East African Medical Journal

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An assessment of facility-based care of diabetes, hypertension, and heart failure across western Kenya

P Tulshian, H Zubairi, S Villegas, V Palanivel, B.D. Nelson, K Ouma, T.F. Burke


Background: Low- and middle- income countries account for three-fourths of the global non- communicable disease related mortality. In response to the increasing number of non- communicable disease diagnoses in Kenya, the government released a national strategy for non- communicable disease in 2015. The purpose of this study was to assess facility-based care of diabetes, hypertension, and heart failure across western Kenya.

Methods: A 71-question cross-sectional survey was administered among facility-based healthcare workers in Siaya County, western Kenya, between October 2015 and January 2016. All Level 4 and 5 facilities, as well as a cohort of lower-level facilities were surveyed.

Results: Of the 21 health facilities surveyed, six (31.6%) had specific non-communicable disease clinics. Eleven of the 21 (52.4%) facilities had glucometers, and providers indicated that even these glucometers were often not functional. Three of the 21 facilities (14.3%) had a diabetic registry, one a functioning electrocardiogram machine, and one other a congestive heart failure registry.

Conclusions: Facilities at every level were lacking equipment and medications expected by the Kenya’s Essential Package of Health Services. Improvement for follow up and referral services could be achieved through the development of comprehensive non-communicable disease registries.

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