Non-communicable Diseases Services Research Articles

Care-seeking practices for non-communicable chronic conditions in a low-income neighborhood in Southern India.

Given that access to healthcare is less challenging in urban India, evidence shows that affordable government healthcare services are underutilized by the vulnerable and disadvantaged groups. There are emerging studies on healthcare seeking behavior in the context of short-term morbidities and communicable diseases that attempted to understand this gap of underutilization of government healthcare services, but similar studies are rare in the context of non-communicable diseases (NCDs) and associated chronic conditions. Given the urban health system is ill- prepared and ill-equipped to deliver NCD services, it is important to understand how the vulnerable and disadvantaged groups seek healthcare for chronic conditions. This article investigates the care-seeking practices of these individuals living in a low-income neighborhood and care-seeking pathways for chronic conditions. The study is conducted at Kadugondanahalli-a low-income neighborhood with the presence of a recognized slum, in Bengaluru city. A total of twenty in-depth interviews are conducted with individuals diagnosed with non-communicable chronic conditions. Participants were selected through purposive and snowball sampling method. The data is collected between January 2020 to June 2021. The study participants practice a wide range of care-seeking practices based on the management of comorbidity and multimorbidity, recognizing the symptoms and severity, experiences of family members, belief, and purchase and consumption of medicines. These practices clearly highlighted not only the nuances of non-adherence to the long-term treatment and medications, but it also strongly influences the care-seeking behavior, which in turn make the care-seeking continuum very complex. The care-seeking continuum attempted each of the components (i.e. the screening, diagnosis, treatment, and control) of NCD care cascade but participants often failed to do screening on time, delayed diagnosis, and did not meet the treatment goals, leading to their conditions becoming further uncontrolled due to the care-seeking practices they practice. These practices delayed not only the diagnosis but also the completion of each component of the care cascade. This study emphasizes strengthening of the health system in addressing the individual and community level practices, that significantly affect the entire care-seeking continuum, in the sustained monitoring and adherence to the treatment of chronic conditions.

Noncommunicable Disease Service Utilization from the Upgraded Primary Care Centers: A Cross-Sectional Study from Kerala, India

ABSTRACT Introduction: World Health Organization recommends the integrated management of noncommunicable diseases (NCDs) in primary care. Hence, this study aimed to determine the NCD service utilization from an upgraded primary care center and to find the reasons for nonutilization. Materials and Methods: This community-based cross-sectional analytical study was conducted among 387 individuals aged 30 years and above in a selected upgraded primary care center. A validated semistructured questionnaire was used. A log-binomial regression was done, and adjusted prevalence ratios (aPR) were calculated. Results: The prevalence of utilization of NCD services from upgraded primary care center was 55.3% (95% confidence interval [CI] 50.2–60.3). The screening or treatment service utilization for hypertension, diabetes, and cardiovascular diseases was reported to be 54% (95% CI 48.9–59.1), 37.5% (95% CI 32.6–42.5), and 7.2% (95% CI 4.9–1.3), respectively. The reasons for the nonutilization of services were preference for the private sector (35.3%), distance to the facility (27.2%), and lack of awareness regarding the amenities at family health centers (11.3%). The younger age (aPR = 1.70, 95% CI 1.29–2.23, P = 0.033), unemployment (aPR = 1.46, 95% CI 1.01–2.10, P = 0.043), and social class (aPR = 1.62, 95% CI 1.16–2.26, P = 0.004) were significantly associated with NCD service nonutilization. The willingness to avail of NCD services among nonutilizers was 46.8% and salaried individuals had a high chance of unwillingness (aPR = 5.01, 95% CI 1.69–14.78, P = 0.003) compared to daily waged workers. Conclusion: Nearly half of the participants were not utilized upgraded primary care centers for NCD care. Strengthening outreach services and improving awareness among beneficiaries may improve the utilization in the community.

An Online Survey of the Perceptions of Clinical and Non-Clinical Professionals on Healthcare for Non-Communicable Diseases and COVID-19 Measures During the Pandemic in Malaysia.

