Readiness Status Research Articles

Pediatric Readiness and Trauma Center Access for Children

Children initially treated in a timely fashion at trauma centers with high levels of pediatric readiness have been shown to have improved survival, but children historically have had geographically disparate access to pediatric trauma center care. Considerable effort has been invested in improving pediatric readiness nationally, including the implementation of new standards to improve emergency department pediatric readiness at all trauma centers. To assess current access to US pediatric-ready trauma center care and to estimate potential improvement in access if all high-level trauma centers had optimal pediatric readiness. This descriptive cross-sectional study collated trauma centers from national organizational lists, state government websites, and online searches. A geospatial analysis was performed of access by pediatric patients (aged ≤18 years) to trauma centers by ground or air ambulance within 60 minutes, stratified by trauma center type and pediatric readiness status. Population density was estimated using 2020 US census data. Weighted pediatric readiness scores (wPRS) were obtained from the 2021 National Pediatric Readiness Project assessment. The data analysis was performed between April 1 and June 30, 2023. Access times to trauma centers. The main outcome of interest was access to a pediatric-ready trauma center, defined as a high-level pediatric trauma center (level I-II) or high-level adult trauma center (level I-III) with a wPRS of at least 93 (out of 100). Access times were calculated using previously validated methods and service network model analysis for each trauma center to census block group centroid. The analysis included 148 pediatric and 1075 high-level adult trauma centers. A total of 273 adult centers (25%) were pediatric ready. Pediatric trauma center access within 60 minutes by ground or air ambulance was available for 65% of all 74 090 665 children; 73% of children had access to a pediatric-ready trauma center within 60 minutes, and 92% had access to any high-level trauma center within 60 minutes. These findings suggest that access to pediatric trauma center care is limited, even with air ambulance transport. Ensuring pediatric readiness at all high-level adult trauma centers may substantially improve access to early high-quality initial resuscitative trauma care for children.

Readiness for hospital discharge and associated factors in patients with oral cancer: A cross-sectional study.

To evaluate the current status of discharge readiness among postoperative oral cancer patients and identify the primary associated factors. Information from 713 oral cancer patients was collected using questionnaire surveys. One-way ANOVA or t-tests were employed to compare differences in discharge readiness across various demographic characteristics. Correlation analyses were conducted to examine the relationships between discharge readiness and discharge teaching quality, as well as social support. Multiple stepwise regression analysis was utilized to identify independent factors associated with discharge readiness. The mean discharge readiness score of postoperative oral cancer patients was 89.52±8.63. Seven variables, such as age, marital status, and income, were identified as significant associated factors. Furthermore, both the quality of discharge teaching and social support exhibited a significant positive correlation with discharge readiness. Postoperative oral cancer patients had moderate levels of discharge readiness and social support but low levels of discharge teaching quality. Discharge readiness among these patients is linked to various factors.

The Expanding Role of the U.S. Army Paramedic.

The combat medic (68W) will play a critical role in medical operations in the event of future large-scale combat operations (LSCOs). However, the combat medic is largely not prepared for LSCOs. The revised Medical Education and Demonstration of Individual Competence (TC 8-800) state 68Ws much be able to provide advanced airway and trauma management, medication administration, and advanced casualty movement. To meet the increased prehospital medical demands under LSCOs, the U.S. Army should require the Battalion, Brigade, and Division Medical Readiness Noncommisioned Officers (NCOs) to be Nationally Registered Paramedics (who are identified with the 3P Additional Skill Identifier [ASI]). They should have the responsibility to oversee the wartime medical skills sustainment of Combat Medic Specialists (68W) within their organization. These paramedics should drive medical simulation training events and improve current operation medical skills training. These medical readiness NCOs should attend the Medic Master Training Course and serve as advisors to commanders on the status of medic skill readiness within their organization. Commanders will be able to utilize these paramedics to augment the ongoing medical training of their medics to ensure they are operating at the fullest extent of their scope of practice.

Investigating emergency rescue readiness on Indian national highways: A case study of Jaipur-Jodhpur Highways (India) using a geospatial approach.

