Skip to main content
Top
Published in: Globalization and Health 1/2016

Open Access 01-12-2016 | Research

Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia

Authors: Mekitew Letebo, Fassil Shiferaw

Published in: Globalization and Health | Issue 1/2016

Login to get access

Abstract

Background

Chronic non-communicable diseases (NCDs) have become a huge public health concern in developing countries. Many resource-poor countries facing this growing epidemic, however, lack systems for an organized and comprehensive response to NCDs. Lack of NCD national policy, strategies, treatment guidelines and surveillance and monitoring systems are features of health systems in many developing countries. Successfully responding to the problem requires a number of actions by the countries, including developing context-appropriate chronic care models and programs and standardization of patient and program monitoring tools.

Methods

In this cross-sectional qualitative study we assessed existing monitoring and evaluation (M&E) tools used for NCD services in Ethiopia. Since HIV care and treatment program is the only large-scale chronic care program in the country, we explored the M&E tools being used in the program and analyzed how these tools might be adapted to support NCD services in the country. Document review and in-depth interviews were the main data collection methods used. The interviews were held with health workers and staff involved in data management purposively selected from four health facilities with high HIV and NCD patient load. Thematic analysis was employed to make sense of the data.

Results

Our findings indicate the apparent lack of information systems for NCD services, including the absence of standardized patient and program monitoring tools to support the services. We identified several HIV care and treatment patient and program monitoring tools currently being used to facilitate intake process, enrolment, follow up, cohort monitoring, appointment keeping, analysis and reporting. Analysis of how each tool being used for HIV patient and program monitoring can be adapted for supporting NCD services is presented.