Objectives: This study assesses the opinions of health professionals in Malaysia on the disruption of non-communicable disease (NCD) services during the COVID-19 pandemic from March 2020 to January 2022. Methods: We conducted a cross-sectional online survey with 191 non-clinical public health workers and clinical health service workers in Malaysia from November 2021 to January 2022. Participants were recruited by the Malaysian Ministry of Health using major networks including key experts and practitioners. Secondary respondents were subsequently enrolled through snowballing. Results: The most notable issues raised by the survey participants relate to NCD service disruption, the redirection of NCD care resources, and NCD care being overburdened post-pandemic. Respondents also reported accounts of resilience and prompt reaction from the healthcare system, as well as calls for innovation. Conclusion: Most respondents perceived that the challenges arising from COVID-19 were mostly managed well by the healthcare system, which was able to provide the necessary services to NCD patients during this health emergency. However, the study identifies gaps in the health system response and preparedness capacity, and highlights solutions for strengthening NCD services.

Implementation of Nursing Care in Hypertension Patients with a family approach: A Case Study

Hypertension is the number one cause of death in the world every year, including in Indonesia. It has been proven that in Indonesia alone in 2020 there will be around 80 million people with hypertension. For this reason, prevention and control of hypertension in the community must be strengthened and improved in terms of quality of service, health promotion, community empowerment in early detection and monitoring of hypertension risk factors at First Level Health Facilities through Integrated Services for non-communicable diseases. The role of nurses is very important in preventing and controlling hypertension in the community, especially in First Level Health Facilities. Objective: To determine the implementation of family nursing care in hypertensive patients with a family approach as an effort to reduce blood pressure. Objective: To determine the implementation of family nursing care in hypertensive patients with a family approach as an effort to reduce blood pressure. Research Method: The design of this study used a case study method that implemented the application of family nursing care in hypertensive patients with a family approach as an effort to reduce blood pressure. This research was conducted on hypertensive patients in Mr. S's family with hypertension problems in Pedurenan Village, RT 08 RW 02 Karang Tengah, Tangerang. Results: Implementation of family nursing care with a family approach for 3 days reduced hypertension from 160/100mmHg to 140/80 mmHg.

The resiliency of noncommunicable diseases services during the public health crisis: a lesson from Bangkok, Thailand

BackgroundThe healthcare services for non-communicable diseases (NCD) are commonly affected by public health crises like the COVID-19 pandemic. During the pandemic, all healthcare facilities in Bangkok had been overwhelmed by the extreme caseload of COVID-19. Health service resiliency is crucial for the continued service of healthcare facilities post pandemic. This study aims to explore the impacts of COVID-19 on NCD service disruption and addressed the resilience of healthcare services at the operational level.MethodsHealthcare facility-based surveys and in-depth interviews were conducted among representatives of the facilities in Bangkok from April 2021 to July 2021. The web-based, self-administered questionnaire, was sent to directors or authorities of all healthcare facilities in Bangkok Thailand (n = 169). Two healthcare facilities from three levels of health services were purposively selected. The directors or medical doctors and nurses who are in charge of the NCD service, and working at the six selected health facilities, were invited to participate in the in-depth interviews. Descriptive statistics were used to analyze the survey data, and thematic analysis was used to analyze the data from the in-depth interviews.ResultsThe impact of COVID-19 on NCD service disruption in the second wave (2021) was more severe than in the first wave (2020). The main reasons for NCD service disruptions are insufficient staff, and the closure of some services offered by the healthcare facilities. Surprisingly, both the budget and medical supply for healthcare facilities in Bangkok are less affected by the COVID-19 pandemic. Our study revealed resilience capability i.e. absorptive, adaptive, and transformative capabilityamong the healthcare facilities that provide a continuum of care by increasing availability and accessibility to healthcare services for chronic illness as DM. The service disruption in Bangkok may alter from other provinces because of variations in COVID-19 incidence and health services contexts.ConclusionDuring the public health crisis, using affordable and common digital technologies to ensure DM patients can access a continuum of care and providing alternative services such as mobile medical laboratories, medication delivery, and medical refill at drug stores can increase consistent monitoring of glycemic levels and use of prescribed medication.

Assessment of Functioning of Health and Wellness Centers of Western Odisha: A Cross-Sectional Study.

