Health systems in low- and middle-income countries not prepared to diagnose and treat common diseases
Cardiovascular diseases, chronic respiratory diseases and diabetes are among the leading causes of death worldwide. A new UCLA study has found that Bangladesh, Haiti, Malawi, Nepal and Tanzania each has fewer than five health facilities that can provide the full suite of supplies and equipment, trained staff and medication that are needed to properly diagnose and treat all three diseases.
"These five countries, paralleling global trends, are seeing an increase in the number of people with these noncommunicable diseases," said the lead author, Corrina Moucheraud, assistant professor of health policy and management at the UCLA Fielding School of Public Health. "Analyses like this one can help inform decisions about where to allocate resources so that people with noncommunicable diseases have access to the high-quality care they need."
Moucheraud analyzed standardized, nationally representative data that were collected by the Demographic and Health Surveys Program Service Provision Assessments between 2013 and 2015, from 5,205 public and private health facilities across all five countries. The shortfalls were most pronounced at rural facilities and at those that do not charge fees for service.
In the paper, Moucheraud recommends that policymakers throughout the world expand training opportunities for clinicians, including continuing education and mentorship, and find ways to work across public, private and nonprofit sectors to come up with solutions for addressing noncommunicable diseases. Programs such as the Affordable Medicines Facility-malaria and Gavi, the global vaccine alliance, may serve as models for public-private partnerships that could help, she said. Moucheraud also advised that policymakers work to make drugs affordable and available.
"There is limited publicly available information about how the health systems in low- and middle-income countries are managing the vast burden of noncommunicable diseases," Moucheraud said. "It is imperative for policymakers and clinicians to design and utilize measurement tools that properly capture the quality of care people receive over their lifespans."
The study is published in the August issue of Health Affairs.