Performance Of Council Health Management Team, Primary Health Facilities Readines And Health Care Providers Compitence On Providing Noncommunicable Diseases Service In Katavi Region Tanzania

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ABSTRACT

Background: non-communicable disease by its nature is a serious global public challenge in management. This is because it has physiological, social, and economic impacts that may result in chronic mortality if left to continue. This study assessed the performance of facilities readiness, health provider’s knowledge, attitude and practice in providing non-communicable disease services in Katavi Region.

Methods: Analytical cross-sectional study was done with 416 health providers who involved in the study. The compliance of the health council’s management team in providing NCD services was assessed in five councils. The readiness of 95 health facilities was assessed through WHO PEN standard tools with four domains. A structured self-administered questionnaire was used to assess health providers’ knowledge, attitude and practices in providing NCDs services. Descriptive statistics were used to elaborate facilities’ profile, respondents’ demographic characteristics while logistic regression was used to identify the association between the study variables.

Results: Out of 420 responds, 416 (a response rate of 99%) returned a filled questionnaire; males were 47% and females were 53%. 95% of all health facilities were assessed. Out of these, 15.8% were health centres and 84.2% were dispensaries whereby 81.1% were public facilities and 18.9% were private facilities; 73.7% were located in rural settings and 26.3%in urban settings. 20% of councils were revealed to have good compliance in providing NCD services and 60% of health facilities were revealed to be ready in providing services for non-communicable diseases. Furthermore, the analysis revealed that health centres have high availability of NCD equipment for 94% compared to dispensaries 77.6%. Further, the availability of NCD equipment is higher in public facilities (79.5%) compared to the private facilities (41.8%) and the facilities located in rural settings had more NCD equipment (82.8%) compared to those of urban settings (63.4%).

Also, health centres were observed to have more essential drugs for NCD management 77.3% compared to dispensaries 51.1%. The private facilities had NCDs essential drugs for 58.3%compare to public health facilities were 55.2%, and health facilities located in rural had 57% of the availability of NCD drugs compared to the facilities located in urban areas (51%). The analysis revealed that health

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providers working in dispensaries were two times less knowledgeable of non-communicable diseases compared to those working in health centres (AOR 0.217,P< 0.001,CI.95%) while health provider working in rural settings were more eight times knowledgeable compared those working in urban settings, AOR=8.037, P= 0.002. The health providers working in dispensaries had positive attitude (three times) compared to the health providers working in health centres (AOR=0.343, P < 0.001 CI.95%). Moreover, the study identified that health providers working in private health sectors were seventeen times more likely to provide good practice compared to the health providers working in public health setting in providing non-communicable disease services (AOR=17.592 ,P=0.010,CI.95%).

Conclusion: Poor compliance of the council’s health management team in providing NCDs services contributes to the unavailability of NCDs clinics within the health centre and dispensaries despite having essential NCDs commodities.

Keywords: CHMT Compliance, Facilities Readiness, Health Provider, Communicable Disease Services.