Background The National Health Policy (NHP) 2017 of India recommends strengthening the delivery system of Primary Health Care through the establishment of Health & Wellness Centres (HWC) as the platform to deliver comprehensive primary health care services.HWCs are being set up as an upgraded version of existing sub-centers, primary health care centers, and urban primary health centers. This study was conducted to evaluate the functioning of health and wellness centers in Western Odisha. Objective To assess the availability of human resources, health care services, drug availability, lab services, and IT services at the health and wellness centers of Western Odisha. Methods Out of 10 districts of Western Odisha, two districts (Sambalpur and Deogarh) were selected for convenience, and a cross-sectional study was conducted from January 2021 to December 2022. All 43 health and wellness centers (35 rural primary health centers (PHCs) and eight urban PHCs) of the above two districts were included in the study. All relevant data were collected using a predesigned, pretested, and semi-structured questionnaire. Results The study showed that all 43 HWCs had good availability of pharmacists and lab technicians but less availability of medical officers, AYUSH medical officers, and staff nurses. Maternal and childhood services, family planning, and non-communicable disease (NCD) services were conducted regularly in all health and wellness centers, but basic oral health services and palliative care services were inadequate. All laboratory services like blood grouping, differential count/total leucocyte count, rapid test for pregnancy, urine albumin, urine routine examination/microscopic examination along with culture/sensitivity and water quality testing were done at urban PHC HWCs, whereas these lab services were less available at rural PHC HWCs.Drug groups like antipyretics, antihistaminic, antifungal, antihypertensive, oral hypoglycemic agent (OHA), antispasmodics, and antiseptic ointments were adequately available (>80%) at all urban and rural PHC HWCs. For IT support, appliances like desktops, internet facilities, and telephone facilitieswerefound to be present at all HWCs. Teleconsultation services were found to be available at 88% of urban PHC HWCs and 60% of rural PHC HWCs. ​Conclusion The study showed that infrastructure, human resources, and 12 service packages of health care and drugs should be addressed on a priority basis to achieve desired goals as envisaged by Ayushman Bharat to achieve the full potential of the health and wellness centers.

Health facility readiness to provide antenatal care (ANC) and non-communicable disease (NCD) services in Nepal and Bangladesh: Analysis of facility-based surveys.

Antenatal care (ANC) visits provide an important opportunity for diagnostic, preventive, and curative services for non-communicable diseases (NCDs) during pregnancy. There is an identified need for an integrated, system-wide approach to provide both ANC and NCD services to improve maternal and child health outcomes in the short and long term. This study assessed the readiness of health facilities to provide ANC and NCD services in Nepal and Bangladesh, identified as low-and middle-income countries. The study used data from national health facility surveys in Nepal (n = 1565) and Bangladesh (n = 512) assessing recent service provision under the Demographic and Health Survey programs. Using the WHO's service availability and readiness assessment framework, the service readiness index was calculated across four domains: staff and guidelines, equipment, diagnostic, and medicines and commodities. Availability and readiness are presented as frequency and percentages, while factors associated with readiness were examined using binary logistic regression. Of the facilities, 71% in Nepal, and 34% in Bangladesh reported offering both ANC and NCD services. The proportion of facilities which showed readiness for providing ANC and NCD services was 24% in Nepal and 16% in Bangladesh. Gaps in readiness were observed in the availability of trained staff, guidelines, basic equipment, diagnostics, and medicines. Facilities managed by the private sector or a Non-Governmental Organization, located in an urban area, with management systems to support the delivery of quality services were positively associated with readiness to provide both ANC and NCD services. There is a need to strengthen the health workforce by ensuring skilled personnel, having policy, guidelines and standards, and that diagnostics, medicines, and commodities are available/provided in health facilities. Management and administrative systems are also required, including supervision and staff training, to enable health services to provide integrated care at an acceptable level of quality.

What is the NCD service capacity and disruptions due to COVID-19? Results from the WHO non-communicable disease country capacity survey in the Americas region

ObjectiveThis article presents the Americas regional results of the WHO non-communicable diseases (NCDs) Country Capacity Survey from 2019 to 2021, on NCD service capacity and disruptions from the COVID-19 pandemic.SettingInformation...

Prevalence of and factors associated with diabetes mellitus among people living with HIV in Vietnam.

Studies have shown that people living with HIV (PLWH) have a higher risk of having non-communicable diseases (NCDs) than do people without HIV. In Vietnam, HIV remains a major public health concern, and with recent rapid economic growth, NCDs such as diabetes mellitus (DM) have become a significant disease burden. This cross-sectional study was conducted to examine the prevalence of DM and the factors associated with DM among PLWH on antiretroviral therapy (ART). In total, 1,212 PLWH were included in the study. The age-standardized prevalence of DM and pre-diabetes were 9.29% and 10.32%, respectively. In the multivariate logistic regression analysis, male sex, age above 50 years, and body mass index ≥ 25 kg/m2 were associated with DM, and borderline p-value was found for associations with current smoking and years on ART. The results suggest higher DM prevalence among PLWH and that longer time on ART could be an important risk factor for DM among PLWH. These findings also suggest that interventions such as weight control and smoking cessation support could be provided at outpatient clinics. Integration of HIV/AIDS and NCDs services is essential to address health needs comprehensively and enhance health-related quality of life for PLWH.