Highways represent the most significant capital asset that any country's public sector holds. A system of national highways with easy access to ambulance and trauma centers is termed emergency rescue ready and helps reduce the mortality due to road accidents. Given the rich impetus for road infrastructure development by the government of India, there is a need to consider emergency rescue readiness on highways. Previous research suggests that on typical Indian highways, an ambulance can reach the accident scene within 30 minutes; the remaining 30 minutes of golden hour is essential for saving the life of the injured by admitting to a healthcare facility with a trauma unit. To investigate the emergency rescue readiness for a stretch of highway between two cities in India. The main objective is to determine the possibility of transporting the injured due to the accident on the highway to the nearest available trauma center within 30 minutes. A Geographic Information System (GIS)-based network analysis method has been adopted to find the possibility of transporting the injured anywhere on the circuit of a national highway to the nearest healthcare unit within 30 minutes. A map representing the status of emergency rescue readiness has been presented for the study area. For a circuit of national highway with a length of 805 km, in a stretch of 89.5% (718.5 km), the injured can be transported to the healthcare unit within 30 minutes. In the remaining 10.5% of the highway, the healthcare units are significantly far from the highways and may hamper the post-crash rescue operations. There exists a wide disparity in trauma care delivery in the study area. Currently, the healthcare units established to serve the areas with dense populations also serve as emergency rescues during accidents on the national highways. Using GIS techniques for highway stretches with difficulty reaching the trauma centers, a national-level assessment is highly recommended.

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Digital transformation, which is taking place worldwide, is making major changes in labor structures and labour markets. This poses the challenge of building a workforce equipped with digital skills to be ready to meet the demands of the digital economy. The aim of this study is to explore the relevant skills needed for employees in the digital environment. Using statistical techniques that describe, compare, and synthesize analysis from documentation, domestic and foreign reports, data collected from 2018 to 2023, combined discussions on the impact of digital skills on employee performance with experts on the status of digital skill readiness of employees in a changing and highly competitive context. At the same time, evaluate the positive achievements and the limitations that have not been achieved. On that basis, making proposals and solutions for both employers and employees to recognize the need for digital skills in the workplace is a compulsory trend for organizations. The results show that technology has changed the demands on employment in many different professions, setting demands for professional qualifications as well as digital skills of an increasingly large, complex and sophisticated workforce to respond to efficient and sustainable operations for organizations.

Exploring the Readiness for Electronic Voting (E-Voting) in Emerging Economies: Evidence from Dodoma, Tanzania

There has been a lot of research on e-voting recently. Most studies assume that the implementation of e-voting is not merely about technology but also relates to several critical factors, such as the readiness of human resources and infrastructure, public trust, and others. This study explored the readiness for e-voting in developing countries, a case study of Tanzania. Specifically, the study aimed to examine the challenges of the current voting system, establish the e-voting readiness status in Tanzania, and find out factors for establishment of e-voting system in Tanzania. This study was quantitative in nature and obtained data from 196 respondents selected from Independent National Electoral Commission (INEC) officers and voters in Dodoma using purposive and convenient sampling techniques. Data was obtained from questionnaires distributed to officers and voters. The obtained data were analysed through descriptive statistics by the help of MS excel. The results show that the current voting system is faced with several challenges including limited safety, lack of trust, threat and insecurity vulnerability to mention but a few. It was further revealed that respondents were ready to adopt and use e-voting because it improves voters’ trust, ease voting procedures, reduces transportation costs on election materials/equipment and saves time. The study recommends the Independent National Election Commission of Tanzania, through various stakeholders see the possibility of establishing e-voting to achieve free and fair elections.

An Empirical Investigation of Organizational Readiness towards Hospital Autonomy.

We aimed to investigate Tehran's University of Medical Sciences (TUMS) affiliated hospitals organizational readiness toward implementing the 'Autonomous Hospitals' program as a change initiative from a managerial perspective in 2020. A census covering all eligible managers working in TUMS affiliated hospitals, Tehran, Iran (350 individuals) was carried out. Overall, 281 questionnaires were returned (a 30% non-responsiveness rate). A standard construct was adopted for data collection which was validated through a process of translation- back translation, face validity, and content validity (CVI=0.86, CVR=0.76). The reliability was acquired using Cronbach's alpha coefficient (0.87 and over 0.7). Both descriptive and inferential statistics were employed to draw conclusions .SPSS 26 was used for data analysis. Total organizational readiness for change (TORC) in hospitals was 60.75%±10.11 showing a state of medium to upper-medium readiness status. Also, the 'Clear mandate and centralized leadership' theme scored the lowest mean (53.02%±15.78) for ORC. 'Hospital accreditation level' (r=-0.14, P≤0.05), 'bed occupancy rate' (r=-0.19, P ≤0.05), and 'leadership status' (r=0.26, P≤0.001), also showed significant association with TORC. In addition, 'standardized bed occuPancy rate' (P≤0.05, B=-2.41), a 'male' leader (P ≤0.05, B=3.42), and 'academic affiliation' (P≤0. 1, B=-9.52), were good Predictors of TORC based on 'Backward Multiple Linear Regression' analysis. Full support from hospital and headquarters executives, delegation of sufficient decision-making authority to hospital managers, and implementation of comprehensive performance evaluation criteria were prerequisites for robust hospital autonomy in TUMS-affiliated hospitals.

