Public policy, health system, and community actions against illness as platforms for response to NCDs in Tanzania: a narrative review

Abstract

BackgroundMost low- and middle- income countries are facing a rise of the burden of non-communicable diseases (NCDs) alongside the persistent burden of infectious diseases. This narrative review aims to provide an inventory of how the existing policy environment, health system, and communities are addressing the NCDs situation in Tanzania and identify gaps for advancing the NCD research and policy agenda.MethodologyA literature search was performed on PubMed and Google scholar with full text retrieval from HINARI of English language articles published between 2000 and 2012. Documents were read to extract information on what Tanzanian actors were doing that contributed to NCDs prevention, treatment, and control, and a narration was written out of these. Reference lists of all retrieved articles were searched for additional relevant articles. Websites of organizations active in the field of NCDs including the Government of Tanzania and WHO were searched for reports and grey literature.ResultsLack of a specific and overarching NCD policy has slowed and fragmented the implementation of existing strategies to prevent and control NCDs and their determinants. The health system is not prepared to deal with the rising NCD burden although there are random initiatives to improve this situation. How the community is responding to these emerging conditions is still unknown, and the current health-seeking behavior and perceptions on the risk factors may not favor control of NCDs and their risk factors.Conclusion and recommendationThere is limited information on the burden and determinants of NCDs to inform the design of an integrative and multisectorial policy. Evidence on effective interventions for NCD services in primary care levels and on community perceptions on NCDs and their care seeking is virtually absent. Research and public health interventions must be anchored in the policy, health system, and community platforms for a holistic response.

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“…The prevalence of hypertension ranged from 12 to 69% among garage workers to rich traditional chiefs in West Africa ( 28 ). In Tanzania, NCDs were estimated at 27% ( 29 ). Uganda's NCD prevalence, although not very high, could be under-reported.…”

The Burden of Hypertension and Diabetes in an Emergency Department in Northern Tanzania

“…3,4 Health systems in SSA must overcome multiple challenges to effectively manage the rising epidemic of hypertension and diabetes, including medication shortages, lack of diagnostic equipment, poor patient and physician knowledge and training, absent or inadequate treatment guidelines, cost of long-term treatment, and lack of effective screening programs, among others. [5][6][7][8][9][10][11] In Tanzania, for example, primary care provision is limited and in 2012 there were only 7.1 health care workers per 10,000 people, 12,13 an inadequate number to effectively manage and prevent NCDs. Furthermore, recent surveys of Tanzanian health care facilities have demonstrated that many lack basic functioning diagnostic equipment such as blood pressure cuffs or glucometers, and the majority of facilities lack protocols for NCD management.…”

Insufficient Fruit and Vegetable Intake in a Low- and Middle-Income Setting: A Population-Based Survey in Semi-Urban Tanzania

“…In Tanzania, the Ministry of Health and Social Welfare promotes two important elements of FV intake, first is daily consumption and second is consumption in high quantities. Shortage of detailed evidence on FV consumption practices hampers targeted responses at policy and health system levels to promote FV consumption [ 32 ].…”