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Task Shifting the Management of Non-Communicable Diseases to Nurses in Kibera, Kenya: Does It Work? | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Task Shifting the Management of Non-Communicable Diseases to Nurses in Kibera, Kenya: Does It Work?

Some D, Edwards JK, Reid AJ, Van der Bergh R, Kosqei RJ, Wilkinson E, Baruani B, Kizito W, Khabala K, Shah SK, Kibachio J, Musembi P
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Abstract
BACKGROUND
In sub-Saharan Africa there is an increasing need to leverage available health care workers to provide care for non-communicable diseases (NCDs). This study was conducted to evaluate adherence to Médecins Sans Frontières clinical protocols when the care of five stable NCDs (hypertension, diabetes mellitus type 2, epilepsy, asthma, and sickle cell) was shifted from clinical officers to nurses.

METHODS
Descriptive, retrospective review of routinely collected clinic data from two integrated primary health care facilities within an urban informal settlement, Kibera, Nairobi, Kenya (May to August 2014).

RESULTS
There were 3,554 consultations (2025 patients); 733 (21%) were by nurses out of which 725 met the inclusion criteria among 616 patients. Hypertension (64%, 397/616) was the most frequent NCD followed by asthma (17%, 106/616) and diabetes mellitus (15%, 95/616). Adherence to screening questions ranged from 65% to 86%, with an average of 69%. Weight and blood pressure measurements were completed in 89% and 96% of those required. Laboratory results were reviewed in 91% of indicated visits. Laboratory testing per NCD protocols was higher in those with hypertension (88%) than diabetes mellitus (67%) upon review. Only 17 (2%) consultations were referred back to clinical officers.

CONCLUSIONS
Nurses are able to adhere to protocols for managing stable NCD patients based on clear and standardized protocols and guidelines, thus paving the way towards task shifting of NCD care to nurses to help relieve the significant healthcare gap in developing countries.

Countries

Kenya

Subject Area

non-communicable disease

Languages

English
DOI
10.1371/journal.pone.0145634
Published Date
26 Jan 2016
PubMed ID
26812079
Journal
PLOS One
Volume | Issue | Pages
Volume 11, Issue 1, Pages e0145634
Issue Date
2016-01-26
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