Improving NCD care in Uganda: a health worker’s perspective

PCI, in partnership with LifeNet International (LN), is piloting a model of care that brings the power to identify and treat NCDs into the hands of health workers in local health facilities, which are direct access-points for care for most Ugandans. Hear directly about this experience from Mukasa, a nurse charged with running a health centre’s new NCD clinic.

Early detection and treatment of non-communicable diseases (NCDs) can mean the difference between life and death. Patients in Uganda are often unaware they are living with an NCD and do not seek care until they experience a life-threatening complication. It’s no surprise that, according to the World Health Organization, NCDs cause 27% of deaths in Uganda.

This PCI and LifeNet project reduces bottlenecks in larger city hospitals and helps patients identify their NCD and have the opportunity to receive care from their local health facilities before they experience an emergency complication. The project was made possible by the Botswana based corporation Letshego Financial Services, (read more about the project here!)

Jonathan Nsamba, the LifeNet Project Officer for the NCD project, recently sat down to discuss the project with Mukasa, a nurse who works in Nkoni Health Center III and who is charged with running the health center’s newly formed NCD clinic. Mukasa was trained and prepared for this role through the NCD trainings he received in the PCI/LN program. During the conversation with Jonathan, Mukasa shared his perspective on the challenges to NCD care he faces in Uganda. He also gives us some insight into how the NCD trainings he and other health workers have received have affected their ability to provide quality care to their patients.

Challenges for NCD Care in Uganda

Economic instability and significant knowledge gaps complicate NCD care for health workers and patients in Uganda. Mukasa identified a lack of knowledge as a key challenge for NCD care in Uganda. Patients, in general, are reluctant to undergo screening for an NCD or are hesitant to participate in treatment regimens if they are not experiencing any acute symptoms at the time.

“Some people attending our community screening events don’t know what NCDs are,” said Mukasa. “Others in the community think that they are OK and don’t see the rationale of NCD check-ups.”

Further difficulties arise even after patients are diagnosed with a non-communicable disease. Mukasa notes that patients are often worried about the financial burden of ongoing treatment due to transportation and medication costs. These burdens can cause patients to miss important recurring appointments at the clinic. Patients may also experience anxiety about how the disease will affect their quality of life and their ability to care for their families.

Understanding, managing, and coming to terms with the need for ongoing care is difficult for all patients suffering from chronic conditions. These challenges are further intensified for people experiencing these conditions in lower-income countries. Mukasa points to mass education on NCDs as a vital need for the greater public to better understand the importance of NCD screening and care.

NCD training

Mukasa, along with fellow health workers in the Nkoni Health center, participated in the NCD training program funded by Letshego and provided through a PCI/LN partnership. Here, Mukasa reflects on the changes he has experienced and witnessed as a result of that training.

“The trainings included management, diagnosis, and care for NCD patients. I greatly appreciated learning the classification of drugs and stages of disease progression and my knowledge has greatly improved. We shared our experiences and knowledge during the trainings and, thanks to the case studies we had, it helped us understand NCD care.

“There has been an improvement in NCD care, treatment regimen, classifications of disease progression and so much more among all the health workers at the health center where I work. The health workers have a good understanding of NCDs thanks to the trainings and the ongoing talks we have with Jonathan and other LifeNet staff.

“I greatly appreciate LifeNet and PCI for the support and capacity that they have improved among us. I also like the way the NCD program is designed to incorporate community screening events, phone credit for us to follow up with our patients, and planned home visits. I want to see my patients and the wider community improve their knowledge in preventing diabetes and hypertension.”

NCD awareness, prevention, and treatment is an ever-growing need for patients in Uganda and other low-and-middle-income countries. Trainings through the PCI/LN project look at strengthening broader health systems and train and mentor healthcare staff. Health workers like Mukasa are vital to ensuring that all people living with a non-communicable disease receive the care, treatment, and knowledge they need to live healthy and whole lives.

 

This blog was developed jointly with LifeNet, with thanks to Jonathan Nsamba and Grace Humbles. With special thanks to Mukasa for sharing his experience and his time.
Photo of Jonathan and Musaka. Credit: LifeNet