Service availability and readiness for diabetes care at health facilities in Ethiopia

Abstract Background: Non-communicable diseases (NCDs) are the leading causes of death globally. Available data demonstrate that nearly 80% deaths of NCDs occur in low- and middle-income countries. Of these deaths, an estimated 1.5 million, or 4% were due to diabetes. In Ethiopia, data on the preparedness of health facilities to cope with the rising epidemic of diabetes are insufficient. Objective: This survey was aimed to assess service availability and readiness for diabetes health care. Methods: The data used in this study is part of the 2014 Ethiopian service provision assessment survey which was conducted from 10 March to 25 July, 2014. The study employed stratified random sampling designed to provide representative results for Ethiopia. In this study, health facility types managed by different management authorities were included from the eleven administrative regions of the country. There were a total of 873 health facilities included in this particular study. Data were collected using a facility inventory questionnaire that assessed whether the providers in the facility are prepared to provide required services to patients with diabetes. Information about readiness of facilities to provide good-quality client services on diabetes, including the availability of guidelines, trained staff, basic medical equipment, and essential medicines were also collected. Results: Among all health facilities, 59% of health facilities offer services for diabetes. Forty percent of the facilities have diagnostic capacity for blood glucose while 56 % have capacity for urine protein test and 52 % has urine glucose test. Of the facilities that offer service for diabetes, 12 % of them had guidelines for diagnosis and management of diabetes at the service site during the survey. On the other hand, facilities that offer diabetes services were more likely to have basic equipment that support and enhance the provision of services. Conclusions: The findings indicate that availability of treatment services, guidelines for diagnosis and management, trained staff and medicines for diabetes were found to be inadequate. But the availability of the basic medical equipment necessary for the diagnosis and management of diabetes appear to be adequate. Therefore, strengthening health care system towards improved service delivery through availing national guidelines, protocols or standards for managing diabetes, in-service training for providers, and provision of essential ¬medicines are required to improve diabetes service delivery in health facilities. [Ethiop. J. Health Dev. 2017;31(2):110-118] Key words: Diabetes Mellitus, Disease, Service, Availability, Readiness, Health Facility, Ethiopia