Recognizing the roles of primary health care in addressing non-communicable diseases in low- and middle-income countries: Lesson from COVID-19, implications for the future

Yadav, Uday Narayan; Mistry, Sabuj Kanti; Ghimire, Saruna; Schneider, Carmen Huckel; Rawal, Lal; Acharya, Shambhu; Harris‐Roxas, Ben; Harris, Mark

doi:10.7189/jogh.11.03120

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…During this pandemic, older adults are expected and encouraged to avoid any places such as clinics, medical centres or pharmacies where they could contract the virus, which coupled with the shortage of medicine supply during the pandemic, resulting in their low access to necessary medicines [ 53 , 54 ]. Research also documented that COVID-19-related lockdowns and restrictions measures have restricted Bangladeshi older people’s access to routine medical care, thus deteriorating their existing chronic conditions [ 55 56 ]. This situation has made them tense, increased their anxiety level and exacerbated psychological health.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 related anxiety and its associated factors: a cross-sectional study on older adults in Bangladesh

et al. 2022

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Background The COVID-19 pandemic has resulted in serious mental health conditions, particularly among older adults. This research explored the prevalence of COVID-19-related anxiety and its associated factors among older adults residing in Bangladesh. Methods This cross-sectional study was conducted among 1,045 older Bangladeshi adults aged ≥ 60 years through telephone interviews in September 2021. A semi-structured interview schedule was used to collect data on participants’ characteristics and COVID-19-related anxiety. The anxiety level was measured using the Bengali version of the five-point Coronavirus Anxiety Scale (CAS). A linear regression model explored the factors associated with COVID-19-related anxiety. Results Overall, the prevalence of COVID-19-related anxiety was 23.2%. The regression analysis revealed that the average COVID-19-related anxiety score was significantly higher among females (β: 0.43, 95% CI: 0.05 to 0.81), and among those who faced difficulty getting medicine (β: 0.57, 95% CI: 0.16 to 0.97), felt isolated (β: 0.60, 95% CI: 0.24 to 0.95), and felt requiring additional care during the pandemic (β: 0.53, 95% CI: 0.16 to 0.91). Alternatively, the average COVID-19-related anxiety score was significantly lower among those who were widowed (β: -0.46, 95% CI: -0.87 to -0.04) and living distant from the health centre (β: -0.48, 95% CI: -0.79 to -0.17). Conclusion The findings of the present study suggest providing immediate psychosocial support package to the older adults, particularly females and those who are vulnerable to receive health and social care support during the COVID-19 pandemic in Bangladesh.

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Section: Discussionmentioning

confidence: 99%

COVID-19 related anxiety and its associated factors: a cross-sectional study on older adults in Bangladesh

et al. 2022

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“…The primary health care has a significant role to play for the prevention and management of NCDs ( 47 ) including diabetes at the community level; however, resources and support provided to these care services now are inadequate. Given the importance of providing NCDs and diabetes related programs at the primary care level, there is a need for revitalizing the primary health care systems that effectively integrates the NCDs and diabetes related programs within the current health care systems.…”

Section: Discussionmentioning

confidence: 99%

Analyzing the Implementation of Policies and Guidelines for the Prevention and Management of Type 2 Diabetes at Primary Health Care Level in Nepal

