Non-communicable Diseases Patients Research Articles

Effectiveness of the health and wellness centers in improving identification and primary care of non-communicable diseases in Chhattisgarh State of India

ABSTRACT Introduction: India launched a national initiative named Health and Wellness Centres (HWCs) in 2018 to provide population-based primary care including for the non-communicable diseases (NCDs) in rural areas. The current study assesses whether operationalization of HWCs improved the detection of NCDs and increased the share of public sector facilities in providing NCD services. Methods: Two rounds of household surveys were conducted in rural Chhattisgarh in 2019 and 2022. With a focus on NCDs, the household survey covered a representative sample of individuals above the age of 30 years – 2760 individuals in 2019 and 2638 in 2022. Multi-variate regression analysis was carried out to determine effects of HWCs on identification of NCDs and utilization of public sector services. Results: The population covered by HWCs had 25% greater chance of being identified with NCDs as compared to the population without HWCs (AOR = 1.25, P = 0.03). The NCD patients living in areas covered by HWCs had 70% greater chance of utilizing the public healthcare facilities (AOR = 1.70, P = 0.01). In the population covered by HWCs, the share of the public sector in NCD care increased from 41.2% in 2019 to 62.1% in 2022, whereas the share of informal private providers dropped from 23.5% in 2019 to 8.4% in 2022. Conclusion: The HWCs showed effectiveness in increasing detection of NCDs at the population level and bringing a larger share of NCD patients to utilize public sector services. They can prove to be a crucial architectural correction for improving primary care service delivery for NCDs and other population health needs in India.

IJCM_188A: Exploring Factors Influencing Medication Non-Adherence Among Urban Residents with Non-Communicable Diseases in Chengalpattu District: A Descriptive Cross-Sectional Study

Background: Medication non-adherence is a modifiable risk factor for non-communicable diseases (NCDs). WHO estimated the average rate of medication adherence to be around 50% in developed countries and to be lower in the developing countries. Objectives: To find the factors influencing medication non-adherence among patients diagnosed with NCDs in the urban areas. Methodology: A cross sectional study was conducted among 200 patients visiting Urban Health Training Centre, MAPIMS. A structured questionnaire was used to collect data on socio-demographic characteristics, risk factors, self-care practices, access to health care and family support to medication adherence. The outcome of the study was medication adherence measured using the eight-item Morisky medication adherence scale (MMAS-8). Results: Among the 200 participants with one or more non-communicable diseases (NCDs), the result found the prevalence of poor medication adherence rate to be 53.5%. Poor medication adherence was more prevalent in the older age group (39%, n=78), female patients (57.5%, n=115), with primary education (49.5%, n=99), unemployed individuals (58.5%, n=117), those without regular physical activities (63.5%, n=127) and classified as obese (43%, n=86). Conclusion: The study concluded that the prevalence of poor medication adherence was more common among NCD patients and the need to develop effective strategies to enhance medication adherence according to patient’s requirements through a holistic approach, by strengthening the primary health care system to achieve better health outcomes.

IJCM_181A: Health behavioral change and Associated factors among patients diagnosed with non-communicable diseases in the Rural areas of Southern India

Background: Non-communicable diseases (NCDs) contributed to 71% of the global mortality and affect the ageing population with variable proportions. NCD diagnosis gives an opportunity for patients to change their health behaviors. Secondary prevention strategies like diet modification, physical activity and smoking cessation after NCD diagnosis are important and should be emphasized particularly for middle-aged and older adults. Objectives: 1. To assess the level of health behavioral change adopted by the patients diagnosed with NCDs registered under Rural field practice area. 2. To evaluate the factors influencing the health behavioral change in NCD patients. Methodology: This is a Cross-sectional study design conducted at Rural Health & Training Centre, Government Medical College, Ananthapuramu, from August 2023 to October 2023. Simple random sampling was used to select 150 registered NCD cases from the RHTC data-base. We included participants who were diagnosed with either diabetes, cardiovascular disease, chronic lung disease, or cancer after recruitment. Data were collected by using pre-designed semi-structured questionnaire. Data was analyzed using IBM SPSS version 25.0. Associations were tested using chi-squares and for all comparisons p-value <0.05 was considered significant. Results: In total 48 (32%) NCD cases have adopted suggested behavioral change instructed by the physician. Factors such as females, graduates, Class III & above SES, diagnosed between 5 to 10 years, not having any other co-morbidities were significantly associated with good health behavioral change. Conclusion: Around two third of the diagnosed NCD cases were not compliant to health behavioral change. Hence, health care providers need to provide behavioral change communication related to health behaviors in addition to standard medical care.

