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Assessing the readiness of health facilities for diabetes and cardiovascular services in Bangladesh: a cross-sectional survey
  1. Tuhin Biswas1,
  2. M Moinuddin Haider2,
  3. Rajat Das Gupta3,4,
  4. Jasim Uddin1
  1. 1 Universal Health Coverage, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
  2. 2 Initiative for Climate Change and Health, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
  3. 3 Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
  4. 4 Centre for Science of Implementation and Scale-Up, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
  1. Correspondence to Dr Tuhin Biswas; tuhin_sps04{at}yahoo.com

Abstract

Objective The objective of this study was to assess the readiness of health facilities for diabetes and cardiovascular services in Bangladesh.

Design This study was a cross-sectional survey.

Setting This study used data from a nationwide Bangladesh Health Facility Survey conducted by the Ministry of Health and Social Welfare in 2014.

Participants A total of 319 health facilities delivering services focused on diabetes and cardiovascular diseases (CVD) were included in the survey. Some of these facilities were run by the public sector while others were managed by the private sector and non-governmental organisations. It was a mix of primary and secondary care facilities.

Primary and secondary outcome measures The primary outcome was readiness of health facilities for diabetes and cardiovascular services. We analysed relevant data following the Service Availability and Readiness Assessment manual of the WHO to assess the readiness of selected health facilities towards services for diabetes and CVD.

Results 58% and 24.1% of the facilities had diagnosis and treatment services for diabetes and CVD, respectively. Shortage of trained staff (18.8% and 14.7%) and lack of adequate medicine supply (23.5% and 43.9%) were identified to be factors responsible for inadequate services for diabetes and CVD. Among the facilities that offer services for diabetes and CVD, only 0.4% and 0.9% had all the four service readiness factors (guideline, trained staff, equipment and medicine).

Conclusions The study suggests that health facilities suffered from numerous drawbacks, such as shortage of trained staff and required medicine. Most importantly, they lack effective guidelines on the diagnosis and treatment for diabetes and CVD. It is, therefore, essential now to ensure that there are trained staff, adequate medicine supply, and appropriate guidelines on the diagnosis and treatment for diabetes and CVD in Bangladesh.

  • quality In health care
  • human resource management
  • organisational development

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors TB, MMH and JU conceptualised the study. TB, MMH and RDG designed the study and acquired the data. TB and MMH conducted the data analysis. TB, RDG and JU interpreted the data. TB, MMH and RDG prepared the first draft. TB, MMH, RDG and JU participated in critical revision of the manuscript and contributed to its intellectual improvement. All authors went through the final draft and approved it for submission. The authors are alone responsible for the integrity and accuracy of data analysis and writing of the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The data sets were obtained from the DHS Program following proper procedure. The study was exempt from collecting ethical approval because the survey protocols were reviewed and approved by Nepal Health Research Council (NHRC) and the ICF Institutional Review Board in Calverton, Maryland, USA. Ethics approval for the BHFS was obtained from the Institutional Review Board of the Medical Research Council of Bangladesh.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data set of BHFS 2014 is available at the Demographic and Health Surveys Program. Additional data are available on request at http://dhsprogram-com/what-we-do/survey/survey-display-349.cfm.

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