Reorienting Primary Health Care Services for Non-Communicable Diseases: A Comparative Preparedness Assessment of Two Healthcare Networks in Malawi and Zambia

Veronica Shiroya, Naonga Shawa, Beatrice Matanje, John Haloka, Elvis Safary, Chikondi Nkhweliwa, Olaf Mueller, Sam Phiri, Florian Neuhann and Andreas Deckert
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Veronica Shiroya: Heidelberg Institute of Global Health, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
Naonga Shawa: CHRESO Ministries, Lusaka 10101, Zambia
Beatrice Matanje: The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe 207233, Malawi
John Haloka: CHRESO Ministries, Lusaka 10101, Zambia
Elvis Safary: Heidelberg Institute of Global Health, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
Chikondi Nkhweliwa: The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe 207233, Malawi
Olaf Mueller: Heidelberg Institute of Global Health, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
Sam Phiri: The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe 207233, Malawi
Florian Neuhann: Heidelberg Institute of Global Health, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
Andreas Deckert: Heidelberg Institute of Global Health, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany

IJERPH, 2021, vol. 18, issue 9, 1-22

Abstract: Despite positive NCD policies in recent years, majority of Sub-Saharan African (SSA) health systems are inadequately prepared to deliver comprehensive first-line care for NCDs. Primary health care (PHC) settings in countries like Malawi and Zambia could be a doorway to effectively manage NCDs by moving away from delivering only episodic care to providing an integrated approach over time. As part of a collaborative health system strengthening project, we assessed and compared the preparedness and operational capacity of two target networks of public PHC settings in Lilongwe (Malawi) and Lusaka (Zambia) to integrate NCD services within routine service delivery. Data was collected and analyzed using validated health facility survey tools. These baseline assessments conducted between August 2018 and March 2019, also included interviews with 20 on-site health personnel and focal persons, who described existing barriers in delivering NCD services. In both countries, policy directives to decentralize disease-specific NCD services to the primary care level were initiated to meet increased demand but lacked operational guidance. In general, the assessed PHC sites were inadequately prepared to integrate NCDs into various service delivery domains, thus requiring further support. In spite of existing multi-faceted limitations, there was motivation among healthcare staff to provide NCD services.

Keywords: health systems; implementation research; mixed methods study; low-income countries; chronic disease control; human resources for health; primary care; health policy; health service delivery; Sub-Saharan Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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