Shrestha

Yadav

Shrestha

et al. 2022

Front. Public Health

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BackgroundNepal, in recent years, is witnessing an increasing problem of type 2 diabetes that has resulted significant premature deaths and disability. Prevention and management of non-communicable diseases (NCDs) including diabetes have been prioritized in the national policies and guidelines of the Nepal Government. However, research looking at the overview of the implementation of the existing policies and guidelines for diabetes prevention and control is scarce. Hence, this study reviewed diabetes related existing policies and its implementation process at the primary health care level in Nepal.MethodsThis study involved two phases: Phase I: situation analyses through review of documents and Phase II: qualitative exploratory study. In phase I, four databases (Medline, Web of Science, Embase and PubMed) were systematically searched using key search terms related to diabetes care and policies between January 2000 and June 2021. Also, relevant gray literature was reviewed to understand the trajectory of policy development and its translation with regards to diabetes prevention and management at primary health care level in Nepal. Following the phase I, we conducted in-depth interviews (IDI) and key informant interviews (KII) with health care providers, policy makers, and managers (IDI = 13, and KII = 7) at peripheral and central levels in Kavrepalanchowk and Nuwakot districts of Nepal. The in-depth interviews were audio recorded, transcribed, and coded. The triangulation of data from document review and interviews was done and presented in themes.ResultsFour key themes were identified through triangulating findings from the document review and interviews including (i) limited implementation of policies into practices; (ii) lack of coordination among the different levels of service providers; (iii) lack of trained human resources for health and inadequate quality services at the primary health care level, and (iv) inadequate access and utilization of diabetes care services at primary health care level. Specifically, this study identified some key pertinent challenges to the implementation of policies and programs including inadequate resources, limited engagement of stakeholders in service design and delivery, lack of trained health care providers, lack of financial resources to strengthen peripheral health services, fragmented health governance, and weak reporting and monitoring systems.ConclusionThis study revealed that the policies, plans, and strategies for prevention and management of NCDs in Nepal recognized the importance of diabetes prevention and control. However, a major gap remains with adequate and lack of clarity in terms of implementation of available policies, plans, strategies, and programs to address the problem of diabetes. We suggest the need for multisectoral approach (engaging both health and non-health sectors) at central as well as peripheral levels to strengthen the policies implementation process, building capacity of health care providers, ensuring adequate financial and non-financial resources, and improving quality of services at primary health care levels.

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“…Beyond ensuring community leaders and other stakeholders can receive the latest guidance about the situation and ask questions, there is also the need to consider broader training opportunities during pandemics or other emergencies, as well as ways to expand the potential pool of practitioners rapidly in response to pandemics and health emergencies [ 29 , 30 ]. Potential focus areas for training could be around strategies that support communication, discussing vaccines and effectively addressing misinformation.…”

Section: Discussionmentioning

confidence: 99%

Speaking COVID-19: supporting COVID-19 communication and engagement efforts with people from culturally and linguistically diverse communities

et al. 2022

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Background Since the emergence of COVID-19, issues have been raised regarding the approach used to engage with Culturally and Linguistically Diverse (CaLD) communities during this public health crisis. This study aimed to understand the factors impacting communication and engagement efforts during the COVID-19 pandemic from the perspective of crucial CaLD community stakeholders and opinion leaders. Methods Forty-six semi-structured telephone interviews were undertaken with key stakeholders who have an active role (established before the pandemic) in delivering services and other social support to CaLD communities in Australia. Results Seven key themes emerged: (1) the digital divide and how to connect with people; (2) information voids being filled by international material; (3) Differentiating established with new and emerging communities’ needs; (4) speaking COVID-19; (5) ineffectiveness of direct translations of English language resources; (6) coordination is needed to avoid duplication and address gaps and (7) recognising the improvements in governments’ approach. Conclusion Alliances must be set up that can be activated in the future to reduce issues around resource development, translation, and dissemination of messages to minimise gaps in the response. Financial assistance must be provided in a timely way to community organisations to support the development and dissemination of culturally appropriate communication materials.

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Recognizing the roles of primary health care in addressing non-communicable diseases in low- and middle-income countries: Lesson from COVID-19, implications for the future

Cited by 12 publications

References 21 publications

COVID-19 related anxiety and its associated factors: a cross-sectional study on older adults in Bangladesh

COVID-19 related anxiety and its associated factors: a cross-sectional study on older adults in Bangladesh

Analyzing the Implementation of Policies and Guidelines for the Prevention and Management of Type 2 Diabetes at Primary Health Care Level in Nepal

Speaking COVID-19: supporting COVID-19 communication and engagement efforts with people from culturally and linguistically diverse communities

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