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Health Aff (Millwood). 2018 Aug;37(8):1321-1330. doi: 10.1377/hlthaff.2018.0151.

Service Readiness For Noncommunicable Diseases Was Low In Five Countries In 2013-15.

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Corrina Moucheraud ( ) is an assistant professor in the Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, at the University of California Los Angeles.


The growing burden of noncommunicable diseases (NCDs) may pose challenges for resource-limited health systems. This study used standardized, nationally representative data from Service Provision Assessments conducted in 2013-15 and the Service Availability and Readiness Assessment methodology to examine NCD service availability and readiness in Bangladesh, Haiti, Malawi, Nepal, and Tanzania. Both service availability and readiness were found to be very low: Very few facilities were fully "ready" to provide any one NCD service. Shortages of trained health workers and essential medicines were critical limitations to readiness. Rural and free facilities had lower availability and readiness, which may present access barriers. Policy makers should draw on decades of experience with global health initiatives to close these service gaps through the training of health workers on NCD screening and treatment, engaging the private sector on NCDs, and ensuring access to NCD medicines. Such efforts must be attentive to distributional equity and the multiple dimensions of care quality.


Access To Care; Developing World < International/global health studies; Non-communicable diseases; Quality Of Care


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