在乌兹别克斯坦设计和实施应对非传染性疾病的简易干预措施。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Olakunle Alonge, Maysam Homsi, Mahnoor Syeda Rizvi, Regina Malykh, Karin Geffert, Nazokat Kasymova, Nurshaim Tilenbaeva, Lola Isakova, Maria Kushubakova, Dilbar Mavlyanova, Tursun Mamyrbaeva, Marina Duishenkulova, Adriana Pinedo, Olga Andreeva, Kremlin Wickramasinghe
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引用次数: 0

摘要

在乌兹别克斯坦,包括心血管疾病、癌症和糖尿病在内的非传染性疾病占 2019 年死亡率的 80% 以上。2021 年,国家利益相关者与世界卫生组织共同确定了在初级卫生保健环境中实施的简短干预措施 (BI),以改变不健康的行为并减轻该国的非传染性疾病负担。简短干预包括一组经过验证的问题,用于识别和测量非传染性疾病的行为风险因素,以及与患者/客户就其行为进行简短交谈,并提供转诊机会,以便在需要时进行进一步的深入咨询或治疗。我们采用了文献综述、参与式研讨会和关键信息提供者访谈等多种方法来描述乌兹别克斯坦如何设计和实施 BI,并为其大规模实施提出了变革理论。乌兹别克斯坦的 BIs 针对 4 个风险因素(酗酒、吸烟、不健康饮食和缺乏运动),需要培训临床医生如何使用 5A 和 5R 工具包开展行为改变咨询,进行支持性监督,并利用反馈来改进服务的提供。该计划由卫生部、高等教育部、科学部和创新部等多个部门的利益相关者合作设计,并得到了主要政治领导人的支持。该计划的潜在影响(即降低非传染性疾病的发病率)通过个人、初级保健和社区层面的多个中间和实施结果来实现。该计划仍面临着重大的卫生系统挑战,例如人力资源有限、缺乏对临床医生的激励、用于绩效监测的系统和数据收集流程过时以及不同相关部门之间的协调。要确保在乌兹别克斯坦和类似的低收入和中等收入国家有效地大规模实施商业健康保险,就必须应对这些挑战和其他挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Design and Implementation of Brief Interventions to Address Noncommunicable Diseases in Uzbekistan.

In Uzbekistan, NCDs, including cardiovascular diseases, cancer, and diabetes, accounted for over 80% of mortality in 2019. In 2021, national stakeholders, in conjunction with the World Health Organization, identified brief interventions (BIs) to implement in primary health care settings to change unhealthy behaviors and reduce the burden of NCDs in the country. BIs consist of a validated set of questions to identify and measure NCD behavioral risk factors and a short conversation with patients/clients about their behavior, as well as the provision of a referral opportunity for further in-depth counseling or treatment if needed. We used a multimethod approach of document review, participatory workshops, and key informant interviews to describe how BIs were designed and implemented in Uzbekistan and generated a theory of change for its large-scale implementation. BIs in Uzbekistan targeted 4 risk factors (alcohol use, tobacco use, unhealthy diet, and physical inactivity) and entailed training clinicians on how to conduct behavioral change counseling using the 5As and 5Rs toolkit, conducting supportive supervision, and using feedback to improve service delivery. The program was collaboratively designed by multiple stakeholders across sectors, including the Ministries of Health, Higher Education, Science, and Innovations, with buy-in from key political leaders. The potential impact of the program (i.e., reducing the incidence of NCDs) was mediated by several intermediate and implementation outcomes at the individual, primary care, and community levels operating along multiple pathways. Significant health system challenges remain to the program, such as limited human resources, lack of incentives for clinicians, outdated systems and data collection processes for performance monitoring, and coordination among different relevant sectors. These and other challenges will need to be addressed to ensure the effective large-scale implementation of BIs in Uzbekistan and similar LMICs.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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