The longitudinal association of stressful life events with depression remission among SHARP trial participants with depression and hypertension or diabetes in Malawi.

Depressive disorders are leading contributors to morbidity in low- and middle-income countries and are particularly prevalent among people with non-communicable diseases (NCD). Stressful life events (SLEs) are risk factors for, and can help identify those at risk of, severe depressive illness requiring more aggressive treatment. Yet, research on the impact of SLEs on the trajectory of depressive symptoms among NCD patients indicated for depression treatment is lacking, especially in low resource settings. This study aims to estimate the longitudinal association of SLEs at baseline with depression remission achievement at three, six, and 12 months among adults with either hypertension or diabetes and comorbid depression identified as being eligible for depression treatment. Participants were recruited from 10 NCD clinics in Malawi from May 2019-December 2021. SLEs were measured by the Life Events Survey and depression remission was defined as achieving a Patient Health Questionaire-9 (PHQ-9) score <5 at follow-up. The study population (n = 737) consisted predominately of females aged 50 or higher with primary education and current employment. At baseline, participants reported a mean of 3.5 SLEs in the prior three months with 90% reporting ≥1 SLE. After adjustment, each additional SLE was associated with a lower probability of achieving depression remission at three months (cumulative incidence ratio (CIR) 0.94; 95% confidence interval: 0.90, 0.98, p = 0.002), six months (0.95; 0.92, 0.98, p = 0.002) and 12 months (0.96; 0.94, 0.99, p = 0.011). Re-expressed per 3-unit change, the probability of achieving depression remission at three, six, and 12 months was 0.82, 0.86, and 0.89 times lower per 3 SLEs (the median number of SLEs). Among NCD patients identified as eligible for depression treatment, recent SLEs at baseline were associated with lower probability of achieving depression remission at three, six, and 12 months. Findings suggest that interventions addressing SLEs during integrated NCD and depression care interventions (e.g., teaching and practicing SLE coping strategies) may improve success of depression treatment among adult patient populations in low-resource settings and may help identify those at risk of severe and treatment resistant depression.

Prevalence of hepatitis B and C infection and linkage to care among patients with Non-Communicable Diseases in three ruralRwandan districts: a retrospective cross-sectional study.

Rwanda's Hepatitis C elimination campaign has relied on mass screening campaigns. An alternative "micro-elimination" strategy focused on specific populations, such as non-communicable disease (NCD) patients, could be a more efficient approach to identifying patients and linking them to care. This retrospective cross-sectional study used routine data collected during a targeted screening campaign among NCD patients in Kirehe, Kayonza, and Burera districts of Rwanda and patients receiving oncology services from the Butaro District Hospital. The campaign used rapid diagnostic tests to screen for Hepatitis B surface antigen (HBsAg) and Hepatitis C antibody (anti-HCV). We reported prevalences and 95% confidence intervals for HBsAg and anti-HCV, assessed for associations between patients' clinical programs and hepatitis B and C, and reported cascade of care for the two diseases. Out of 7,603 NCD patients, 3398 (45.9%) self-reported a prior hepatitis screening. Prevalence of HBsAg was 2.0% (95% CI: 1.7%-2.3%) and anti-HCV was 6.7% (95% CI: 6.2%-7.3%). The prevalence of HBsAg was significantly higher among patients < 40years (2.4%). Increased age was significantly associated with anti-HCV (12.0% among patients ≥ 70years). Of the 148 individuals who screened positive for HbsAg, 123 had viral load results returned, 101 had detectable viral loads (median viral load: 451 UI/mL), and 12 were linked to care. Of the 507 individuals who screened positive for anti-HCV, 468 had their viral load results returned (median viral load: 1,130,000 UI/mL), 304 had detectable viral loads, and 230 were linked to care. Anti-HCV prevalence among Rwandan patients with NCD was high, likely due to their older age. NCD-HCV co-infected patients had high HCV viral loads and may be at risk of poor outcomes from hepatitis C. Hepatitis C micro-elimination campaigns among NCD patients are a feasible and acceptable strategy to enhance case detection in this high-prevalence population with elevated viral loads and may support linkage to care for hepatitis C among elderly populations.

