The EXPERIENCES AND KNOWLEDGE OF HEALTH CARE WORKERS IN CHRONIC DISEASE MANAGEMENT IN LOW AND MIDDLE INCOME COUNTRIES - NAMIBIA, AFRICA

Abstract

Chronic diseases burden has been increasing globally and is the leading cause of death in many LMICs. However, health systems have been primarily designed for acute conditions and must be adaptive in order to deal with the complexities that come with Chronic disease management (CDM). The CCM emphasizes the need for patient centred care with meaningful interactions between the health system and the patient. Health care workers (HCWs) are the drivers of improved CDM but are thought to be inadequately prepared for this shift. This study explored the experiences and perceived roles of HCWs in CDM in the out-patients department of Otjiwarongo Hospital, Namibia

Methods: A qualitative study was done among the HCWs rendering services in the out-patients department. Data was collected using a semi-structured interview guide and audio-recording of interviews. Transcribing was done and analysis done through an inductive method of thematic analysis. Emerging codes and sub-themes were arranged into overarching themes.

Results: The following were the emerging themes: 1. Understanding role as HCWs 2. Understanding patients’ expectations 3. Social support-role of family/community 4. Models of care 5. Opportunities for improvement. The results show that the HCWs lacked understanding of the needs for chronic care. As such they were not able to leverage on existent support structures to offer patient centred care in line with CCM.

Conclusion: HCWs lacked an understanding of the dynamics of CDM and how it differs from acute care. Consequently, they do not have supportive relationships with their patients to keep them motivated to treatment plan. Their experiences show that the health systems have not adequately adapted to the dynamics of CDM. It is recommended that efforts be made to empower them with skills and knowledge. Through trainings to enhance their role in CDM.

Keywords: CDM; primary care setting; HCW; Namibia; Africa;