Project Lead(s): Gerald Yonga
Low- and middle-income countries are ill-equipped to face the double burden of persistent infectious diseases and the emergence of chronic non-communicable diseases.
In 2008, 63% of global deaths were due to non-communicable diseases (NCD), with 80% of these occurring in developing countries.
While primary healthcare settings in developing countries are relatively well-designed to manage infectious diseases, the same cannot be said of managing NCDs.
Implemented in Kenya, the project undertook to create a model for integrating NCD-related care into existing HIV/AIDS and maternal and child health/family planning units present in primary healthcare facilities in Kenya.
The approach involved imparting new knowledge, skills and attitudes about the diagnosis and management of common NCDs in primary care to existing health workers, by training them and enabling task-shifting in the clinics.
Capacity building was also supported by supplying affordable and easy-to-use, point-of-care NCD diagnostic equipment and essential drugs.
The project also involved the establishment of referral systems and network involvement of the county health authorities.
A total of 5,500 patients, accompanying relatives/and community members were educated on NCD prevention. The training sessions, and equipment and aids provision built the capacity for NCD management within the facility and aided in task-shifting, patient screening, diagnosis and management, and the development of triage, care pathways and referral pathways.
In the project, 1,515 patients were screened for NCDs.
Findings from the project have informed policy-making and the model created is now being replicated successfully at other sites.
The project brought the importance of the prevailing burden of NCDs in the Kenyan setting to the attention of policy-makers/administrators, healthcare workers, patients and the community.
This has led to a change in attitudes and practices, driving a move to create policies for prevention and control by the policy-making stakeholders, the expansion of scope of care afforded to patients by the healthcare workers, and a change in behaviour and health-seeking patterns in the community where the project was carried out.
Routine NCD screening at the project site and many other health institutions with whom the project team have interacted in Kenya is now an accepted principle.
In addition to the usual reporting of project results, a USAID-funded Ministry of Health (MOH) “Situational Analysis for Kenya National Health Quality Improvement Policy, Strategy and Action Plan” has referred to the model employed by this project as being the recommended model of primary care.
Plans are underway to scale up the project and potential key partners in Phase II are the National Ministry of Health, the County ministries of Health, Safaricom Limited, Phillip Medical Systems, media companies, the Kenyan offices of USAID and the Centers for Disease Control and Prevention (CDC) and their implementing organisations in various parts of Kenya, and the University of Alberta.