The Baseline Self-Efficacy Scores to Manage Chronic Diseases Amongst Nigerian Patients with Non-Communicable Diseases are Sub-Optimal.

Nigeria is one of the developing countries with a major burden of non-communicable diseases (NCDs) without a disease self-management program in its healthcare system. Thus, this study was aimed to assess the baseline self-efficacy levels of Nigerian patients with chronic NCDs at tertiary level hospitals. This is a cross sectional study of 286 NCD patients attending tertiary level clinics from 26 July to 27 October 2023. Patients were interviewed on a 10 Self-Efficacy to Manage Chronic Disease (SEMCD) item scales that were considered suitable for the Nigerian population. The 10 SEMCD questions covered: (i) Exercise regularly scale, (ii) Help from community, family and friends scale, (iii) Communication with Physician scale, (iv) Manage disease scale and (v) Manage symptom self-efficacy domains. Data were analyzed both descriptively and statistically using Student's t-tests and Chi-square tests as appropriate. The results showed that more female (59.4%) than males (40.6%) attended clinics during the study, and the mean age of the patients did not differ between gender (P > .05). About 40% of all the patients manage their NCDs with medications alone, a trend that is similar in male and female patients (P > .05). While all the patients had a relatively lower self-efficacy scores under regular exercise scale (52%-55%) and manage disease symptoms scale (53%-55%), they tended toward higher self-efficacy scores under getting assistance from community, family, and friends (79%-80%) and communication with attending physicians (81%-85%). It is concluded that Nigeria literate NCD patients registered at tertiary level institution routine clinics are less than optimal in disease self-management care. We recommend that this study population will benefit from introduction and implementation of disease self-management program in the healthcare system.

Non-communicable disease care in Sierra Leone: a mixed-methods study of the drivers and barriers to retention in care for hypertension

ObjectiveTo retrospectively analyse routinely collected data on the drivers and barriers to retention in chronic care for patients with hypertension in the Kono District of Sierra Leone.DesignConvergent mixed-methods study.SettingKoidu Government...

The effect of exercise to cardiac fibrosis in mice with non-communicable diseases, especially myocardial infarction and diabetes mellitus: A literature review

Non-communicable diseases (NCDs) are chronic disease caused by multifactor mainly unhealthy lifestyle and are still have one of the highest mortality rate in the world. Cardiovascular manifestations are commonly found in several type of NCDs such as heart disease and diabetes Mellitus (DM). One of that cardiovascular manifestation is cardiac remodeling especially cardiac fibrosis. Regular exercise has been considered as the effective method to improve cardiovascular function in NCD patients especially heart disease and DM, it also can reduce cardiac fibrosis in mice with NCD. This review aims summarize the effect of various exercise to cardiac fibrosis in mice with NCD especially myocardial infarction and diabetes mellitus. From six studies that reviewed in this article, five of them found that exercise can reduce cardiac fibrosis in mice with myocardial infarction or diabetic mice. Further study is required to determine the effect of various exercise type, intensity, and intervention period to cardiac remodeling, especially cardiac fibrosis, in mice with other NCDs.

Variations in Hospital Admissions of Non-Communicable Disease Patients Before and During The COVID-19 Pandemic (A Tertiary Care Setting, January 2018-June 2021).

This study aimed to analyze the variations (if any) in hospital admissions of patients with any of the five common non-communicable diseases (NCDs), based on secondary analysis of electronic health records of patients admitted to Hacettepe University Hospitals at least once, from January 1, 2018 through June 15, 2021. Data were recruited from hospital's electronic health records on patients with diagnoses of ischemic heart disease, hypertension, diabetes, cancer, and chronic obstructive pulmonary disease, using relevant ICD-10 codes. Compared to the corresponding time span in the pre-pandemic period, the number of hospital admissions of patients with selected five NCDs significantly decreased during the pandemic, with an official start in Turkey on March 11, 2020. Number of total-, out-patient-, and in-patient admissions of NCD patients were significantly lower in the pandemic period compared to the expected values in time series analysis, controlling for patient characteristics, and seasonality. Study findings suggest that there has been a prominent impediment in NCD patients' access to, and/or use of health care services over the pandemic, which might evolve to higher admission rates, severity and fatality of such patients in the upcoming years. Further studies are warranted for confirmation of our findings in other care settings, with individual-based data on care compensation through settings other than regular admission sites (if any), and/or the reasons for under-use of services.

