2018

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.

blood pressure machine

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

Corrina Moucheraud
Corrina Moucheraud
Health Policy and Management
Read Faculty Profile
Image of Dr. Susan Ettner
Susan Ettner
Health Policy and Management
Read Faculty Profile
Dr. Daniel Eisenberg
Daniel Eisenberg
Health Policy and Management
Read Faculty Profile
Dr. Jennifer Wortham
Jennifer Wortham
Health Policy and Management
Read Faculty Profile
Laura Erskine
Laura Erskine
Health Policy and Management
Read Faculty Profile
Olivia Jung
Olivia Jung
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Robert Brook
Health Policy and Management
Read Faculty Profile
Galper, Michael
Michael Galper
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Brennan Spiegel
Health Policy and Management
Read Faculty Profile
Dr. Elizabeth (Becky) Yano
Elizabeth (Becky) Yano
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Mark Litwin
Health Policy and Management
Read Faculty Profile
Comanor, Bill
William Comanor
Health Policy and Management
Read Faculty Profile
Dr. Arturo Vargas Bustamante
Arturo Vargas Bustamante
Health Policy and Management
Read Faculty Profile
Moira Inkelas
Moira Inkelas
Health Policy and Management
Read Faculty Profile
Leah Vriesman
Leah Vriesman
Health Policy and Management
Read Faculty Profile
Dr. Alice Kuo
Alice Kuo
Health Policy and Management
Read Faculty Profile
Mangione, C
Carol Mangione
Health Policy and Management
Read Faculty Profile
Clifford Ko
Clifford Ko
Health Policy and Management
Read Faculty Profile
Dr. Dylan Roby
Dylan Roby
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Lori Pelliccioni
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Alan Tomines
Health Policy and Management
Read Faculty Profile
Dr. Aria Fallah
Aria Fallah
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Annette Maxwell
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Arlene Fink
Health Policy and Management
Read Faculty Profile
Dr. Kenneth Wells
Kenneth Wells
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Emmeline Chuang
Health Policy and Management
Read Faculty Profile
Aronberg, Sandra
Sandra Aronberg
Health Policy and Management
Read Faculty Profile
Kadiyala, Srikanth
Srikanth Kadiyala
Health Policy and Management
Read Faculty Profile
Freund, Deborah
Deborah Anne Freund
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Neal Halfon
Health Policy and Management
Read Faculty Profile
silhoette
Ty Robbins
Health Policy and Management
Read Faculty Profile
Dr. Samuel Sessions
Samuel Sessions
Health Policy and Management
Read Faculty Profile
Gerald Kominski
Gerald Kominski
Health Policy and Management
Read Faculty Profile
Paul Chung
Paul Chung
Health Policy and Management
Read Faculty Profile
Isomi Miake-Lye
Isomi Miake-Lye
Health Policy and Management
Read Faculty Profile
Nadereh Pourat
Nadereh Pourat
Health Policy and Management
Read Faculty Profile
Dr. Felicia Hodge
Felicia Hodge
Health Policy and Management
Read Faculty Profile
Dr. Anthony Schiff
Anthony Hunter Schiff
Health Policy and Management
Read Faculty Profile
Dr. Kristen Choi
Kristen Choi
Health Policy and Management
Read Faculty Profile
Jeanne Miranda
Jeanne Miranda
Health Policy and Management
Read Faculty Profile
Avram Kaplan
Avram Kaplan
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Ron Andersen

Dr. Ron Andersen is the Wasserman Professor Emeritus in the UCLA Departments of Health Policy and Management.

Health Policy and Management
Read Faculty Profile
Balgrosky headshot
Jean Balgrosky
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
David Hayes-Bautista
Health Policy and Management
Read Faculty Profile
Dr. Naomi Zewde
Naomi Zewde
Health Policy and Management
Read Faculty Profile
Warren Scott Comulada
Warren Scott Comulada
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Thomas Priselac
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Julie A. Elginer

EMPH Academic Program Director with expertise in healthcare marketing, finance, and reproductive health policy, teaching in the EMPH, MPH, MHA program

Health Policy and Management
Read Faculty Profile
Dr. Xi Zhu
Xi Zhu
Health Policy and Management
Read Faculty Profile
Dr. Jonathan Fielding
Jonathan Fielding
Health Policy and Management
Read Faculty Profile
Dr. Ninez Ponce
Ninez Ponce
Health Policy and Management
Read Faculty Profile
Dr. Frederick Zimmerman
Frederick Zimmerman
Health Policy and Management
Read Faculty Profile
Dr. Beth Glenn
Beth Glenn
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Barbara Berman
Health Policy and Management
Read Faculty Profile
Gordon headshot
Thomas D. Gordon
Health Policy and Management
Read Faculty Profile
Dr. Paul Fu, Jr.
Paul Fu, Jr.
Health Policy and Management
Read Faculty Profile
Dr. Risha Gidwani
Risha Gidwani
Health Policy and Management
Read Faculty Profile
Dr. Joann Elmore
Joann G. Elmore
Health Policy and Management
Read Faculty Profile
Jody Heymann
Jody Heymann
Epidemiology Health Policy and Management
Read Faculty Profile
Yusuke Tsugawa
Yusuke Tsugawa
Health Policy and Management
Read Faculty Profile
Michael Ong
Michael Ong
Health Policy and Management
Read Faculty Profile
Dr. Thomas Rice
Thomas Rice
Health Policy and Management
Read Faculty Profile
Robert Kaplan
Robert Kaplan
Health Policy and Management
Read Faculty Profile
Davidson - headshop
Pamela Davidson
Health Policy and Management
Read Faculty Profile
Dr. John Lu
Z. John Lu
Health Policy and Management
Read Faculty Profile
Roshan Bastani Headshot
Roshan Bastani
Health Policy and Management
Read Faculty Profile
Burt Cowgill
Burt Cowgill
Health Policy and Management
Read Faculty Profile
James Macinko
James Macinko

Professor of Community Health Sciences & Health Policy and Management, and Associate Dean for Research

Community Health Sciences Health Policy and Management
Read Faculty Profile
Ron D. Hays
Ron D. Hays

@UCLA since 1997

Health Policy and Management
Read Faculty Profile
Vickie Mays
Vickie Mays
Health Policy and Management
Read Faculty Profile
Dr. Lillian Gelberg
Lillian Gelberg
Health Policy and Management
Read Faculty Profile
Dr. Stephanie Taylor
Stephanie L. Taylor

Nationally recognized health services researcher and sociomedical scientist with 25+ years' experience in effectiveness and implementation research.

Health Policy and Management
Read Faculty Profile
Diana Hilberman
Diana Hilberman
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Steven Teutsch
Health Policy and Management
Read Faculty Profile
Rosenstock
Linda Rosenstock
Environmental Health Sciences Health Policy and Management
Read Faculty Profile
Sangeeta Ahluwalia
Sangeeta Ahluwalia
Health Policy and Management
Read Faculty Profile
Jack Needleman
Jack Needleman
Health Policy and Management
Read Faculty Profile
Patricia Ganz
Patricia Ganz
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Jose J. Escarce
Health Policy and Management
Read Faculty Profile
Michelle Keller
Michelle S. Keller

Dr. Michelle S. Keller is a health services researcher whose research focuses on the use and prescribing of high-risk medications.

Health Policy and Management
Read Faculty Profile
Dr. William McCarthy
William J. McCarthy
Health Policy and Management
Read Faculty Profile
Emily Abel
Emily Abel
Health Policy and Management
Read Faculty Profile
Dr. Yvonne Flores
Yvonne Flores
Health Policy and Management
Read Faculty Profile