The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases
Abstract Background The rapid rise of non-communicable diseases (NCDs) has become a significant public health concern in Bangladesh. This study assesses the readiness of primary healthcare facilities to manage the following NCDs: diabetes mellitus (DM), cervical cancer, chronic respiratory diseases...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-023-02016-6 |
| _version_ | 1797863963227062272 |
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| author | Ashraful Kabir Md Nazmul Karim Baki Billah |
| author_facet | Ashraful Kabir Md Nazmul Karim Baki Billah |
| author_sort | Ashraful Kabir |
| collection | DOAJ |
| description | Abstract Background The rapid rise of non-communicable diseases (NCDs) has become a significant public health concern in Bangladesh. This study assesses the readiness of primary healthcare facilities to manage the following NCDs: diabetes mellitus (DM), cervical cancer, chronic respiratory diseases (CRIs), and cardiovascular diseases (CVDs). Methods A cross-sectional survey was conducted between May 2021 and October 2021 among 126 public and private primary healthcare facilities (nine Upazila health complexes (UHCs), 36 union-level facilities (ULFs), 53 community clinics (CCs), and 28 private hospitals/clinics). The NCD-specific service readiness was assessed using the World Health Organization’s (WHO) Service Availability and Readiness Assessment (SARA) reference manual. The facilities’ readiness was assessed using the following four domains: guidelines and staff, basic equipment, diagnostic facility, and essential medicine. The mean readiness index (RI) score for each domain was calculated. Facilities with RI scores of above 70% were considered ‘ready’ to manage NCDs. Results The general services availability ranged between 47% for CCs and 83% for UHCs and the guidelines and staff accessibility were the highest for DM in the UHCs (72%); however, cervical cancer services were unavailable in the ULFs and CCs. The availability of basic equipment was the highest for cervical cancer (100%) in the UHCs and the lowest for DM (24%) in the ULFs. The essential medicine for CRI was 100% in both UHCs and ULFs compared to 25% in private facilities. The diagnostic capacity for CVD and essential medicine for cervical cancer was unavailable at all levels of public and private healthcare facilities. The overall mean RI for each of the four NCDs was below the cut-off value of 70%, with the highest (65%) for CRI in UHCs but unavailable for cervical cancer in CCs. Conclusion All levels of primary healthcare facilities are currently not ready to manage NCDs. The notable deficits were the shortage of trained staff and guidelines, diagnostic facilities, and essential medicine. This study recommends increasing service availability to address the rising burden of NCDs at primary healthcare levels in Bangladesh. |
| first_indexed | 2024-04-09T22:45:09Z |
| format | Article |
| id | doaj.art-abe0e60f051e405aa210c7ffd3af68f5 |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-04-09T22:45:09Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-abe0e60f051e405aa210c7ffd3af68f52023-03-22T11:57:21ZengBMCBMC Primary Care2731-45532023-03-0124111510.1186/s12875-023-02016-6The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseasesAshraful Kabir0Md Nazmul Karim1Baki Billah2Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash UniversityDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash UniversityDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash UniversityAbstract Background The rapid rise of non-communicable diseases (NCDs) has become a significant public health concern in Bangladesh. This study assesses the readiness of primary healthcare facilities to manage the following NCDs: diabetes mellitus (DM), cervical cancer, chronic respiratory diseases (CRIs), and cardiovascular diseases (CVDs). Methods A cross-sectional survey was conducted between May 2021 and October 2021 among 126 public and private primary healthcare facilities (nine Upazila health complexes (UHCs), 36 union-level facilities (ULFs), 53 community clinics (CCs), and 28 private hospitals/clinics). The NCD-specific service readiness was assessed using the World Health Organization’s (WHO) Service Availability and Readiness Assessment (SARA) reference manual. The facilities’ readiness was assessed using the following four domains: guidelines and staff, basic equipment, diagnostic facility, and essential medicine. The mean readiness index (RI) score for each domain was calculated. Facilities with RI scores of above 70% were considered ‘ready’ to manage NCDs. Results The general services availability ranged between 47% for CCs and 83% for UHCs and the guidelines and staff accessibility were the highest for DM in the UHCs (72%); however, cervical cancer services were unavailable in the ULFs and CCs. The availability of basic equipment was the highest for cervical cancer (100%) in the UHCs and the lowest for DM (24%) in the ULFs. The essential medicine for CRI was 100% in both UHCs and ULFs compared to 25% in private facilities. The diagnostic capacity for CVD and essential medicine for cervical cancer was unavailable at all levels of public and private healthcare facilities. The overall mean RI for each of the four NCDs was below the cut-off value of 70%, with the highest (65%) for CRI in UHCs but unavailable for cervical cancer in CCs. Conclusion All levels of primary healthcare facilities are currently not ready to manage NCDs. The notable deficits were the shortage of trained staff and guidelines, diagnostic facilities, and essential medicine. This study recommends increasing service availability to address the rising burden of NCDs at primary healthcare levels in Bangladesh.https://doi.org/10.1186/s12875-023-02016-6BangladeshHealth systemNon-communicable diseasesPrimary healthcare facilitiesService Availability and Readiness AssessmentWHO SARA |
| spellingShingle | Ashraful Kabir Md Nazmul Karim Baki Billah The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases BMC Primary Care Bangladesh Health system Non-communicable diseases Primary healthcare facilities Service Availability and Readiness Assessment WHO SARA |
| title | The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases |
| title_full | The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases |
| title_fullStr | The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases |
| title_full_unstemmed | The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases |
| title_short | The capacity of primary healthcare facilities in Bangladesh to prevent and control non-communicable diseases |
| title_sort | capacity of primary healthcare facilities in bangladesh to prevent and control non communicable diseases |
| topic | Bangladesh Health system Non-communicable diseases Primary healthcare facilities Service Availability and Readiness Assessment WHO SARA |
| url | https://doi.org/10.1186/s12875-023-02016-6 |
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