Sleep duration and mortality in patients with chronic noncommunicable disease: a population-based cohort study.

Inadequate sleep behaviors may confer a higher risk of premature death, however, evidence in patients with chronic noncommunicable disease (NCD) is scarce. To investigate the relationship between sleep duration and mortality from all-cause and heart diseases in NCD patients from a prospective cohort. Totally, 14,171 participants with at least one NCD, including 8275 with hypertension, 7547 with high cholesterol, 4065 with diabetes, and 5815 with chronic renal failure were enrolled from the National Health and Nutrition Examination Survey during 2005-2014. Cox proportional hazard models were performed to estimate the hazard ratio (HR) for sleep duration and mortality after adjusting for potential confounding factors. After a median follow-up of 9 years, 2514 all-cause deaths were identified. Compared with sleeping 7-8 h/day, sleeping over 8 h/day was significantly associated with a higher risk of all-cause mortality, where the multivariable-HRs were 1.29 (1.11, 1.50) for hypertension, 1.23 (1.01, 1.51) for high cholesterol, 1.44 (1.13, 1.82) for diabetes, and 1.36 (1.10, 1.68) for chronic renal failure. Similar patterns were observed for heart disease mortality. A nonlinear association was detected between sleep duration and mortality in patients with NCD. Age modified the association in patients with hypertension (P-interaction: 0.036). Trouble sleeping modified the association in patients with diabetes (P-interaction: 0.042). Long sleep duration was associated with higher risks of all-cause and heart disease mortality in patients with chronic NCD. Our findings highlight that improving sleep behaviors may decrease the risk of premature deaths and help to NCD tertiary prevention.

Non-communicable diseases and HIV/AIDS burden by socio-demographic characteristics in Malawi

Background The co-existence of non-communicable diseases (NCDs) and HIV/AIDS is a health concern that needs to be promptly addressed in Sub-Saharan Africa. However, with limited data, responding to this problem may be difficult. This paper aims to describe the burden of NCDs and HIV/AIDS within patients’ socio-demographic and health facility characteristics across the cities and districts in Malawi. Methods We analysed health facility-based data extracted from NCD patient mastercards from 2019 to 2022 from 70 health facilities in 11 cities and districts in Malawi. Data analysis was done in R using mean, proportions, frequency distributions and charts. Hybrid k-means clustering was used to determine health facilities with similar cases. Results A total of 29,196 patients had at least one non-communicable disease, with 7.9% having NCDs comorbid with HIV/AIDS. The southern part of Malawi (54.2%), inland locations (69.9%) and health centres (55.3%) recorded large numbers of cases in their respective categories. The health facilities’ case clustering indicated that Neno and Salima district hospitals had similar cases. About 16.1% of the young adults (19 - 39 years) had either a non-communicable disease or NCD-HIV/AIDS comorbidity. The most prominent NCD was hypertension (63.2%), followed by asthma (9.2%). The most commonly employed intervention was medication for NCD (51.6%) and NCD-HIV/AIDS comorbidity (43.4%). Only 13% of all the health facilities in the selected cities/districts used NCD mastercards from which data for this study was extracted. Conclusions NCDs and NCD-HIV/AIDS comorbidity among young adults pose a major concern since the ailment would lead to days off during the peak of their productivity. The NCD and NCD-HIV/AIDS comorbidity is a major public health problem that needs more attention than realised since the cases reported in this study could be under-reported.