Current status and factors influencing the work readiness of middle-aged and young postoperative lung cancer patients.

To identify the current status of return-to-work readiness and analyze its influencing factors among middle-aged and young postoperative lung cancer patients. From July 2022 to February 2023, a total of 144 middle-aged and young postoperative lung cancer patients who had been treated in the Department of Thoracic Surgery of West China Hospital, Sichuan University and had not returned to work were selected as the research subjects. A general information questionnaire, the Readiness for Return-To-Work (RRTW) Scale, the General Self-Efficacy Scale (GSES), and the Simplified Coping Style Questionnaire (SCSQ) were used for the survey. Univariate analysis and ordinal logistic regression analysis were used to assess the current status of work readiness and its influencing factors. The distribution of work readiness from high to low was as follows: behavioral preparation-self-assessment stage, intention stage, preintention stage, and behavioral preparation-action stage. Univariate analysis showed that age, place of residence, occupation, nature of work, average family income, scope of surgery, postoperative complications, surgical site, and primary coping strategies were statistically significant (P < .05). The ordinal logistic regression analysis revealed that patients engaged in mentally oriented work (odds ratio [OR] = 13.78, P < .001), with a monthly family income of ≥ 10,000¥ (OR = 6.28, P = .017), proactive coping strategies (OR = 4.84, P = .019), and higher self-efficacy (OR = 1.17, P < .001) had higher work readiness. Patients engaged in other industries (OR = 0.25, P = .028), agricultural, forestry, and fishing labor (OR = 0.08, P < .001), unemployed (OR = 0.12, P = .038), and with a monthly family income of < 1000¥ (OR = 0.07, P = .026) had lower work readiness. In overall, this study suggests that the work readiness of postoperative lung cancer patients needs improvement. Occupation, nature of work, average family income, primary coping strategies, and general self-efficacy are associated with return-to-work readiness among middle-aged and young postoperative lung cancer patients.

1293-P: Real-World Status of Autoantibody Screening and Teplizumab Administration Readiness among Centers Participating in the T1D Exchange Quality Improvement Collaborative (T1DX-QI)

1293-P: Real-World Status of Autoantibody Screening and Teplizumab Administration Readiness among Centers Participating in the T1D Exchange Quality Improvement Collaborative (T1DX-QI)

Artificial intelligence and project management maturity: A study of selected project-based organizations in Pakistan

Artificial intelligence (AI) is significantly impacting modern project management (PM) nowadays, especially as it begins to be integrated into business applications. This study focused on evaluating the readiness for AI implementation and the maturity level of PM in selected project-oriented organizations in Pakistan. Data from 12 such organizations were gathered through focus groups to examine the status of AI readiness and PM maturity and to explore their association. The methods used included exploratory data analysis and research on extreme cases. The findings indicated that AI readiness was relatively high in areas of governance and legal aspects but lower in solution development. Conversely, PM maturity was found to be higher in PM but less developed in program and portfolio management. Analysis of extreme cases suggested a positive relationship between AI readiness and PM maturity, supporting the idea that AI can enhance PM. These findings are crucial both for theoretical understanding and practical application.

Status and influencing factors of returning to work 6 months after discharge from hospital with severe acute pancreatitis-a cross-sectional descriptive-analytical study in China.