Lessons from the COVID-19 Pandemic: Strengthening our Commitment to Eye Care

Lessons from the COVID-19 Pandemic: Strengthening our Commitment to Eye Care

Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand

BackgroundThis study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients.MethodsData were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates.ResultsAmong 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles.ConclusionsThis study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap.

'Makkalai Thedi Maruthuvam' scheme in Tamil Nadu: an intersectionality-based analysis of access to NCD care.

There are gross inequities in access to non-communicable disease (NCD) care in India. The Indian state of Tamil Nadu recently launched the "Medicine at people's doorstep" (Makkalai Thedi Maruthuvam - MTM) scheme in which screening and medications for NCDs are delivered at people's doorsteps. This is likely to improve geographical access to NCD services in the community. The objective of this study is to analyse the MTM scheme and recommend policy interventions for improved and equitable access to NCD services in the community. We analysed the MTM policy document using the intersectionality-based policy analysis framework. This analysis was supplemented further with literature review to enhance understanding of the various intersecting axes of inequities, such as gender discrimination, caste oppression, poverty, disabilities and geographical access barriers. The MTM policy document, while it removes the physical access barrier, does not frame the problem of NCDs from an intersectionality perspective. This can increase the chances of inequities in access to NCD services persisting despite this scheme. We also recommend interventions for the short, intermediate and long term to make NCD care more accessible. Creation of a gender, caste, class, geographical access, and disabilities disaggregated database of patients with NCDs, using this database for monitoring the delivery of MTM services, dynamic mapping of vulnerability of the target populations for delivery of MTM services and long term ongoing digital surveillance of factors inducing inequities to access of NCD services can all help reduce inequities in access to NCD care.

Strengthening cancer control in the South Pacific through coalition-building: a co-design framework

Cancer is a significant problem for the South Pacific region due to a range of complex health challenges. Currently gaps in diagnosis, treatment and palliative care are significant, and while governmental commitment is strong, economic constrains limit health system strengthening. Alliances have been successful in strengthening non-communicable disease and cancer control policy and services in resource constrained settings. A regional coalition approach has therefore been recommended as an effective solution to addressing many of the challenges for cancer control in the South Pacific. However, evidence regarding the effective mechanisms for development of alliances or coalitions is scarce. This study aimed to 1) create a Coalition Development Framework; 2) assess the use of the Framework in practice to co-design a South Pacific Coalition. Creation of the Coalition Development Framework commenced with a scoping review and content analysis of existing literature. Synthesis of key elements formed an evidence-informed step-by-step guide for coalition-building. Application of the Framework comprised consultation and iterative discussions with key South Pacific cancer control stakeholders in Fiji, New Caledonia, Papua New Guinea, Samoa and Tonga. Concurrent evaluation of the Framework utilising Theory of Change (ToC) and qualitative analysis of stakeholder consultations was undertaken. The finalised Coalition Development Framework comprised four phases with associated actions and deliverables: engagement, discovery, unification, action and monitoring. Application of the Framework in the South Pacific identified overwhelming support for a Cancer Control Coalition through 35 stakeholder consultations. Framework phases enabled stakeholders to confirm coalition design and purpose, strategic imperatives, structure, local foundations, barriers and facilitators, and priorities for action. ToC and thematic consultation analysis confirmed the Framework to be an effective mechanism to drive engagement, unification and action in alliance-building. A Coalition to drive cancer control has significant support among key Pacific stakeholders, and establishment can now be commenced. Importantly results confirm the effective application of the Coalition Development Framework in an applied setting. If momentum is continued, and a regional South Pacific Coalition established, the benefits in reducing the burden of cancer within the region will be substantial. This work was completed for a Masters of Public Health project. Cancer Council Australia provided project funding.

Rapid assessment of NCD services rollout in Health and Wellness Centres in North-Eastern Indian state: A cross- sectional study.

