a West African setting and for mHealth as an alternative to expensive residential courses, which is a major constraint to NCD care scale-up.…”
Section: Main Findingsmentioning
confidence: 99%
“…8 Traditionally, management of patients with diabetes in SSA is carried out in health facilities which are often congested, distant from patients' location and where these patients have to wait for long hours to access care. 9 Care delivery for uncomplicated cases and low-risk groups in the community could result in fewer clinic visits, not having to travel long distances, not waiting in queues, and freeing up medical services in the facility for complicated cases and high-risk groups like pregnant women. 10 Community-based care refers to interventions delivered outside of health facilities, in contrast to facility-based care which is delivered or based in clinics or hospitals.…”
Section: Introductionmentioning
confidence: 99%