Availability of Hypertension and Diabetes Mellitus Care Services at Subdistrict Level in Bangladesh.

ABSTRACT

BACKGROUND: In Bangladesh, the rapid rise of noncommunicable diseases (NCDs) has become a significant public health concern. This study assesses the readiness of hypertension (HTN)- and diabetes mellitus-related services at primary health-care facilities in Northeast Bangladesh. METHODOLOGY: A cross-sectional survey using a semi-structured interview was conducted between April 2021 and May 2021 among 51 public primary health-care facility staff (upazila health complexes [UHCs]). The NCD-specific service readiness was assessed using an adapted questionnaire from the WHO manual of Service Availability and Readiness Assessment and included four domains guidelines and staff, basic equipment, diagnostic facility, and essential medicine. For each domain, the mean readiness index score was calculated. Facilities with a readiness score of above 70% were considered to be ready. RESULTS: The diagnostic capacity of the UHCs ranged from 0% to 88.9%, the availability of essential medicine and basic equipment varied between 15.4%-69.2% and 36.4%-100%, respectively, whereas the score in availability of basic amenities was between 57.1% and 100%. The score for the protocol drugs used to manage HTN was 52.9%, whereas for diabetes, it was 88.2%. The average general service readiness score for the facilities was 59.1%. Overall 17.6% of the facilities were assessed to be ready. CONCLUSION: Currently, primary health-care facilities are not ready to implement the national guidelines for diagnosing and treating diabetes and HTN due to shortages of medications, staff, and diagnostic materials.