在资源有限的环境中扩大非传染性疾病护理:经验教训和对政策的影响
Yoseph Mamo1, Mirchaye Mekoro2, David I W Phillips3
1Tropical Health Education Trust, Addis Ababa, Ethiopia.
BMC health services research
|July 26, 2024
概括
这项埃塞俄比亚项目成功地将综合性非传染性疾病 (NCD) 护理扩大到数百万,培训卫生工作者并查许多人. 然而,在广泛的NCD检测和治疗可访问性方面,仍然存在挑战.
科学领域:
- 公共卫生 公共卫生
- 全球健康 全球健康
- 加强卫生系统 加强卫生系统
背景情况:
- 在撒哈拉以南非洲,有限的综合,分散的社区级非传染性疾病 (NCD) 护理模式存在.
- 埃塞俄比亚的一个为期四年的项目旨在扩大NCD护理范围,覆盖15家医院和45个卫生中心,为750万人口提供服务.
研究的目的:
- 评估扩大埃塞俄比亚常见非传染性疾病的综合,分散型模型的可行性和结果.
- 评估培训卫生工作者和社区参与改善非传染性疾病管理的有效性.
主要方法:
- 在60个地点进行了基线评估,随后对621名卫生工作者进行了对主要非传染性疾病 (高血压,糖尿病,慢性呼吸道疾病,) 的级联培训.
- 实施了培训前后评估,指导,供应链管理,报告系统和社区宣传活动.
- 对高血压和糖尿病进行了人口查.
主要成果:
- 超过643,000人接受了查;24,313人被诊断患有高血压/糖尿病并开始接受治疗.
- 新出现的呼吸道疾病 (3,986) 和 (1,925) 病例也得到治疗.
- 总的来说,死亡率低,但在农村高血压患者中更高 (10.2%);在卫生中心的随访 (20-30%) 显著损失.
结论:
- 扩大集成NCD服务的规模是可行的,可复制的,可持续的和具有成本效益的.
- 在实现广泛的非传染性疾病检测和确保所有人口获得一致的治疗方面,仍然存在重大挑战.
- 该项目强调需要继续努力,在各种环境中克服NCD护理障碍.
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