The creation of health and wellness centres (HWCs) to deliver comprehensive primary healthcare (CPHC) is a programmatic response to the changing demographic and epidemiological profile in India. Since the north-eastern (NE) states face distinct challenges to routine healthcare services, and it has been two years since the rollout of non-communicable disease (NCD) services through the HWCs, a rapid assessment of the rollout with respect to all components of CPHC was undertaken in the NE state of Manipur. The assessment was undertaken using a mixed methodology to assess the rollout of NCD services under CPHC based on the functionality criteria of HWCs. The districts and the facilities were sampled purposively using pre-defined criteria. Primary data were collected using adapted pre-tested semi-structured tools and an interview schedule, which were triangulated with facility-based records and field observations. The data were anonymized, analysed thematically and presented under the domains of CPHC. The assessment aided in identifying progress and challenges in the rollout of NCD services through the HWCs. Overall, the initiative was successful in generating demand and community awareness of the expanded range of services at the primary level. Yet, constraints posed by infrastructural gaps, logistical delays, training gaps, fund flow and weak community-level convergence compounded by the COVID-19 pandemic challenged seamless NCD service delivery. In as much as the attainment of universal health coverage is dependent on NCD prevention and control, the rollout of NCD services is dependent on strong institutional structures, especially at the primary level. The assessment highlights the need to strengthen the HWCs through adequate financing, human resources, logistics for medicines and technology, community participation, citizen engagement and change management.

Health System Preparedness in Provision of Noncommunicable Diseases’ Services in Lakhimpur District, Assam State, India

Background: While noncommunicable diseases (NCDs) are one of the leading causes of mortality in the world today, we are unsure of the preparedness of the public health system in terms of provision for and utilization of NCD services in Assam. Methods: Preparedness of public health facility was assessed using WHO-SARA (Service Availability and Readiness Assessment) tool and Indian Public Health Standards tool. Ethics approval was obtained from the Institutional Human Ethics Committee of the Central University of Kerala. Results: The overall readiness of primary health centers (PHCs) ranged from 60% to 76% for NCD services, community health centers (CHCs) ranged from 72% to 87%, subdivisional hospitals from 70% to 87%, and district hospitals from 76% to 100%. Deficiencies were also noted in terms of the availability of equipment and medicines. Conclusion: The deficiencies in the PHCs and CHCs highlighted in the study emphasize the need to strengthen the health system, thereby strengthening the response of the health system to NCDs in India.

Effects of the COVID-19 Pandemic on the Implementation of NCD Care at the Primary Care Level in the Philippines: A Qualitative Inquiry.

The focusing of resources to COVID-19 response hampered and disadvantaged primary care services including that for Non-Communicable Diseases (NCDs), compromising continuity of care and hence, patients' disease status. However, studies from low- and middle-income countries (LMICs) remain sparse; therefore, evidence generation on how the pandemic impacted the provision of these primary care services in LMICs will help further understand how policies can be reframed, and programs be made more efficient and effective despite similar crises. To bridge this gap, the study investigated how the pandemic affected the implementation of NCD care at the primary care level in the Philippines. Thirty-one online focus group discussions via Zoom Meetings were conducted among 113 consenting physicians, nurses, midwives, and community health workers from various facilities - community health centers and stations, free-standing clinics, infirmaries, and level 1 hospitals - located within two provinces in the Philippines. All interviews were video-recorded upon participants' consent and transcribed verbatim. Inductive thematic analysis was employed through NViVo 12® to generate themes, identify categories, and describe codes. The impact of COVID-19 on NCD care at the primary care level revolved around heightened impediments to service delivery, alongside worsening of pre-existing challenges experienced by the healthcare workforce; subsequently compelling the public to resort to unhealthy practices. These detriments to the primary healthcare system involved resource constraints, discontinued programs, referral difficulties, infection, overburden among workers, and interrupted training activities. Citizens were also observed to adopt poor healthcare seeking behavior, thereby discontinuing treatment regimen. Healthcare workers asserted that disadvantages caused by the pandemic in their NCD services at the primary care level possibly threaten patients' health status. Besides the necessity to address such detriments, this also emphasizes the need for quantitative studies that will aid in drawing inferences and evaluating the effect of health crises like the pandemic on such services to bridge gaps in improving quality of care.

Acceptability and feasibility of tuberculosis and diabetes mellitus bidirectional screening and joint treatment services in Malawi: a cross-sectional study and a policy document review

ObjectivesA cross-sectional and a policy document review study was performed to investigate perceived acceptability and feasibility to implementing different integration measures for tuberculosis (TB) and diabetes mellitus (DM) healthcare among...

