Health systems in low- and middle-income countries not prepared to diagnose and treat common diseases
UCLA FSPH's Corrina Moucheraud says policymakers should focus on training health workers, ensuring access to essential medicines.
Cardiovascular diseases, chronic respiratory diseases and diabetes are among the leading causes of death worldwide. A new UCLA study has found that Bangladesh, Haiti, Malawi, Nepal and Tanzania each has fewer than five health facilities that can provide the full suite of supplies and equipment, trained staff and medication that are needed to properly diagnose and treat all three diseases.
“These five countries, paralleling global trends, are seeing an increase in the number of people with these noncommunicable diseases,” said the lead author, Corrina Moucheraud, assistant professor of health policy and management at the UCLA Fielding School of Public Health. “Analyses like this one can help inform decisions about where to allocate resources so that people with noncommunicable diseases have access to the high-quality care they need.”
Moucheraud analyzed standardized, nationally representative data that were collected by the Demographic and Health Surveys Program Service Provision Assessments between 2013 and 2015, from 5,205 public and private health facilities across all five countries. The shortfalls were most pronounced at rural facilities and at those that do not charge fees for service.
In the paper, Moucheraud recommends that policymakers throughout the world expand training opportunities for clinicians, including continuing education and mentorship, and find ways to work across public, private and nonprofit sectors to come up with solutions for addressing noncommunicable diseases. Programs such as the Affordable Medicines Facility-malaria and Gavi, the global vaccine alliance, may serve as models for public-private partnerships that could help, she said. Moucheraud also advised that policymakers work to make drugs affordable and available. “There is limited publicly available information about how the health systems in low- and middle-income countries are managing the vast burden of noncommunicable diseases,” Moucheraud said. “It is imperative for policymakers and clinicians to design and utilize measurement tools that properly capture the quality of care people receive over their lifespans.”
The study is published in the August issue of Health Affairs.
The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has more than 600 students from more than 25 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.
Faculty Referenced by this Article
Dr. Ron Andersen is the Wasserman Professor Emeritus in the UCLA Departments of Health Policy and Management.
Nationally recognized health services researcher and sociomedical scientist with 25+ years' experience in effectiveness and implementation research.
EMPH Academic Program Director with expertise in healthcare marketing, finance, and reproductive health policy, teaching in the EMPH, MPH, MHA program
Professor of Community Health Sciences & Health Policy and Management, and Associate Dean for Research
Dr. Michelle S. Keller is a health services researcher whose research focuses on the use and prescribing of high-risk medications.
