Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers
Background The COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the pandemic. This study aimed to identify policy gaps, if any, in the manageme...
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BMJ Publishing Group
2024-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/3/e073261.full |
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| author | Frances Mair Gershim Asiki Shukri F Mohamed Christopher Bunn Sally M Mtenga Cindy Gray Peter Binyaruka Lyagamula Kisia Richard E Sanya Caroline H Karugu Irene Mashiashi Jennifer P Wisdom Peter M Kibe |
| author_facet | Frances Mair Gershim Asiki Shukri F Mohamed Christopher Bunn Sally M Mtenga Cindy Gray Peter Binyaruka Lyagamula Kisia Richard E Sanya Caroline H Karugu Irene Mashiashi Jennifer P Wisdom Peter M Kibe |
| author_sort | Frances Mair |
| collection | DOAJ |
| description | Background The COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the pandemic. This study aimed to identify policy gaps, if any, in the management of NCDs, particularly diabetes, during COVID-19 in Kenya and Tanzania to inform recommendations for priority actions for NCD management during any future similar crises.Methods We undertook a desk review of pre-existing and newly developed national frameworks, policy models and guidelines for addressing NCDs including type 2 diabetes. This was followed by 13 key informant interviews with stakeholders involved in NCD decision-making: six in Kenya and seven in Tanzania. Thematic analysis was used to analyse the documents.Results Seventeen guidance documents were identified (Kenya=10; Tanzania=7). These included pre-existing and/or updated policies/strategic plans, guidelines, a letter, a policy brief and a report. Neither country had comprehensive policies/guidelines to ensure continuity of NCD care before the COVID-19 pandemic. However, efforts were made to update pre-existing documents and several more were developed during the pandemic to guide NCD care. Some measures were put in place during the COVID-19 period to ensure continuity of care for patients with NCDs such as longer supply of medicines. Inadequate attention was given to monitoring and evaluation and implementation issues.Conclusion Kenya and Tanzania developed and updated some policies/guidelines to include continuity of care in emergencies. However, there were gaps in the documents and between policy/guideline documents and practice. Health systems need to establish disaster preparedness plans that integrate attention to NCD care to enable them to better handle severe disruptions caused by emergencies such as pandemics. Such guidance needs to include contingency planning to enable adequate resources for NCD care and must also address evaluation of implementation effectiveness. |
| format | Article |
| id | doaj-art-b8e8e93e748441a4b591306ddc88b702 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b8e8e93e748441a4b591306ddc88b7022025-08-20T03:11:33ZengBMJ Publishing GroupBMJ Open2044-60552024-03-0114310.1136/bmjopen-2023-073261Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makersFrances Mair0Gershim Asiki1Shukri F Mohamed2Christopher Bunn3Sally M Mtenga4Cindy Gray5Peter Binyaruka6Lyagamula Kisia7Richard E Sanya8Caroline H Karugu9Irene Mashiashi10Jennifer P Wisdom11Peter M Kibe12College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UKChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaSchool of Social and Political Sciences, University of Glasgow, Glasgow, UKDepartment of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, TanzaniaSchool of Social and Political Sciences, University of Glasgow, Glasgow, UKDepartment of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, TanzaniaChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaDepartment of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, TanzaniaWisdom Consulting, New York, New York, USAChronic Disease Management Unit, African Population and Health Research Center, Nairobi, KenyaBackground The COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the pandemic. This study aimed to identify policy gaps, if any, in the management of NCDs, particularly diabetes, during COVID-19 in Kenya and Tanzania to inform recommendations for priority actions for NCD management during any future similar crises.Methods We undertook a desk review of pre-existing and newly developed national frameworks, policy models and guidelines for addressing NCDs including type 2 diabetes. This was followed by 13 key informant interviews with stakeholders involved in NCD decision-making: six in Kenya and seven in Tanzania. Thematic analysis was used to analyse the documents.Results Seventeen guidance documents were identified (Kenya=10; Tanzania=7). These included pre-existing and/or updated policies/strategic plans, guidelines, a letter, a policy brief and a report. Neither country had comprehensive policies/guidelines to ensure continuity of NCD care before the COVID-19 pandemic. However, efforts were made to update pre-existing documents and several more were developed during the pandemic to guide NCD care. Some measures were put in place during the COVID-19 period to ensure continuity of care for patients with NCDs such as longer supply of medicines. Inadequate attention was given to monitoring and evaluation and implementation issues.Conclusion Kenya and Tanzania developed and updated some policies/guidelines to include continuity of care in emergencies. However, there were gaps in the documents and between policy/guideline documents and practice. Health systems need to establish disaster preparedness plans that integrate attention to NCD care to enable them to better handle severe disruptions caused by emergencies such as pandemics. Such guidance needs to include contingency planning to enable adequate resources for NCD care and must also address evaluation of implementation effectiveness.https://bmjopen.bmj.com/content/14/3/e073261.full |
| spellingShingle | Frances Mair Gershim Asiki Shukri F Mohamed Christopher Bunn Sally M Mtenga Cindy Gray Peter Binyaruka Lyagamula Kisia Richard E Sanya Caroline H Karugu Irene Mashiashi Jennifer P Wisdom Peter M Kibe Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers BMJ Open |
| title | Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers |
| title_full | Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers |
| title_fullStr | Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers |
| title_full_unstemmed | Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers |
| title_short | Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers |
| title_sort | policies for type 2 diabetes and non communicable disease management during the covid 19 pandemic in kenya and tanzania a desk review and views of decision makers |
| url | https://bmjopen.bmj.com/content/14/3/e073261.full |
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