To describe the return to work of patients with severe acute pancreatitis within 6 months after discharge, and to explore the influence of demographic, clinical, and psychosocial factors on their return to work. Prospective 6 months follow-up study. A third class hospital in Guizhou Province. Adult of severe acute pancreatitis(18-60years), with a job before admission, in the intensive care unit ≥ 24 h, were included. To study return to work and influencing factors one, three and six months severe acute pancreatitis patients discharge. several measurements were used, including General Health Questionnaire (Demographic, disease-related, job-related and health behavior data), Readiness for Return-To-Work Scale and the Hospital Anxiety and Depression Scale. Forty-three severe acute pancreatitis patients were included in our study, with mean age 41.53 years. Twenty-nine (67.44%) patients returned to work within 6 months, and fourteen patients did not return to work. The status of Readiness for Return-To-Work Scale: fourteen severe acute pancreatitis patients who did not return to work were mainly in the precontemplation dimension and prepared for action-self-evaluative dimension both 5 cases (35.71%), and the 29 patients who had returned to work were in the Proactive maintenance stage. The study showed that the independent risk factors for returning to work in SAP patients were chronic disease (OR, 0.095; 95% CI [0.011-0.822]; p=0.008), sepsis (OR, 0.071; 95% CI [0.015-0.339]; p=0.009), low education level (OR, 2.905; 95% CI [0.969-8.710]; p<0.001), and anxiety and depression at 6 months (OR, 1.418; 95% CI [0.996-2.019]; p=0.004). In conclusion, the return to work of patients with severe acute pancreatitis needs to be improved. Chronic diseases, sepsis, low level of education and higher degree of anxiety and depression at 6 months were important factors leading to their failure to return to work.

Knowledge Transfer of Site Based Construction Management Team of ABC Company: Basis for the Development of Knowledge Transfer Plan

The study determines the readiness of ABC Company and the status of the project site based construction management team (CMT) on knowledge transfer (KT) as basis for the development of the proposed knowledge transfer plan (KTP). Descriptive method was used to obtain information on the levels of readiness on organizational characteristics and resources requirement of ABC Company and on the gaps in terms of idea creation, sharing, dissemination, evaluation and adoption in the project site based CMT. Descriptive statistics was used to present the data on readiness; anything below 100% in terms of idea creation, sharing, dissemination, evaluation and adoption was considered a gap. The study revealed that ABC Company has a moderately ready status on its readiness. Improvement was needed on KT strategy, rewards systems, knowledge hoarding, knowledge required, budget, and even on the core and support team that was essential in the development of the proposed KTP. The project site based CMT had gaps to be attended to on idea creation, sharing and dissemination. Those gaps were considered valuable input in the development of the proposed KTP. The development of the proposed KTP was grounded on quality management system that considered the readiness of ABC Company and the gaps found in the project site based CMT as inputs. The proposed KTP composed of four stages, namely, Management Responsibility, Resource Management, Knowledge Transfer Realization and Measurement, Analysis and Improvement. Intervention strategies presented in the KTP would address the particular area determined to be either absent or not consistently implemented with feed forward and feedback for continual improvement.

Status and predictors of readiness for hospital discharge in women with caesarean section: A latent profile analysis

BackgroundWomen undergoing caesarean section (CS) experience difficulties when preparing for discharge, and readiness for hospital discharge (RHD) may depend on individual characteristics. ObjectiveTo explore the status of RHD in women with CS, identify the latent classes of RHD, and analyse predictors from a bio-psycho-social perspective. MethodsA sample of 410 women with CS completed the following questionnaires on demographic and obstetric characteristics: Readiness for Hospital Discharge Study-New Mother Form (RHDS-NMF), Parents' Postnatal Sense of Security (PPSS), Quality of Discharge Teaching Scale (OB-QDTS), and Postpartum Support Questionnaire (PSQ). Latent profile analysis was used to identify the latent classes of RHD. Multiple logistic regression analysis was used to analyse the predictors. ResultsIn total, 96.6 % of women with CS reported discharge ready, and the score of RHDS-NMF was 136.09 ± 25.59. Three latent classes were identified as Low RHD (16.1 %), Moderate RHD (41.7 %), and High RHD (42.2 %). Primiparas (OR = 2.867 / 1.773; P = 0.012 / 0.033), emergency CS (OR = 3.134 / 2.470; P = 0.006 / 0.002), lower levels of PPSS (OR = 0.909 / 0.942; P = 0.009 / 0.013) and OB-ODTS (OR = 0.948 / 0.975; P < 0.001) were associated with Moderate and Low RHD. Lower PSQ predicted a higher probability of Low RHD (OR = 0.955; P = 0.038). ConclusionsThe perception of RHD by women in the study was inaccurate, with more than half not being classified as High RHD. Healthcare professionals can anticipate interventions for maternal well-being based on the characteristics of the different RHD classes.