Patient-provider experiences with chronic non-communicable disease care during COVID-19 lockdowns in rural Uganda: A qualitative analysis

Non-communicable diseases (NCDs) are a growing health burden in Sub-Saharan Africa and especially Uganda, where they account for over one third of all deaths. During the COVID-19 pandemic, public health control measures such as societal “lockdowns” had a significant impact on longitudinal NCD care though no studies have looked at the lived experience around NCD care during the pandemic. Our objective was to understand the experience of NCD care for both patients and providers in southwestern Uganda during the COVID-19 pandemic. We conducted in-depth, in-person qualitative interviews with 20 patients living with hypertension, diabetes, and/or cardiac disease purposefully selected from the outpatient clinics at Mbarara Regional Referral Hospital and 11 healthcare providers from public health facilities in Mbarara, southwestern Uganda. We analyzed transcripts according to conventional content analysis. We identified four major themes that emerged from the interviews; (1) difficulty accessing medication; (2) food insecurity; (3) barriers to the delivery of NCD clinical care and (4) alternative forms of care. Pre-existing challenges with NCD care were exacerbated during COVID-19 lockdown periods and care was severely disrupted, leading to worsened patient health and even death. The barriers to care were exacerbations of underlying systemic problems with NCD care delivery that require targeted interventions. Future work should leverage digital health interventions, de-centralizing NCD care, improving follow-up, providing social supports to NCD patients, and rectifying supply chain issues.

Prevalence of psychiatric morbidity and cognitive impairment among non-communicable disease patients in Southern Chennai, Tamil Nadu.

According to the WHO, non-communicable diseases cause 71% of all deaths globally. Despite many studies showing a significant association between non-communicable diseases (NCDs) and cognitive decline, it is not researched in Tamil Nadu. Hence, this study was conducted to screen for psychiatric morbidity and cognitive impairment (CI) among NCD patients in Southern Chennai. The aim of this study was to estimate the prevalence of psychiatric morbidity and CI and their associated factors among NCD patients attending NCD clinics of tertiary care hospitals. A cross-sectional study was carried out in NCD patients (n = 343) attending an NCD clinic in a tertiary care hospital. Basic sociodemographic and clinical details were obtained by a semi-structured questionnaire. Cognition function and psychiatric morbidity were assessed using mini-mental state examination, patient health questionnaire 9 and generalised anxiety disorder 7 tools, respectively. The mean age of the study participants was 58 years. Of 343 participants, 19.2% had severe CI, 26.8% had severe depression, and 29.7% had severe anxiety. Among 180 participants aged 59-86 years, 25.5% participants had osteoarthritis; of these, 41.3% had severe CI (P < 0.0001), 82.6% had severe depression (P < 0.0001) and 63% had severe anxiety (P < 0.027), and their association was statistically significant. This study concludes that about one-fourth of the NCD patients suffered from CI and psychiatric morbidity, which are of rising concern. Musculoskeletal diseases are neglected to be assessed under NCDs, and in this study, osteoarthritis was found to be significantly associated with depression, anxiety and CI.

Does training on the WHO package of essential noncommunicable (PEN) disease interventions enhance consultation quality? A real-world assessment of adherence to PEN protocol in primary health centres in the Republic of Moldova

ABSTRACT Background Noncommunicable diseases (NCDs) pose a significant global health challenge. Primary health centres are pivotal in addressing this challenge by providing essential care to NCD patients. The WHO Package of Essential Noncommunicable (PEN) disease interventions has been designed to enhance the quality of NCD consultations and ensure adherence to the protocol. This study investigates the effects of PEN training in Moldova. Objectives The primary objective of this study is to assess the effects of training on WHO PEN on the quality of NCD consultations and adherence to the PEN protocol in a real -world setting in primary health centres in Moldova. Methods An observational, cross-sectional study was conducted, comparing primary health centres where health personnel received PEN training, provided by the Healthy Life project, to those where such training was not provided. In total, 24 family doctors and 24 medical assistants were observed for 233 workdays and covering 2,166 NCD consultations. Results Intervention primary health centres (PHCs) showed longer NCD consultation durations, with family doctors and medical assistants spending an added 1 minute 43 seconds and 3 minutes 10 seconds, respectively. These PHCs also reported a higher proportion of primary NCD consultations, indicating better screening for new NCD patients. Medical assistants in the intervention group took on a more pronounced role in NCD care. However, the findings also highlight the necessity to refine aspects of the PEN training, especially concerning follow-up consultations, risk assessments, and task delegation. Conclusions The findings suggest that the PEN training contributed to improvement of both the quality of NCD consultations and adherence to the PEN protocol. Yet, there is a need for enhancing the identified aspects of the PEN training. The findings highlight the potential of PEN training in primary healthcare settings for improved NCD management.

Can ChatGPT provide appropriate meal plans for NCD patients?

