Patient trust and positive attitudes maximize non-communicable diseases management in rural Tanzania

Sato, Haruko; Nakamura, Keiko; Kibusi, Stephen M.; Seino, Kaoruko; Maro, Isaac; Tashiro, Yuri; Bintabara, Deogratius; Shayo, Festo K.; Miyashita, Ayano; Ohnishi, Mayumi

doi:10.1093/heapro/daad007

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…Currently , the top NCDs (cardiovascular disease (CVD), cancer, obesity, and diabetes) are increasingly affecting disability adjusted life years (DALYs) for the patients with these illnesses. While health funding, resource management, and drug manufacturing are turning their focus from communicable diseases to NCDs, the burden of managing these diseases falls on grass roots efforts to provide health education on prevention and management to slow their rising tide [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Idealism Versus Realism in Sustainable Global Research

2023

Int J Nurs Health Care Res

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In sub-Saharan African countries, non-communicable diseases (NCDs) such as Type II diabetes are increasing in incidence and prevalence. Glycated hemoglobin (HbA1c) is a diagnostic tool for monitoring and managing patients with diabetes that is unavailable in many resource constrained environments. Following a qualitative study with key informants in rural northwestern Tanzania, point of care HbA1c machines were introduced to improve care of patients with diabetes. Education modules were developed for study participants in Shirati, Tanzania to improve disease management in this remote area that included locally available food choices, exercises to reduce blood glucose, and overall understanding of the disease process. A greater understanding of the cultural norms and mores as well as factors affecting supply of equipment are essential to improve care provided to this population. This paper contributes knowledge to the ongoing challenges of appropriate sustainable research to improve health in low resource areas.

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Section: Introductionmentioning

confidence: 99%

Idealism Versus Realism in Sustainable Global Research

2023

Int J Nurs Health Care Res

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Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviours

Miyashita,

Nakamura,

Kibusi

et al. 2024

International Health

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Background The rise of hypertension (HTN) and diabetes mellitus (DM) in Tanzania underscores the importance of self-care practices (SCP) for disease management. Despite the proven effectiveness of SCP, financial barriers in resource-limited rural areas hinder continuous care. Health insurance (HI) emerges as a critical solution to alleviate financial constraints and support SCP. Methods This study examined an association between HI and SCP by generalised linear and ordinal logistic regressions, adjusted for sociodemographic factors. Mediation analysis highlighted the role of disease management behaviours (hospital visits and medication adherence) in the association. Data were collected through individual interviews with 909 patients. Results Better SCP for HTN and DM were associated with the National Health Insurance Fund (HTN: coefficient=0.571; DM: coefficient=0.567, p<0.001) and the improved Community Health Fund (iCHF) or CHF (HTN: coefficient=0.330; DM: coefficient=0.472, p<0.05), after adjustment for sociodemographic variables. Mediation analysis showed that disease management behaviours partially or fully mediated the relationship between HI and SCP. Conclusions Enrolment in HI by patients in rural Tanzania exhibited better disease management behaviours and SCP. Efforts should focus on leveraging the HI schemes to expand their coverage in rural areas, which could benefit patients with non-communicable diseases.

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Decentralization Matters: Association of Adherence to Treatment and Distance for the Management of Non-Communicable Diseases in Rural Tanzania

Belardi,

Bazzanini,

Cera

et al. 2024

IJERPH

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Since March 2019, a non-communicable diseases program has been established at hospital level, with enrollment and clinical reassessment every 6 months. Since July 2023, monthly enrollment and visits have also been conducted at health center level. This study aimed at assessing the adherence to scheduled follow-up visits following the decentralization of the integrated NCDs program from Hospital to Health Center level and investigate factors influencing follow-up adherence. The study was performed in a rural district in Iringa Region, Tanzania. Adherence was measured at both levels. Multivariate regression analysis was conducted to describe socio-demographic and clinical factors influencing attendance at the 6-month hospital-level visit. Among 2198 patients enrolled at the hospital level, weighted adherence over 42 months was 40.8% (95% CI 39.0–42.6%) at the 6-month visit. Multivariate analysis revealed that as the distance from the hospital increased, the probability of attendance decreased (OR 0.17; 95% CI: 0.08–0.39). Among 571 patients enrolled at the residence level, adherence over the first 10 months of program implementation was 91.6% (90.4–92.8%). The findings showed that distance was by far the most important barrier to follow-up adherence and suggested that decentralizing the program from the hospital to peripheral health centers may ensure high follow-up rates.

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Patient trust and positive attitudes maximize non-communicable diseases management in rural Tanzania

Cited by 4 publications

References 32 publications

Idealism Versus Realism in Sustainable Global Research

Idealism Versus Realism in Sustainable Global Research

Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviours

Decentralization Matters: Association of Adherence to Treatment and Distance for the Management of Non-Communicable Diseases in Rural Tanzania

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