Readiness of health facilities and determinants to manage diabetes mellitus: evidence from the nationwide Service Provision Assessment survey of Afghanistan, Bangladesh and Nepal

Huda, Md Durrul; Rahman, Mosiur; Rahman, Md. Mizanoor; Islam, Monirul; Haque, Syed Emdadul; Mostofa, Md. Golam

doi:10.1136/bmjopen-2021-054031

Cited by 5 publications

(6 citation statements)

References 32 publications

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“…Although guidelines for managing substance use disorders were present in most facilities, the number of staff trained in screening, diagnosing, and managing SUD was limited. This finding aligns with studies conducted in Bangladesh and Nepal, which revealed that the availability of protocols or guidelines in a facility does not guarantee their implementation if employees lack the necessary training [ 38 ]. In our context, this shortage of trained staff can be attributed to the insufficient number of mental health professionals and a scarcity of students choosing to specialize in mental health care [ 1 , 20 ].…”

Section: Discussionsupporting

confidence: 87%

Health facility readiness to screen, diagnose and manage substance use disorders in Mbale district, Uganda

Aber-Odonga,

Nuwaha,

Kisaakye

et al. 2023

Subst Abuse Treat Prev Policy

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Background Substance use disorders (SUD) pose a significant public health problem in Uganda. Studies indicate that integrating mental health services into Primary Health Care can play a crucial role in alleviating the impact of SUD. However, despite ongoing efforts to integrate these services in Uganda, there is a lack of evidence regarding the preparedness of health facilities to effectively screen and manage SUD. Therefore, this study aimed to assess the readiness of health facilities at all levels of the health system in Mbale, Uganda, to carry out screening, diagnosis, and management of SUD. Methods A health facility-based cross-sectional study was carried out among all the 54 facilities in Mbale district. A composite variable adapted from the WHO Service Availability and Readiness Assessment manual (2015) with 14 tracer indicators were used to measure readiness. A cut-off threshold of having at least half the criteria fulfilled (higher than the cutoff of 7) was classified as having met the readiness criteria. Descriptive analyses were performed to describe readiness scores across various facility characteristics and a linear regression model was used to identify the predictors of readiness. Results Among all health facilities assessed, only 35% met the readiness criteria for managing Substance Use Disorders (SUD). Out of the 54 facilities, 42 (77.8%) had guidelines in place for managing SUD, but less than half, 26 (48%), reported following these guidelines. Only 8 out of 54 (14.5%) facilities had staff who had received training in the diagnosis and management of SUD within the past two years. Diagnostic tests for SUD, specifically the Uri stick, were available in the majority of facilities, (46/54, 83.6%). A higher number of clinical officers working at the health centres was associated with higher readiness scores (score coefficient 4.0,95% CI 1.5–6.5). Conclusions In this setting, a low level of health facility readiness to provide screening, diagnosis, and management for substance use disorders was found. To improve health facility readiness for delivery of care for substance use disorders, a frequent inventory of human resources in terms of numbers, skills, and other resources are required in this resource-limited setting.

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Section: Discussionsupporting

confidence: 87%

Health facility readiness to screen, diagnose and manage substance use disorders in Mbale district, Uganda

Aber-Odonga,

Nuwaha,

Kisaakye

et al. 2023

Subst Abuse Treat Prev Policy

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“…According to the results of this study, the ability of health facilities in the three nations under investigation to perform both diagnosis and treatment was more likely to be correlated with higher readiness scores. These results are congruent with those of other research investigations [10,49,51] carried out in various other developing countries. Another significant discovery is that many health facilities in Bangladesh and Nepal lack treatment facilities, despite having ample diagnostic capabilities.…”

Section: Comparable To Other Studiessupporting

confidence: 92%

“…A few studies carried out in several LMICs, including South Asian nations, found low readiness to offer services for noncommunicable diseases like diabetes [10][11][12], hypertension [13][14][15] and chronic respiratory diseases [14,16,17]. There is, however, a dearth of research on CVD readiness and related factors in LMICs [14,[17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Health Facilities Readiness and Determinants to Manage Cardiovascular Disease in Afghanistan, Bangladesh, and Nepal: Evidence from the National Service Provision Assessment Survey