ObjectivesDietary habits significantly affect health conditions and are closely related to the onset and progression of non-communicable diseases (NCDs). Consequently, a well-balanced diet plays an important role in lessening the effects of various disorders, including NCDs. Several artificial intelligence recommendation systems have been developed to propose healthy and nutritious diets. Most of these systems use expert knowledge and guidelines to provide tailored diets and encourage healthier eating habits. However, new advances in large language models such as ChatGPT, with their ability to produce human-like responses, have led individuals to search for advice in several tasks, including diet recommendations. This study aimed to determine the ability of ChatGPT models to generate appropriate personalized meal plans for patients with obesity, cardiovascular diseases, and type 2 diabetes. MethodsUsing a state-of-the-art knowledge-based recommendation system as a reference, we assessed the meal plans generated by two large language models in terms of energy intake, nutrient accuracy, and meal variability. ResultsExperimental results with different user profiles revealed the potential of ChatGPT models to provide personalized nutritional advice. ConclusionAdditional supervision and guidance by nutrition experts or knowledge-based systems are required to ensure meal appropriateness for users with NCDs.

Assessing socioeconomic vulnerability and COVID-19 infection risk among NCD patients in rural Sierra Leone: a cross-sectional study

BackgroundIn Sierra Leone, non-communicable diseases (NCDs) are an increasingly important source of mortality and morbidity. However, Sierra Leonean NCD patients’ experience of direct exposure to COVID-19-related risks and indirect effects of the COVID-19 pandemic on socioeconomic determinants of health has not been described.MethodsWe conducted a cross-sectional telephone survey among adult (≥ 18 years) hypertensive, diabetic, and heart failure patients receiving treatment at the NCD clinic at Koidu Government Hospital (KGH) in rural Sierra Leone. We described patient demographics, COVID-19 related knowledge, and practice of infection prevention measures. Patients were categorized into nationally representative wealth quintiles using an asset-based wealth index and measures of social vulnerability were reported by clinical program and wealth category.ResultOf the 400 respondents, 80.5% were between 40 and 69 years old and 46.1% were male. The majority of patients (> 90%) knew utilizing masks, social distancing, isolation from positive cases, and avoiding hand shaking were effective COVID-19 prevention measures. However, only 27.3% of the population had access to adequate handwashing facilities, 25.5% had attended crowded events in the past two weeks, and only 5.8% always used face masks. Compared with the national distribution of wealth, 33.0% of our population belonged in the richest quintile, 34.8% in the second-richest quintile, and 32.2% in the bottom 3 poorest-middle quintiles. Socioeconomic vulnerability was high overall with significant disparities between wealth categories. In the 30 days before the interview, almost 60% of the poorest-middle categories experienced one barrier to essential health services, 87.4% used at least one emergency coping mechanism to cover food, housing, or health care, and 98.4% were worried about having food. In the richest category, the proportion of patients experiencing these challenges was 32.3%, 39.5% and 81.6%, respectively.ConclusionOur patients had good knowledge of COVID-19 prevention measures; however, we found substantial discrepancies between patients’ self-reported knowledge and practices. Although our population was wealthier than the national average, the NCD patients were still exposed to unacceptable levels of socioeconomic vulnerability, reflecting a high absolute poverty in Sierra Leone. Furthermore, wealth-based disparities in access to essential resources persist among NCD patients.

Social Protection Supports and Management of Non-Communicable Diseases in Ghana: A Qualitative Cross-Sectional Perspective of Health Stakeholders

Introduction: Africa faces a double burden of communicable and non-communicable diseases (NCDs). Already, health systems in Africa are overwhelmed with a high burden of communicable diseases with perennial outbreaks of highly infectious diseases. The rise in NCDs comprises an already fragile health system challenging its ability to provide comprehensive care to people living with these diseases. Without responsive social support systems, NCDs will draw more people into catastrophic health financing, worsening health outcomes, and poverty. This study explores how vulnerable people negotiate major disease burdens with the social protection supports available in Ghana. Methods: The study applied a cross-sectional design with a qualitative approach involving healthcare professionals and non-healthcare professionals in 4 regions in Ghana with a total of 32 qualitative interviews analyzed thematically. Results: The main social protection support for the health sector in Ghana is the National Health Insurance Scheme. Other social protection supports such as free maternal healthcare, Livelihood Empowerment Against Poverty, and conventional informal social protection mechanisms do not directly target people afflicted with NCDs. Even though national health insurance covers about 90% of diseases, the quality of care is questionable. Again, the exclusion of diagnostic investigations makes national health insurance a setback to NCD disease management. Also, NCD patients still do out-of-pocket expenses though they have valid national health insurance. Informal social protection supports which used to be effective sometime back are dwindling due to the rising cost of living, gradual breakdown of the African system of reciprocity, and infiltration of Western lifestyles. Conclusion: NCD patients have very limited social protection for the management of their condition. Health insurance which is the only option for many has limited applications. A multidisciplinary body is established by the government to outline more effective ways of offering social protection support for health services, especially chronic conditions such as NCDs which affect a greater proportion of the population.

