Health workforce availability and competency to manage noncommunicable diseases at secondary care level hospitals of Delhi

Abstract

Context: Health system strengthening is a major component of the national strategy to address noncommunicable diseases (NCDs). Human resource (HR) is an important building block of health system, and its capacity to address NCDs needs to be assessed. Aims: We assessed the availability, training, and self-rated competencies of available staff in secondary-level health facilities under the Government of Delhi for NCD services. Settings and Design: This study was conducted in a secondary care hospital in Delhi; this was a cross-sectional study. Subjects and Methods: Fifteen hospitals listed by the Directorate of Health Services, Delhi, were assessed through personal visits. Medical superintendents provided information regarding the availability of workforce and their training. Self-rated competency was assessed among doctors, nurses, and laboratory workers using a self-administered questionnaire. Results: A total of 85 doctors, 66 nurses and 52 laboratory technicians were interviewed. Shortage of staff ranged from 7.2% for staff nurse to 42.5% for medicine specialist. None of the staff had undergone special training for providing NCD-related services. 96.5% of doctors and 83.3% of nurses reported being aware of standard treatment guidelines for diabetes and hypertension. Key reported deficiencies were seen in doctors and nurses in managing diabetes complications. Cancer was not being managed in any hospital. Proficiency in cardiovascular disease management was reported by 24.7% and COPD management by 83.5% of doctors. There was major gap in competencies related to stroke management. Conclusions: Availability of trained and competent workforce was a limiting step in delivering NCD care in secondary-level public health facilities of Delhi, indicating the need for strengthening the HR capacity.