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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Family Practice 1/2017

A systematic review of primary care models for non-communicable disease interventions in Sub-Saharan Africa

Zeitschrift:
BMC Family Practice > Ausgabe 1/2017
Autoren:
Jennifer Kane, Megan Landes, Christopher Carroll, Amy Nolen, Sumeet Sodhi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12875-017-0613-5) contains supplementary material, which is available to authorized users.

Abstract

Background

Chronic diseases, primarily cardiovascular disease, respiratory disease, diabetes and cancer, are the leading cause of death and disability worldwide. In sub-Saharan Africa (SSA), where communicable disease prevalence still outweighs that of non-communicable disease (NCDs), rates of NCDs are rapidly rising and evidence for primary healthcare approaches for these emerging NCDs is needed.

Methods

A systematic review and evidence synthesis of primary care approaches for chronic disease in SSA. Quantitative and qualitative primary research studies were included that focused on priority NCDs interventions. The method used was best-fit framework synthesis.

Results

Three conceptual models of care for NCDs in low- and middle-income countries were identified and used to develop an a priori framework for the synthesis. The literature search for relevant primary research studies generated 3759 unique citations of which 12 satisfied the inclusion criteria. Eleven studies were quantitative and one used mixed methods. Three higher-level themes of screening, prevention and management of disease were derived. This synthesis permitted the development of a new evidence-based conceptual model of care for priority NCDs in SSA.

Conclusions

For this review there was a near-consensus that passive rather than active case-finding approaches are suitable in resource-poor settings. Modifying risk factors among existing patients through advice on diet and lifestyle was a common element of healthcare approaches. The priorities for disease management in primary care were identified as: availability of essential diagnostic tools and medications at local primary healthcare clinics and the use of standardized protocols for diagnosis, treatment, monitoring and referral to specialist care.
Zusatzmaterial
Additional file 1: Literature results for the a priori framework. (DOCX 25 kb)
12875_2017_613_MOESM1_ESM.docx
Additional file 2: Models of care for NCDs in LMIC. (DOCX 16 kb)
12875_2017_613_MOESM2_ESM.docx
Additional file 3: Example of search terms for primary research studies. (DOCX 16 kb)
12875_2017_613_MOESM3_ESM.docx
Additional file 4: Quality assessment of primary research studies. (DOCX 97 kb)
12875_2017_613_MOESM4_ESM.docx
Additional file 5: A Priori themes in primary research studies for NCDs Interventions in SSA. (DOCX 18 kb)
12875_2017_613_MOESM5_ESM.docx
Additional file 6: A Priori themes in primary research studies for NCD interventions in SSA. (DOCX 17 kb)
12875_2017_613_MOESM6_ESM.docx
Literatur
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