Universalization of Healthcare for Non-Communicable Diseases in India - Promise of Health and Wellbeing, Insurance for Universal Health Coverage.

Noncommunicable diseases (NCDs) pose a significant global health and economic burden, necessitating universal health coverage (UHC). Out-of-pocket (OOPs) payments for healthcare, particularly in low- and middle-income countries lacking social protection and health insurance, contribute to impoverishment and catastrophic expenditure. This scoping review aimed to assess the state of UHC for NCDs in India, including the progress made, coverage of government health insurance schemes, challenges faced, and their potential solutions. A literature search was performed in major databases such as PubMed, Ovid, Web of Science, Embase, Cochrane Library, and Google Scholar using appropriate keywords. Findings indicated that UHC remains a distant dream in India with a disproportionately high NCD burden and a substantial portion of health-care expenses (80% outpatient, 40% inpatient) relying on OOP expenditures, causing financial hardship. Limited universal social security exacerbates health-care access challenges. The coronavirus disease-2019 pandemic has further hindered NCD services and UHC progress. The Ayushman Bharat program, featuring health and wellness centers and the Pradhan Mantri Jan Arogya Yojana, aims to address primary health-care needs and provide NCD coverage in India. Despite this, challenges persist, including inadequate availability of essential medicines and technologies in health-care facilities, as well as gaps in rural health-care access. Telemedicine services like "eSanjeevani" have been implemented to improve access in remote areas. To achieve UHC for NCDs in India, it is crucial to strengthen primary health-care, ensure medicine availability, enhance human resources, establish a referral system, address social determinants, and implement social protection.

Noncommunicable Diseases Healthcare-Specific Service Readiness at the Primary Health-care Centers in Ekiti State, Nigeria

Background: Noncommunicable diseases (NCDs) have been highlighted as a major challenge for sustainable development and an alarming public health challenge of global concern. This study was aimed at assessing the PHC facilities' readiness to provide NCDs management services in Ekiti state, Nigeria. Methodology: A descriptive cross-sectional study was conducted among PHCs in Ekiti state between August and October 2020 in 177 PHC facilities using some components of the World Health Organization's Service Availability and Readiness Assessment tool. Analysis was done using STATA SE 12. Statistical significance was set at a P < 0.05. Results: Majority (95%) of the primary health-care facilities were located in rural areas. Approximately 19% were in Ekiti North II and Ekiti Central II constituencies, and the majority (95%) were health centers. Only 29.4% offer management of NCDs. Among the spacers for inhalers available in 1.7% of the facilities, none were functioning and only 1.4% had equipment for NCD management and control, and 6% had trained staff and guidelines for NCD management. NCD-specific service readiness index was just 11% among the health care, facilities studied. Health-care facilities in the urban areas and the Ekiti North I had statistically significant higher NCD service readiness compared to the rural areas and the other federal constituencies, respectively (P < 0.05). Conclusion: The overall NCD-specific service readiness in Ekiti State was extremely low. The government should provide sufficient tools and equipment with trained workers that will offer adequate management of NCDs in the state.

Exploring key-stakeholder perceptions on non-communicable disease care during the COVID-19 pandemic in Kenya.

over one third of total Disability-Adjusted-Life-Years lost in Kenya are due to non-communicable diseases (NCD). In response, the Government declared significant commitment towards improving NCD care. The COVID-19 pandemic increased the burden on the already overstretched health systems in Kenya. The aims of this study are to assess whether health care providers perceived NCD care to be optimal during the pandemic and explore how to improve responses to future emergencies. this cross-sectional online survey included healthcare personnel with non-clinical roles (public health workers and policy-makers) and those delivering health care (doctors and nurses). Respondents were recruited between May and September 2021 by random sampling, completed by snowball sampling. among 236 participants (42% in clinical, 58% in non-clinical roles) there was an overall consensus between respondents on NCD care being disrupted and compromised during the pandemic in Kenya. Detracted supplies, funding, and technical resources affected the continuity of NCDs' response, despite government efforts. Respondents agreed that the enhanced personnel capacity and competencies to manage COVID-19 patients were positive, but noted a lack of guidance for redirecting care for chronic diseases, and advocated for digital innovation as a solution. this paper explores the perceptions of key stakeholders involved in the management of NCDs in Kenya to improve planning for future emergency responses. Gaps were identified in health system response and preparedness capacity during the pandemic including the perceived need to strengthen NCD services, with solutions offered to guide resilience efforts to protect the health system from disruption.