Service availability and readiness for major non-communicable diseases at health facilities in Ethiopia

Abstract

Introduction: No assessment was conducted previously in Ethiopia to monitor, review and evaluate the availability and readiness of health facilities for non-communicable diseases (NCDs). Thus, the present study aims to provide evidence on service availability and readiness for NCDs in Ethiopia.
Method: A Service Availability and Readiness Assessment (SARA) was conducted in Ethiopia in 2016. The survey used stratified random sampling design to provide data for 11 regions in Ethiopia for different facility types and managing authorities. A total of 547 public and private health facilities were included in this analysis (210 hospitals, 165 health centres and 172 clinics). Data were collected using CAPI (Computer Assisted Personal Interview) designed using CSPro 6.3 Software. This study uses tracer indicators in data analysis. Tracer indicators aim to provide objective information about whether or not a facility meets the required conditions to support provision of basic or specific services with a consistent level of quality and quantity.
Result: Overall, among all health facilities offering service for NCDs, the availability of diagnosis and/or management of diabetes, cardiovascular disease, chronic respiratory disease and cervical cancer were 22%, 41%, 45% and 2%, respectively. Cervical cancer diagnosis was the least available; only 2 in 10 facilities offered this diagnosis service. Among all health facilities offering services for NCDs, the availability of trained staff for diabetes, cardiovascular disease, chronic respiratory disease and cervical cancer prevention and control were 10%, 7%, 8% and 61% respectively. Among health facilities that were offering diabetes diagnosis and/or management services, none of them had all thirteen services. On average, 53% of facilities had seven of the thirteen items. Among facilities that provided cardiovascular disease services, only 1% of them had all twelve items. On average, 41% of these facilities had six of the twelve items. Among health facilities that offered diagnosis and/or management of chronic respiratory disease, no facility had all eleven items. On average, approximately three out of ten health facilities had six of the eleven items. From health facilities that were providing diagnosis and/or management of cervical cancer, only five out of ten health facilities had all four items. On average, 72% of facilities had two out of the four items.
Conclusion: Overall, service availability and readiness of the health facilities to provide NCDs related health services are suboptimal. The overall level of diabetes diagnosis and/or management by health facilities was unsatisfactory and it varied between urban (34%) and rural (5%) health facilities. In general, cervical cancer diagnosis was rarely provided and no rural health facilities offered this service. We hope that the findings of this study will prompt appropriate national policy response for NCDs towards improved health care service delivery across health facilities. 

Key words: NCD, availability, readiness, Ethiopia