2023-09-28 14:46:10 +00:00
|
|
|
abstract: 'Background Non-communicable diseases (NCDs) contribute significantly to
|
|
|
|
|
|
|
|
|
|
the global disease burden, with low-and middle-income (LMICs) countries
|
|
|
|
|
|
|
|
|
|
disproportionately affected. A significant knowledge gap in NCDs
|
|
|
|
|
|
|
|
|
|
exacerbates the high burden, worsened by perennial health system
|
|
|
|
|
|
|
|
|
|
challenges, including human and financial resources constraints. Primary
|
|
|
|
|
|
|
|
|
|
health care workers play a crucial role in offering health care to most
|
|
|
|
|
|
|
|
|
|
people in LMICs, and their views on the barriers to the provision of
|
|
|
|
|
|
|
|
|
|
quality care for NCDs are critical. This study explored perceived
|
|
|
|
|
|
|
|
|
|
barriers to providing NCDs care in primary health care facilities in
|
|
|
|
|
|
|
|
|
|
Zimbabwe. Methods In-depth, individual semi-structured interviews were
|
|
|
|
|
|
|
|
|
|
conducted with general nurses in primary care facilities until data
|
|
|
|
|
|
|
|
|
|
saturation was reached. We focused on diabetes, hypertension, and
|
|
|
|
|
|
|
|
|
|
depression, the three most common conditions in primary care in
|
|
|
|
|
|
|
|
|
|
Zimbabwe. We used thematic content analysis based on an interview guide
|
|
|
|
|
|
|
|
|
|
developed following a situational analysis of NCDs care in Zimbabwe and
|
|
|
|
|
|
|
|
|
|
views from patients with lived experiences. Results Saturation was
|
|
|
|
|
|
|
|
|
|
reached after interviewing 10 participants from five busy urban clinics.
|
|
|
|
|
|
|
|
|
|
For all three NCDs, we identified four cross-cutting barriers, a) poor
|
|
|
|
|
|
|
|
|
|
access to medication and functional equipment such as blood pressure
|
|
|
|
|
|
|
|
|
|
machines, urinalysis strips; b) high cost of private care; c)poor
|
|
|
|
|
|
|
|
|
|
working conditions; and d) poor awareness from both patients and the
|
|
|
|
|
|
|
|
|
|
community which often resulted in the use of alternative potentially
|
|
|
|
|
|
|
|
|
|
harmful remedies. Participants indicated that empowering communities
|
|
|
|
|
|
|
|
|
|
could be an effective and low-cost approach to positive lifestyle
|
|
|
|
|
|
|
|
|
|
changes and health-seeking behaviours. Participants indicated that the
|
|
|
|
|
|
|
|
|
|
Friendship bench, a task-shifting programme working with trained
|
|
|
|
|
|
|
|
|
|
community grandmothers, could provide a platform to introduce NCDs care
|
|
|
|
|
|
|
|
|
|
at the community level. Also, creating community awareness and
|
|
|
|
|
|
|
|
|
|
initiating screening at a community level through community health
|
|
|
|
|
|
|
|
|
|
workers (CHWs) could reduce the workload on the clinic nursing staff.
|
|
|
|
|
|
|
|
|
|
Conclusion Our findings reflect those from other LMICs, with poor work
|
|
|
|
|
|
|
|
|
|
conditions and resources shortages being salient barriers to optimal
|
|
|
|
|
|
|
|
|
|
NCDs care at the facility level. Zimbabwe''s primary health care system
|
|
|
|
|
|
|
|
|
|
faces several challenges that call for exploring ways to alleviate
|
|
|
|
|
|
|
|
|
|
worker fatigue through strengthened community-led care for NCDs.
|
|
|
|
|
|
|
|
|
|
Empowering communities could improve awareness and positive lifestyle
|
|
|
|
|
|
|
|
|
|
changes, thus optimising NCD care. Further, there is a need to optimise
|
|
|
|
|
|
|
|
|
|
NCD care in urban Zimbabwe through a holistic and multisectoral approach
|
|
|
|
|
|
|
|
|
|
to improve working conditions, basic clinical supplies and essential
|
|
|
|
|
|
|
|
|
|
drugs, which are the significant challenges facing the country''s health
|
|
|
|
|
|
|
|
|
|
care sector. The Friendship Bench could be an ideal entry point for
|
|
|
|
|
|
|
|
|
|
providing an integrated NCD care package for diabetes, hypertension and
|
|
|
|
|
|
|
|
|
|
depression.'