Artificial Intelligence Readiness Status of Medical Faculty Students

Objective: This research aims to examine the knowledge level and awareness of Faculty of Medicine students about medical artificial intelligence technologies.&#x0D; Methods: In this study involving students studying at Medical Faculties in Turkey, descriptive questionnaire, and the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) were used. The suitability of continuous variables for normal distribution was tested with the Shapiro-Wilk test. Descriptive statistics for continuous variables are presented as mean and standard deviation or median (Q1-Q3). Descriptive statistics for categorical variables are reported as frequencies and percentages. Homogeneity of variances was evaluated with the Levene test. Mann Whitney U test was used to compare the scale subdimension and total scores according to two independent groups; One-way Analysis of Variance or Kruskal Wallis test was used to compare the scale subdimensions and total scores according to more than two independent groups. Dunn-Bonferroni test was used for multiple comparisons if there was a significant difference between the groups. The relationship between MAIRS-MS subdimensions and MAIRS-MS score was evaluated with the Spearman correlation coefficient. MAIRS-MS reliability was determined by Cronbach alpha value. The value of p

Point-of-Need Additive Manufacturing in Austere Arctic Environments: An Evaluation of Medical Logistics Requirements and Capabilities Demonstration.

Medical response to military conflicts, natural disasters, and humanitarian crises are challenged by operational logistics with unreliable supply chains, delayed medical evacuation, and compatibility of the disparate medical equipment and consumables. In these environments, stocks of supplies will become more quickly depleted and the need for equipment parts increases secondary to their higher likelihood for failure from overuse. Additive Manufacturing (AM), or 3D printing, at or closer to the point-of-need provides potential solutions to mitigate these logistics challenges. AM's ability to tailor the resultant product through computer design enables real-time modification of a product to meet a specific situation. In this study, we deployed two different 3D printers to an arctic locale to demonstrate the utility of 3D printing and bioprinting in austere environments. Deployment of AM solutions in austere environments will likely impact medical care following natural disasters and conflicts with contested logistics. The work presented here furthers the readiness status of AM for use in austere environments to manufacture medical equipment parts and demonstrates its potential use for tissue engineering and advanced medical treatments in remote environments.

Health System Resilience in a PHC Setting in India—A study of Assam and MP

Context: To bolster the ambitious Program of Government of India (GOI), to build a strong and resilient healthcare system plans to establish 1,50,000 Health and Wellness Centres (HWCs) across the country by 2024, the GOI gave a clear to its partners to explore options. Aim: Therefore, LEHS | WISH, initiated a baseline study to assess the service availability and service readiness (SARA) status of 18 Sub-centres (SCs) and Primary Health Centres (PHCs) to be upgraded as HWCs to deliver the twelve package of services as envisaged in HWC guidelines to strengthen the primary healthcare system. Settings and Design: Health system resilience, was assessed against the 10 Areas of Concern, elaborated in National Quality Assurance Standards (NQAS) for all the 12 thematic areas of service delivery of HWCs. Methods and Material: A sequential mixed method of design was adopted, which included both quantitative and qualitative components of assessment. The major focus of the study was quantitative in nature to assess HWC facility level gaps across key areas. Qualitative study with stakeholders including that of the community was undertaken to elicit reasons for such gaps and awareness of the community to respond/ engage with health systems better. Statistical Analysis Used: STATA was used a quantitative analysis tool undertake the analysis. Results: on average, both the last mile healthcare delivery system (PHC and SC) and the community are less than 25% resilient, even for disasters. Conclusion: It is not possible to make the system resilient unless focused effort is made. Therefore, there’s a need to clearly define the essential services and its resource requirement to be made available 24X7 for 365 days without fail, offer regular training to the staff to ensure process resilience, create awareness within the community to engage with the health system optimally, strengthen local governance to assure provision of essential services.