Conclusion

Given the similarity between HIV care and treatment and NCD services and the huge investment already made to implement standardized tools for HIV care and treatment program, adaptation and use of HIV patient and program monitoring tools for NCD services can improve NCD response in Ethiopia through structuring services, standardizing patient care and treatment, supporting evidence-based planning and providing information on effectiveness of interventions.
Literature
2.
go back to reference World Health Statistics. World Health Organization. 2014. World Health Statistics. World Health Organization. 2014.
4.
go back to reference de-Graft Aikins A, Kushitor M, Koram K, Gyamfi S, Ogedegbe G. Chronic non-communicable diseases and the challenge of universal health coverage: insights from community-based cardiovascular disease research in urban poor communities in Accra, Ghana. BMC Public Health. 2014;14 Suppl 2:S3.CrossRefPubMedPubMedCentral de-Graft Aikins A, Kushitor M, Koram K, Gyamfi S, Ogedegbe G. Chronic non-communicable diseases and the challenge of universal health coverage: insights from community-based cardiovascular disease research in urban poor communities in Accra, Ghana. BMC Public Health. 2014;14 Suppl 2:S3.CrossRefPubMedPubMedCentral
5.
go back to reference Echoffu-Tcheugui J, Kengne A. Chronic Non-communicable Diseases in cameroon - burden, determinants and current policies. Global Health. 2011; 7(1):44. Echoffu-Tcheugui J, Kengne A. Chronic Non-communicable Diseases in cameroon - burden, determinants and current policies. Global Health. 2011; 7(1):44.
6.
7.
go back to reference Maher D, Harries AD, Zachariah R, Enarson D. A global framework for action to improve the primary care response to chronic non-communicable diseases: a solution to a neglected problem. BMC Public Health. 2009;9:355.CrossRefPubMedPubMedCentral Maher D, Harries AD, Zachariah R, Enarson D. A global framework for action to improve the primary care response to chronic non-communicable diseases: a solution to a neglected problem. BMC Public Health. 2009;9:355.CrossRefPubMedPubMedCentral
8.
go back to reference Rani M, Nusrat S, Hawken LH. A qualitative study of governance of evolving response to non-communicable diseases in low-and middle- income countries: current status, risks and options. BMC Public Health. 2012;12:877.CrossRefPubMedPubMedCentral Rani M, Nusrat S, Hawken LH. A qualitative study of governance of evolving response to non-communicable diseases in low-and middle- income countries: current status, risks and options. BMC Public Health. 2012;12:877.CrossRefPubMedPubMedCentral
10.
go back to reference Seyoum E, Mekonen Y, Kassa A, Eltom A, Damtew T, Lera M, et al. ART scale-up in Ethiopia: success and challenges. Ethiopia HIV/AIDS Prevention and Control Office (HAPCO) plan monitoring and evaluation directorate. 2009. Seyoum E, Mekonen Y, Kassa A, Eltom A, Damtew T, Lera M, et al. ART scale-up in Ethiopia: success and challenges. Ethiopia HIV/AIDS Prevention and Control Office (HAPCO) plan monitoring and evaluation directorate. 2009.
12.
go back to reference Harries A, Zachariah R, Jahn A, Schouten E, Kamoto K. Scaling up antiretroviral therapy in Malawi: implications for managing other chronic diseases in resource-limited countries. J Acquir Immune Defic Syndr. 2009;52(Supplement 1):S14–6.CrossRefPubMed Harries A, Zachariah R, Jahn A, Schouten E, Kamoto K. Scaling up antiretroviral therapy in Malawi: implications for managing other chronic diseases in resource-limited countries. J Acquir Immune Defic Syndr. 2009;52(Supplement 1):S14–6.CrossRefPubMed
13.
go back to reference Rabkin M, Nishtar S. Scaling up chronic care systems: leveraging HIV programs to support noncommunicable disease services. J Acquir Immune Defic Syndr. 2011;57(Suppllement 2):87–90.CrossRef Rabkin M, Nishtar S. Scaling up chronic care systems: leveraging HIV programs to support noncommunicable disease services. J Acquir Immune Defic Syndr. 2011;57(Suppllement 2):87–90.CrossRef
14.
go back to reference Rabkin M, Melaku Z, Bruce K, Reja A, Koler A, Tadesse Y, et al. Strengthening health systems for chronic care: leveraging HIV programs to support diabetes services in Ethiopia and Swaziland. J Trop Med. 2012;2012:137460.CrossRefPubMedPubMedCentral Rabkin M, Melaku Z, Bruce K, Reja A, Koler A, Tadesse Y, et al. Strengthening health systems for chronic care: leveraging HIV programs to support diabetes services in Ethiopia and Swaziland. J Trop Med. 2012;2012:137460.CrossRefPubMedPubMedCentral
15.
16.
go back to reference Khader A, Ballout G, Shahin Y, Hababeh M, Farajallah L, Zeidan W, et al. Treatment outcomes in a cohort of Palestine refugees with diabetes mellitus followed through use of E-Health over 3 years in Jordan. Trop Med Int Health. 2014;19(2):219–23.CrossRefPubMed Khader A, Ballout G, Shahin Y, Hababeh M, Farajallah L, Zeidan W, et al. Treatment outcomes in a cohort of Palestine refugees with diabetes mellitus followed through use of E-Health over 3 years in Jordan. Trop Med Int Health. 2014;19(2):219–23.CrossRefPubMed
17.
go back to reference Harries AD, Jahn A, Zachariah R, Enarson D. Adapting the DOTS framework for tuberculosis control to the management of non-communicable diseases in sub-Saharan Africa. PLoS Med. 2008;5(6):e124.CrossRefPubMedPubMedCentral Harries AD, Jahn A, Zachariah R, Enarson D. Adapting the DOTS framework for tuberculosis control to the management of non-communicable diseases in sub-Saharan Africa. PLoS Med. 2008;5(6):e124.CrossRefPubMedPubMedCentral
18.
go back to reference Harries AD, Zachariah R, Kapur A, Jahn A, Enarson DA. The vital signs of chronic disease management. Trans R Soc Trop Med Hyg. 2009;103(6):537–40.CrossRefPubMed Harries AD, Zachariah R, Kapur A, Jahn A, Enarson DA. The vital signs of chronic disease management. Trans R Soc Trop Med Hyg. 2009;103(6):537–40.CrossRefPubMed
19.
go back to reference Allain TJ, van Oosterhout JJ, Douglas GP, Joukes S, Gadabu OJ, Darts C, et al. Applying lessons learnt from the ‘DOTS” tuberculosis model to monitoring and evaluating persons with diabetes mellitus in Blantyre, Malawi. Trop Med Int Health. 2011;16(9):1077–84.CrossRefPubMed Allain TJ, van Oosterhout JJ, Douglas GP, Joukes S, Gadabu OJ, Darts C, et al. Applying lessons learnt from the ‘DOTS” tuberculosis model to monitoring and evaluating persons with diabetes mellitus in Blantyre, Malawi. Trop Med Int Health. 2011;16(9):1077–84.CrossRefPubMed
21.
go back to reference Schwartz J, Guwatudde D, Nugent R, Kiiza C. Looking at non-communicable diseases in Uganda through a local lens: an analysis using a locally derived data. Global Health. 2014;10(77):1–9. Schwartz J, Guwatudde D, Nugent R, Kiiza C. Looking at non-communicable diseases in Uganda through a local lens: an analysis using a locally derived data. Global Health. 2014;10(77):1–9.
23.
go back to reference Settumba SN, Sweeney S, Seeley J, Biraro S, Mutungi G, Munderi P, et al. The health system burden of chronic disease care: an estimation of provider costs of selected chronic diseases in Uganda. Trop Med Int Health. 2015;20(6):781–90.CrossRefPubMed Settumba SN, Sweeney S, Seeley J, Biraro S, Mutungi G, Munderi P, et al. The health system burden of chronic disease care: an estimation of provider costs of selected chronic diseases in Uganda. Trop Med Int Health. 2015;20(6):781–90.CrossRefPubMed
24.
go back to reference Alwan A, MacLean DR, Riley LM, d’Espaignet ET, Mathers CD, Stevens GA, et al. Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries. Lancet. 2010;376(9755):1861–8.CrossRefPubMed Alwan A, MacLean DR, Riley LM, d’Espaignet ET, Mathers CD, Stevens GA, et al. Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries. Lancet. 2010;376(9755):1861–8.CrossRefPubMed
25.
go back to reference Aantjes CJ, Quinlan TK, Bounders JF. Practicalities and challenges in re-orienting the health system in Zambia for treating chronic conditions. BMC Health Serv Res. 2014;14(1):295.CrossRefPubMedPubMedCentral Aantjes CJ, Quinlan TK, Bounders JF. Practicalities and challenges in re-orienting the health system in Zambia for treating chronic conditions. BMC Health Serv Res. 2014;14(1):295.CrossRefPubMedPubMedCentral
26.
go back to reference Mamo Y, Seid E, Adams S, Gardiner A, Parry E. A primary healthcare approach to the management of chronic disease in Ethiopia: an example for other countries. Clin Med. 2007;7(3):228–31.CrossRef Mamo Y, Seid E, Adams S, Gardiner A, Parry E. A primary healthcare approach to the management of chronic disease in Ethiopia: an example for other countries. Clin Med. 2007;7(3):228–31.CrossRef
Metadata
Title
Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia
Authors
Mekitew Letebo
Fassil Shiferaw
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2016
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-016-0163-y

Other articles of this Issue 1/2016

Globalization and Health 1/2016 Go to the issue