|
|
|
|
|
affiliation: 'Kamvura, TT (Corresponding Author), Univ Zimbabwe, Fac Med \& Hlth Sci,
|
|
|
|
|
Res Support Ctr, Friendship Bench, Harare, Zimbabwe.
|
|
|
|
|
|
|
|
|
|
Kamvura, Tiny Tinashe; Chiriseri, Ephraim; Turner, Jean; Verhey, Ruth; Chibanda,
|
|
|
|
|
Dixon, Univ Zimbabwe, Fac Med \& Hlth Sci, Res Support Ctr, Friendship Bench, Harare,
|
|
|
|
|
Zimbabwe.
|
|
|
|
|
|
|
|
|
|
Dambi, Jermaine M., Univ Zimbabwe, Fac Med \& Hlth Sci, Rehabil Sci Unit, Friendship
|
|
|
|
|
Bench, Harare, Zimbabwe.'
|
|
|
|
|
article-number: '64'
|
|
|
|
|
author: Kamvura, Tiny Tinashe and Dambi, Jermaine M. and Chiriseri, Ephraim and Turner,
|
|
|
|
|
Jean and Verhey, Ruth and Chibanda, Dixon
|
|
|
|
|
author-email: tiny.kamvura@friendshipbench.io
|
|
|
|
|
author_list:
|
|
|
|
|
- family: Kamvura
|
|
|
|
|
given: Tiny Tinashe
|
|
|
|
|
- family: Dambi
|
|
|
|
|
given: Jermaine M.
|
|
|
|
|
- family: Chiriseri
|
|
|
|
|
given: Ephraim
|
|
|
|
|
- family: Turner
|
|
|
|
|
given: Jean
|
|
|
|
|
- family: Verhey
|
|
|
|
|
given: Ruth
|
|
|
|
|
- family: Chibanda
|
|
|
|
|
given: Dixon
|
|
|
|
|
da: '2023-09-28'
|
|
|
|
|
doi: 10.1186/s12912-022-00841-1
|
|
|
|
|
files: []
|
|
|
|
|
issn: 1472-6955
|
|
|
|
|
journal: BMC NURSING
|
|
|
|
|
keywords: Barriers; Non-communicable diseases; Nurses; Primary care; Zimbabwe
|
|
|
|
|
keywords-plus: 'MIDDLE-INCOME COUNTRIES; SUB-SAHARAN AFRICA; BLOOD-PRESSURE; GLOBAL
|
|
|
|
|
|
|
|
|
|
BURDEN; HIV; INTERVENTION; DEPRESSION'
|
|
|
|
|
language: English
|
|
|
|
|
month: MAR 18
|
|
|
|
|
number: '1'
|
|
|
|
|
number-of-cited-references: '58'
|
|
|
|
|
orcid-numbers: 'dambi, jermaine/0000-0002-2446-7903
|
|
|
|
|
|
|
|
|
|
'
|
|
|
|
|
papis_id: 2b62cd05ee60f3e2b6ad4b6c0e74e876
|
|
|
|
|
ref: Kamvura2022barriersprovision
|
|
|
|
|
researcherid-numbers: 'dambi, jermaine/U-2284-2017
|
|
|
|
|
|
|
|
|
|
Kamvura, Tiny Tinashe/GON-7454-2022'
|
|
|
|
|
times-cited: '6'
|
|
|
|
|
title: 'Barriers to the provision of non-communicable disease care in Zimbabwe: a
|
|
|
|
|
qualitative study of primary health care nurses'
|
2023-10-01 08:15:07 +00:00
|
|
|
type: article
|
2023-09-28 14:46:10 +00:00
|
|
|
unique-id: WOS:000770613100001
|
|
|
|
|
usage-count-last-180-days: '1'
|
|
|
|
|
usage-count-since-2013: '4'
|
|
|
|
|
volume: '21'
|
|
|
|
|
web-of-science-categories: Nursing
|
|
|
|
|
year: '2022'
|