Prioritizing non-communicable diseases in the post-pandemic era based on a comprehensive analysis of the GBD 2019 from 1990 to 2019

This study aimed to assess the burden of communicable diseases (CDs) and non-communicable diseases (NCDs) globally, regionally, and nationally from 1990 to 2019, and propose global strategies to transform the public health policy. Using data from the Global Burden of Disease Study (GBD) 2019, we analyzed CDs and NCDs across various factors such as sex, age, year, and location, and evaluate the temporal trends of these diseases with joinpoint analysis. We also examined the differences between regions based on their socio-demographic index (SDI). In 2019, there were 7,862,907 (95% uncertainty interval [UI], 7,183,475 to 8,654,104) deaths from CDs and 42,034,124 (40,081,323 to 43,942,475) deaths from NCDs recorded worldwide. The low SDI region had markedly high age-standardized death and DALY rates of CDs. Although the age-standardized incidence rate of CDs has decreased in about half of the regions since 1990, NCDs have been on the rise in most regions. Over the past 30 years, the global burden of CDs has decreased significantly, while the burden of NCDs has aggrandized to an extent. In the post-pandemic era, effective interventions and cooperation among countries should be promoted to allocate medical resources more reasonably and improve healthcare for NCD patients.

Delivering Primary Health Care (PHC) Services for Controlling NCDs During the COVID-19 Pandemic: A Scoping Review.

Non-communicable diseases (NCDs) are the leading cause of death worldwide. NCDs also increase mortality from COVID-19 and primary health care (PHC) services are an important component in the prevention and control of long-term NCDs. The main goal of the present study was to review primary healthcare services for the NCDs patients via primary healthcare network during COVID-19 pandemic. In this scoping review, Search engines including PubMed, Scopus, and Science-direct up to 1st February 2022 were searched to identify studies regarding primary care services for NCDs patients via primary health care during COVID-19 pandemic. A total of 42 studies met the inclusion criteria and were included in our analysis. 24 studies were about the status and changes of primary health services for NCDs patients in PHC settings, while 18 studies focused on adaptive strategies used during COVID-19 in different countries including United States, Canada, United Kingdom, Portugal, Georgia, South Africa, Thailand, Mexico, India, Kenya, Guatemala and Saudi Arabia. These strategies included remote monitoring, follow up, consultation, empowerment and educational services as well as home visiting Disruption of NCDs services in PHC during the COVID-19 pandemic was observed in different countries, which highlights the urgency of attention of researchers and policy-makers to development of appropriate and adaptive policies to improve PHC service coverage and its quality during the pandemics.

Willingness to pay brand premiums for generic medicines in Kenya: A bidding game experiment.

Recent growth in the market share of higher priced branded generic medicines in low- and middle-income countries (LMICs) has raised concerns around affordability and access. We examined consumer willingness to pay (WTP) for branded versus unbranded generic non-communicable disease (NCD) medicines in Kenya. We randomly assigned NCD patients to receive a hypothetical offer for either a Novartis Access-branded medicine or for an unbranded generic equivalent. We then analysed WTP data captured using a bidding game methodology. We found that WTP for Novartis Access medicines was on average 23% higher than for unbranded generic equivalents (p=0.009). The WTP brand premium was driven almost entirely by wealthier patients. Our findings suggest that the dominance of branded generics in LMICs like Kenya reflect in part consumer preferences for these medicines. Governments and other health sector actors may be justified in intervening to improve access to these medicines and equivalent non-branded generics, particularly for the poorest patients who appear to have no preference for branded medicines.