Interventions for improving management of chronic non-communicable diseases in Dikgale, a rural area in Limpopo Province, South Africa

BMC Health Services Research

Eric Maimela¹  Marianne Alberts²  Hilde Bastiaens³  Johan Wens³  Herman Meulemans⁴  Jeane Pierre Van Geertruyden⁵  Jesicca Fraeyman⁶ 

[1] Department of Pathology and Medical Sciences, School of Health Care Sciences, University of Limpopo, Turfloop campus;Department of Pathology and Medical Sciences, School of Health Care Services, University of Limpopo, Turfloop campus;Department of Primary and Interdisciplinary care, University of Antwerp;Department of Sociology and Research Centre for Longitudinal and Life Course Studies, University of Antwerp;International Health Unit, University of Antwerp;Research group Medical Sociology and Health Policy, University of Antwerp;

关键词: Community health services;    Health care reform;    Health planning;    Interdisciplinary communication;    Managed care programs;    Primary prevention;   

DOI  :  10.1186/s12913-018-3085-y

来源: DOAJ

【 摘 要 】

Abstract Background Chronic disease management (CDM) is an approach to health care that keeps people as healthy as possible through the prevention, early detection and management of chronic diseases. The aim of this study was to develop interventions to improve management of chronic diseases in the form of an integrated, evidence-based chronic disease management model in Dikgale, a rural area of Limpopo Province in South Africa. Methods A multifaceted intervention, called ‘quality circles’ (QCs) was developed to improve the quality and the management of chronic diseases in the Dikgale Health and Demographic Surveillance System (HDSS). These QCs used the findings from previous studies which formed part of the larger project in the study area, namely, the quantitative study using STEPwise survey and qualitative studies using focus group discussions and semi-structured interviews. Results The findings from previous studies in Dikgale HDSS revealed that an epidemiological transition is occurring. Again, the most widely reported barriers from previous studies in this rural area were: lack of knowledge of NCDs; shortages of medication and shortages of nurses in the clinics, which results in patients having long waiting-time at clinics. Lack of training of health care providers on the management of chronic diseases and the lack of supervision by the district and provincial health managers, together with poor dissemination of guidelines, were contributing factors to the lack of knowledge of non-communicable diseases (NCDs) management among nurses and community health care workers (CHWs). Consideration of all of these findings led to the development of model which focuses on integrating nursing services, CHWs and traditional health practitioners (THPs), including a well-established clinical information system for health care providers. A novel aspect of the model is the inclusion of community ambassadors who are on treatment for NCDs and are, thus, repositories of knowledge who can serve as a bridge between health care workers and community members. Conclusion The model developed highlights the need for health interventions that aim to control risk factors at the population level, the need for availability of NCD-trained nurses, functional equipment and medication and a need to improve the link with traditional healers.

【 授权许可】

Unknown