A national audit of facilities, human and material resources for the comprehensive management of diabetes in Ghana-A 2023 update.

Autor: Yorke E; Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health Sciences, Accra, Ghana., Akpalu J; Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health Sciences, Accra, Ghana., de-Graft Johnson G; Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health Sciences, Accra, Ghana., Atiase Y; Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health Sciences, Accra, Ghana., Reynolds M; Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health Sciences, Accra, Ghana., Laryea R; Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health Sciences, Accra, Ghana., Tetteh J; Department of Community Health, University of Ghana Medical School, College of Health Sciences, Accra, Ghana., Yawson AE; Department of Community Health, University of Ghana Medical School, College of Health Sciences, Accra, Ghana., Amoah AGB; Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health Sciences, Accra, Ghana.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 May 20; Vol. 19 (5), pp. e0303624. Date of Electronic Publication: 2024 May 20 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0303624
Abstrakt: Introduction: The human and material resources as well as the systems for managing diabetes in Africa are inadequate. This study or needs assessment, aimed at updating the human and material resources, identifying the gaps and unmet needs for comprehensive diabetes care in Ghana.
Methods: We conducted a national audit of 122 facilities in all 16 administrative regions of Ghana. Information obtained covered areas on personnel and multidisciplinary teams, access to medications, access to laboratory services, financing, screening services, management of diabetes complications, and availability/use of diabetes guidelines or protocols. Data was analysed using STATA version 16.1. P-values <0.05 were set as significant.
Results: Only 85(69.7%) out of the 122 surveyed facilities had a dedicated centre or service for diabetes care. Twenty-eight (23%) had trained diabetes doctors/specialists; and whilst most centres had ophthalmic nurses and dieticians, majority of them did not have trained diabetes educators (nurses), psychologists, ophthalmologists, podiatrists, and foot/vascular surgeons. Also, 13.9% had monofilaments, none could perform urine dipstick for microalbumin; 5 (4.1%) and just over 50% could perform laboratory microalbumin estimation and glycated haemoglobin, respectively. Access to and supply of human insulins was better than analogue insulin in most centres. Nearly 100% of the institutions surveyed had access to metformin and sulphonylurea with good to excellent supply in most cases, whilst access to Sodium Glucose Transporter-2 inhibitors and Glucagon-like peptide-1 analogues were low, and moderate for Dipeptidyl peptidase-4 inhibitors and thiazolidinediones. Majority of the health facilities (95.1%) offered NHIS as payment mechanism for clients, whilst 68.0% and 30.3% of the patients paid for services using out-of-pocket and private insurance respectively. Fifteen facilities (12.3%) had Diabetes Support Groups in their locality and catchment areas.
Conclusion: An urgent multisectoral collaboration, including prioritisation of resources at the facility level, to promote and achieve acceptable comprehensive diabetes care is required.
Competing Interests: The authors have declared that no competing interests exist
(Copyright: © 2024 Yorke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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