OBJECTIVE: Samoa needs to intensify the response to the growing non-communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. METHODS: The mixed-methods study used the cascade framework as an analysis tool and hypertension as a tracer condition for chronic non-communicable diseases. Household survey data were integrated with medical record data of hypertension patients and results from focus group discussions with patients and healthcare providers. RESULTS: Hypertension prevalence was 38.1% but only 4.7% of hypertensive individuals had controlled blood pressure. There were large gaps in the care continuum especially at screening and referral due to multiple socio-cultural, economic and service delivery constraints. CONCLUSIONS: In Samoa, care for chronic non-communicable diseases is not effectively addressing patient needs. This calls for better health communication, demand creation, treatment support, nutritional interventions and health service redesign, with a focus on primary healthcare and effective patient and community engagement. Implications for public health: The proposed actions can improve the reach, accessibility, quality and effectiveness of Samoa's chronic care services. Health system redesign is necessary to ensure continuity of care and more effective primary prevention. The findings are useful for other countries in the region facing similar challenges.
OBJECTIVE: Samoa needs to intensify the response to the growing non-communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. METHODS: The mixed-methods study used the cascade framework as an analysis tool and hypertension as a tracer condition for chronic non-communicable diseases. Household survey data were integrated with medical record data of hypertension patients and results from focus group discussions with patients and healthcare providers. RESULTS: Hypertension prevalence was 38.1% but only 4.7% of hypertensive individuals had controlled blood pressure. There were large gaps in the care continuum especially at screening and referral due to multiple socio-cultural, economic and service delivery constraints. CONCLUSIONS: In Samoa, care for chronic non-communicable diseases is not effectively addressing patient needs. This calls for better health communication, demand creation, treatment support, nutritional interventions and health service redesign, with a focus on primary healthcare and effective patient and community engagement. Implications for public health: The proposed actions can improve the reach, accessibility, quality and effectiveness of Samoa's chronic care services. Health system redesign is necessary to ensure continuity of care and more effective primary prevention. The findings are useful for other countries in the region facing similar challenges.
Authors: Lauren C LaMonica; Stephen T McGarvey; Anna C Rivara; Chlöe A Sweetman; Take Naseri; Muagatutia Sefuiva Reupena; Hemant Kadiamada; Erica Kocher; Alexa Rojas-Carroll; James P DeLany; Nicola L Hawley Journal: Lancet Reg Health West Pac Date: 2021-11-23
Authors: Lawrence A Palinkas; Meaghan O'Donnell; Susan Kemp; Jemaima Tiatia; Yvonette Duque; Michael Spencer; Rupa Basu; Kristine Idda Del Rosario; Kristin Diemer; Bonifacio Doma; David Forbes; Kari Gibson; Joshua Graff-Zivin; Bruce M Harris; Nicola Hawley; Jill Johnston; Fay Lauraya; Nora Elizabeth F Maniquiz; Jay Marlowe; Gordon C McCord; Imogen Nicholls; Smitha Rao; Angela Kim Saunders; Salvatore Sortino; Benjamin Springgate; David Takeuchi; Janette Ugsang; Vivien Villaverde; Kenneth B Wells; Marleen Wong Journal: Int J Environ Res Public Health Date: 2022-08-08 Impact factor: 4.614