Improving services for chronic non-communicable diseases in Samoa: an implementation research study using the care cascade framework
| Autor: | Shuo Zhang, Muagatutia Sefuiva Reupena, Robert Thomsen, Leausa Take Naseri, Athena Matalavea, Nicole Fraser-Hurt, Anna C Rivara, Alysa Pomer, Victoria Ieremia-Faasili, Nicola L. Hawley, Dayo Carol Obure |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Referral CASCADE Service delivery framework Pacific Island Countries chronic care models primary healthcare Nursing Medicine Humans DIABETES Noncommunicable Diseases Health communication Disease burden Chronic care HYPERTENSION PRIMARY HEALTH CARE NONCOMMUNICABLE DISEASE business.industry Public health Medical record Public Health Environmental and Occupational Health Continuity of Patient Care Focus Groups Government Programs non‐communicable diseases OBESITY IMPLEMENTATION RESEARCH Hypertension care cascade Implementation research Public aspects of medicine RA1-1270 business |
| Zdroj: | Australian and New Zealand Journal of Public Health, Vol 46, Iss 1, Pp 36-45 (2022) |
| ISSN: | 1753-6405 |
| Popis: | Objective: Samoa needs to intensify the response to the growing non‐communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. Methods: The mixed‐methods study used the cascade framework as an analysis tool and hypertension as a tracer condition for chronic non‐communicable diseases. Household survey data were integrated with medical record data of hypertension patients and results from focus group discussions with patients and healthcare providers. Results: Hypertension prevalence was 38.1% but only 4.7% of hypertensive individuals had controlled blood pressure. There were large gaps in the care continuum especially at screening and referral due to multiple socio‐cultural, economic and service delivery constraints. Conclusions: In Samoa, care for chronic non‐communicable diseases is not effectively addressing patient needs. This calls for better health communication, demand creation, treatment support, nutritional interventions and health service redesign, with a focus on primary healthcare and effective patient and community engagement. Implications for public health: The proposed actions can improve the reach, accessibility, quality and effectiveness of Samoa's chronic care services. Health system redesign is necessary to ensure continuity of care and more effective primary prevention. The findings are useful for other countries in the region facing similar challenges. |
| Databáze: | OpenAIRE |
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