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Andre Pascal Kengne, Eugene Sobngwi, Leopold Fezeu, Paschal Kum Awah, Sylvestre Dongmo, Jean-Claude Mbanya, The CENHIP Investigators. Setting-up nurse-led pilot clinics for the management of non-communicable diseases at primary health care level in resource-limited settings of Africa. The Pan African Medical Journal. 2009;3:10 Key words: chronic diseases, nurse-led clinics, diabetes, hypertension, epilepsy, asthma, primary health care, Cameroon, sub-Saharan Africa Permanent link: http://www.panafrican-med-journal.com/content/article/3/10/full Received: 10/08/2009 - Accepted: 11/10/2009 - Published: 24/10/2009 © Andre Pascal Kengne et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Setting-up nurse-led pilot clinics for the management of non-communicable diseases at primary health care level in resource-limited settings of Africa
Andre Pascal Kengne1,2,&, Eugene Sobngwi1,3, Leopold Fezeu1,4,5, Paschal Kum Awah1,6, Sylvestre Dongmo7, Jean-Claude Mbanya1,8, The CENHIP* Investigators
1Health of Population in Transition (HoPiT) research group, Yaoundé, Cameroon, 2The George Institute for International Health, The University of Sydney, Australia, 3Institute of Health and Society, Medical School, Newcastle University, 4Epidemiologic and Biostatistics Research Unit, Inserm Unit 780, Villejuif, France, 5University of Paris XI, Kremlin Bicêtre, France, 6Department of Anthropology, Faculty of Arts, Letters and Social Sciences, University of Yaoundé I, Cameroon, 7Bafut district hospital, Cameroon, 8Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon.
*CENHIP: Cameroon Essential Non-communicable diseases Health Intervention Project
&Corresponding author
Cardiovascular division, The George Institute for International Health, PO Box M201, Sydney, Australia, Phone/Fax +612 99934597/99934502.
Background
This article describes the setting-up process for nurse-led pilot clinics for the management of four chronic diseases: asthma, type 2 diabetes mellitus, epilepsy and hypertension at the primary health care level in urban and rural Cameroon.
Method
The Biyem-Assi urban and the Bafut rural health districts in Cameroon served as settings for this study. International and local guidelines were identified and adapted to the country’s circumstances. Training and follow-up tools were developed and nurses trained by experienced physicians in the management of the four conditions. Basic diagnostic and follow-up materials were provided and relevant essential drugs made available.
Results
Forty six nurses attended six training courses. By the second year of activity, three and four clinics were operational in the urban and the rural areas respectively. By then, 925 patients had been registered in the clinics. This represented a 68.5% increase from the first year. While the rural clinics relied mainly on essential drugs for their prescriptions, a prescription pattern combining generic and proprietary drugs was observed in the urban clinics.
Conclusion
In the quest for cost-effective health care for NCD in sub-Saharan Africa, rethinking health workforce and service delivery has relevance. Nurse-led clinics, algorithm driven service delivery stands as alternatives to overcome the shortage of trained physicians and other issues relating to access to care.