A Study of the Current Status of Readiness for Discharge and Factors Influencing It in Patients with Pulmonary Tuberculosis

A Study of the Current Status of Readiness for Discharge and Factors Influencing It in Patients with Pulmonary Tuberculosis

Analysis of Readiness For Implementation of Electronic Medical Records Using DOQ-IT Method

This study addresses the challenge of managing medical records in Indonesia’s health sector, particularly focusing on the transition to electronic medical records (RME) as mandated by PMK No. 24 of 2022. The primary objective is to assess the readiness for implementing Electronic Medical Records (EMR) at the Milla Husada Clinic using the DOQ-IT (Doctor’s Office Quality-Information Technology) Approach. The research adopts a descriptive design with a quantitative approach, utilizing questionnaires to gather data from 40 clinic officers. Total sampling technique was employed for participant selection. Univariate analysis was used for data interpretation. The findings reveal a high level of readiness for RME implementation at the clinic, with a total readiness score of 117.74, placing it in range III, indicative of a very ready status. The readiness levels, in descending order of scores, were: organizational work culture (4.34), governance and leadership (4.26), IT infrastructure (4.23), and human resource readiness (3.80). Despite the overall readiness, the study identifies human resources as an area requiring further enhancement, specifically the need for specialized training in RME implementation. This research highlights the critical areas for improvement to ensure successful adoption of electronic medical records in the healthcare setting.

Digital Infrastructure Quality Assessment System Methodology for Connected and Automated Vehicles

The rapid integration of Connected and Automated Vehicles (CAVs) into modern transportation systems necessitates a robust and systematic approach to assess the quality of the underlying digital infrastructure. In the presented work, we propose a methodology and evaluation of framework that can be used to assess digital infrastructure segments based on their readiness for the deployment of CAVs. The methodology encompasses a comprehensive framework that collects, processes, and evaluates diverse data sources, including real-time traffic, communication, and environmental data. The proposed framework is developed based on experimental data and provides a systematic approach to assess infrastructure readiness for CAVs. The proposed methodology is applied in a system for detecting the readiness status of digital infrastructure from a Cooperative, Connected, and Automated Mobility (CCAM) perspective. The system can determine the percentage of non-compliance of technical service requirements in terms of latency, bandwidth, and localization accuracy. Thanks to this, we can determine in advance in which state the current digital infrastructure is and which services can be currently operated, and thus locate the segments of the route in which the telecommunication systems need to be supported.

Changes in the readiness of healthcare systems to provide diabetes- and cardiovascular disease-related services: A comparison of indices using data from the 2014 and 2017 Bangladesh Health Facility Surveys

Background: The increasing prevalence of non-communicable diseases (NCDs) in Bangladesh is a significant obstacle for the government's already under-resourced healthcare centers and healthcare management. This study aimed to determine whether healthcare services are prepared to handle cardiovascular disease (CVD) and diabetes in the future. Methods: This cross-sectional study used the Bangladesh Health Facilities Survey (BHFS) 2014 and 2017 data. The BHFS 2014 completed assessment of 317 facilities providing diabetes care and 407 facilities providing CVD care, while the 2017 BHFS included 305 and 368 facilities providing diabetes and CVD care, respectively. Results: A slight increase in facility readiness status was observed in 2017 compared with 2014, though it was not statistically significant. District hospitals (DHs) and Upazila health complexes (UHCs) showed improvement in staff and guidelines, basic equipment, diagnostic capabilities, and essential drugs, as their Readiness Index (RI) value increased in 2017 from 2014. The RI values of non-governmental organizations (NGOs) clinics were 48.65% in 2014, whereas the value was slightly increased to 55.28% in 2017. For private clinics, the RI value diminished in 2017 (56.11%), which was lower than the 2014 survey (60.62%). There was a slightly mixed trend for public and private facilities regarding managing CVDs. In DHs and UHCs, the RI value decreased to 58.5% and 53.06% in 2017 from 64.04% and 53.02% in 2014. NGO clinics were valued at 48.65% in 2014, which dropped to 44.53%. For private clinics, the value showed a decreasing trend as the value in 2017 was 61.58%, lower than the value of 2014 (64.15%). Conclusions: In Bangladesh, public and private healthcare facilities lack readiness for healthcare towards DM and CVD maintenance. It is noteworthy that this improvement has been insignificant over the years in this regard. Healthcare policy reform is urgently required to strengthen NCD healthcare, particularly in public healthcare facilities.