Huda,

Rahman,

Mostofa

et al. 2024

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Background: In South Asia, cardiovascular diseases (CVDs) are an increasing public health concern. One strategy for dealing with the growing CVDs epidemic is to make health facilities more ready to provide CVDs services. The study’s objectives were to: (1) assess healthcare facilities’ readiness to offer CVDs services; and (2) identify the variables that influence such readiness. Methods: This study employed data from the Afghanistan Service Provision Assessment Survey 2018–2019, Bangladesh Health Facility Survey 2017, and Nepal Health Facility Survey 2021 that were cross-sectional and nationally representative. In Afghanistan, Bangladesh, and Nepal, 117, 368, and 1,381 health facilities, respectively, were examined. A total of 10 items/indicators were used to measure a health facility’s readiness to provide CVDs services across three domains. Results: The mean readiness scores of managing CVDs were 6.7, 5.6, and 4.6 in Afghanistan, Bangladesh, and Nepal, respectively. Availability of trained staff for CVD services are not commonly accessible in Afghanistan (21.5%), Bangladesh (15.3%), or Nepal (12.9%), except from supplies and equipment. Afghanistan has the highest levels of medicine and other commodity availability. Among the common factors linked with readiness scores, we ought to expect a 0.02 unit rise in readiness scores for three nations for every unit increase in number of CVDs care providers. In Afghanistan, Bangladesh, and Nepal, availability of both diagnosis and treatment facilities was associated with increases in readiness scores of 27%, 9%, and 17%, respectively. Additionally, an association was observed between nation-specific facility types and the readiness scores. Conclusions: Country-specific factors as well as universal factors present in all three nations must be addressed to improve a health facility’s readiness to provide CVDs care. To create focused and efficient country-specific plans to raise the standard of CVD care in South Asia, more investigation is necessary to ascertain the reasons behind country-level variations in the availability of tracer items.

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“…These findings correspond to a Kenyan national survey finding conducted between 2019-2020 by the African Population and Health Research Center (APHRC) which reported significant gaps in basic equipment readiness in facilities [37]. A multicounty report also reported notable gaps in diabetes basic equipment readiness with none of the facilities reporting presence of all 12 tracer equipment assessed which included blood pressure and adult scales [38]. The findings are consistent with majority PLOS GLOBAL PUBLIC HEALTH Table 5.…”

Section: Basic Equipment To Screen For Diabetes Risk Factorssupporting

confidence: 84%

“…These findings correspond to a Kenyan national survey finding conducted between 2019–2020 by the African Population and Health Research Center (APHRC) which reported significant gaps in basic equipment readiness in facilities [ 37 ]. A multicounty report also reported notable gaps in diabetes basic equipment readiness with none of the facilities reporting presence of all 12 tracer equipment assessed which included blood pressure and adult scales [ 38 ]. The findings are consistent with majority of findings reported in Low and Middle income countries where basic equipment is suboptimal in most of specific services as highlighted by Huda et (2021) in a cross-sectional nationally representative survey in Afghanistan, Bangladesh and Nepal where the three countries reported suboptimal readiness in basic equipment for diabetes management [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetes health care specific services readiness and availability in Kenya: Implications for Universal Health Coverage

Onteri,

Kariuki,

Mathu

et al. 2023

PLOS Glob Public Health

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Diabetes is a major cause of morbidity and mortality worldwide yet preventable. Complications of undetected and untreated diabetes result in serious human suffering and disability. It negatively impacts on individual’s social economic status threatening economic prosperity. There is a scarcity of data on health system diabetes service readiness and availability in Kenya which necessitated an investigation into the specific availability and readiness of diabetes services. A cross sectional descriptive study was carried out using the Kenya service availability and readiness mapping tool in 598 randomly selected public health facilities in 12 purposively selected counties. Ethical standards outlined in the 1964 Declaration of Helsinki and its later amendments were upheld throughout the study. Health facilities were classified into primary and secondary level facilities prior to statistical analysis using IBM SPSS version 25. Exploratory data analysis techniques were employed to uncover the distribution structure of continuous study variables. For categorical variables, descriptive statistics in terms of proportions, frequency distributions and percentages were used. Of the 598 facilities visited, 83.3% were classified as primary while 16.6% as secondary. A variation in specific diabetes service availability and readiness was depicted in the 12 counties and between primary and secondary level facilities. Human resource for health reported a low mean availability (46%; 95% CI 44%-48%) with any NCDs specialist and nutritionist the least carder available. Basic equipment and diagnostic capacity reported a fairly high mean readiness (73%; 95% CI 71%-75%) and (64%; 95%CI 60%-68%) respectively. Generally, primary health facilities had low diabetic specific service availability and readiness compared to secondary facilities: capacity to cope with diabetes increased as the level of care ascended to higher levels. Significant gaps were identified in overall availability and readiness in both primary and secondary levels facilities particularly in terms of human resource for health specifically nutrition and laboratory profession.

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Readiness of health facilities and determinants to manage diabetes mellitus: evidence from the nationwide Service Provision Assessment survey of Afghanistan, Bangladesh and Nepal

Cited by 5 publications

References 32 publications

Health facility readiness to screen, diagnose and manage substance use disorders in Mbale district, Uganda

Health facility readiness to screen, diagnose and manage substance use disorders in Mbale district, Uganda

Health Facilities Readiness and Determinants to Manage Cardiovascular Disease in Afghanistan, Bangladesh, and Nepal: Evidence from the National Service Provision Assessment Survey

Diabetes health care specific services readiness and availability in Kenya: Implications for Universal Health Coverage

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