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BMJ Open. 2019 Oct 7;9(10):e029562. doi: 10.1136/bmjopen-2019-029562.

Non-communicable disease (NCD) corners in public sector health facilities in Bangladesh: a qualitative study assessing challenges and opportunities for improving NCD services at the primary healthcare level.

Author information

1
School of Health Medical and Allied Sciences, CQUniversity Sydney, Sydney, New South Wales, Australia dr.lalrawal@gmail.com.
2
Health Systems Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
3
James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
4
School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia.
5
Health Section, Japanese International Cooperation Agency (JICA), Accra, Ghana.
6
Institute for Social Science Research, University of Queensland, Long Pocket Precinct, Indooroopilly Queensland, Brisbane, Queensland, Australia.
7
mPower Social Enterprises Ltd, Dhaka, Bangladesh.
8
Collaboration for Oral Health Outcomes, Research, Translation and Evaluation (COHORTE) Research Group, Western Sydney University, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.
9
Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia.
10
Global Health Program, Duke Kunshan University, Jiangsu, Kunsan, China.
11
Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA.
12
Exercise and Nutrition Science, Deakin University Faculty of Health, Burwood, Victoria, Australia.
13
Centre of Excellence for Universal Health Coverage (CoE-UHC), James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.

Abstract

OBJECTIVE:

To explore healthcare providers' perspective on non-communicable disease (NCD) prevention and management services provided through the NCD corners in Bangladesh and to examine challenges and opportunities for strengthening NCD services delivery at the primary healthcare level.

DESIGN:

We used a grounded theory approach involving in-depth qualitative interviews with healthcare providers. We also used a health facility observation checklist to assess the NCD corners' service readiness. Furthermore, a stakeholder meeting with participants from the government, non-government organisations (NGOs), private sector, universities and news media was conducted.

SETTING:

Twelve subdistrict health facilities, locally known as upazila health complex (UHC), across four administrative divisions.

PARTICIPANTS:

Participants for the in-depth qualitative interviews were health service providers, namely upazila health and family planning officers (n=4), resident medical officers (n=6), medical doctors (n=4) and civil surgeons (n=1). Participants for the stakeholder meeting were health policy makers, health programme managers, researchers, academicians, NGO workers, private health practitioners and news media reporters.

RESULTS:

Participants reported that diabetes, hypertension and chronic obstructive pulmonary disease were the major NCD-related problems. All participants acknowledged the governments' initiative to establish the NCD corners to support NCD service delivery. Participants thought the NCD corners have contributed substantially to increase NCD awareness, deliver NCD care and provide referral services. However, participants identified challenges including lack of specific guidelines and standard operating procedures; lack of trained human resources; inadequate laboratory facilities, logistics and medications; and poor recording and reporting systems.

CONCLUSION:

The initiative taken by the Government of Bangladesh to set up the NCD corners at the primary healthcare level is appreciative. However, the NCD corners are still at nascent stage to provide prevention and management services for common NCDs. These findings need to be taken into consideration while expanding the NCD corners in other UHCs throughout the country.

KEYWORDS:

health policy; health services administration & management; non-communicable disease; organisation of health services; public health; service delivery

PMID:
31594874
DOI:
10.1136/bmjopen-2019-029562
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Conflict of interest statement

Competing interests: None declared.

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