Universidad Peruana Cayetano Heredia

Forty years after Alma-Ata: primary health-care preparedness for chronic diseases in Mozambique, Nepal and Peru

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dc.contributor.author Cárdenas García-Santillán, María Kathia
dc.contributor.author Pérez León Quinoso, Silvana Patricia
dc.contributor.author Singh, S.B.
dc.contributor.author Madede, T.
dc.contributor.author Munguambe, S.
dc.contributor.author Govo, V.
dc.contributor.author Jha, N.
dc.contributor.author Damasceno, A.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Beran, D.
dc.date.accessioned 2021-12-12T20:24:55Z
dc.date.available 2021-12-12T20:24:55Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/10219
dc.description.abstract Background: Four decades after the Alma-Ata Declaration, strengthening primary health care (PHC) remains a priority for health systems, especially in low- and middle-income countries (LMICs). Given the prominence of chronic diseases as a global health issue, PHC must include a wide range of components in order to provide adequate care. Objective: To assess PHC preparedness to provide chronic care in Mozambique, Nepal and Peru, we used, as ‘tracer conditions’, diabetes, hypertension and a country-specific neglected tropical disease with chronic sequelae in each country. Methods: By implementing a health system assessment, we collected quantitative and qualitative data from primary and secondary sources, including interviews of key informants at three health-system levels (macro, meso and micro). The World Health Organization’s health-system building blocks provided the basis for content analysis. Results: In total, we conducted 227 interviews. Our findings show that the ambitious policies targeting specific diseases lack the support of technical, administrative and financial resources. Data collection systems do not allow the monitoring of individual patients or provide the health system with the information it requires. Patients receive limited disease-specific information. Clinical guidelines and training are either non-existent or not adapted to local contexts. Availability of medicines and diagnostic tests at the PHC level is an issue. Although medicines available through the public health care system are affordable, some essential medicines suffer shortages or are not available to PHC providers. This need, along with a lack of clear referral procedures and available transportation, generates financial issues for individuals and affects access to health care. Conclusion: PHC in these LMICs is not well prepared to provide adequate care for chronic diseases. Improving PHC to attain universal health coverage requires strengthening the identified weaknesses across health-system building blocks en_US
dc.language.iso eng
dc.publisher Taylor and Francis
dc.relation.ispartofseries Global Health Action
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject chronic conditions en_US
dc.subject developing countries en_US
dc.subject Health systems en_US
dc.subject primary health-care en_US
dc.title Forty years after Alma-Ata: primary health-care preparedness for chronic diseases in Mozambique, Nepal and Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1080/16549716.2021.1975920
dc.relation.issn 1654-9880


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