Status of service delivery for major noncommunicable diseases at health facilities: Service availability and readiness assessment in Manimajra block, UT Chandigarh

Abstract

Introduction: To attain the Sustainable Development Goals by 2030, an urgent action is required, directed by the global action plan for prevention and control of noncommunicable diseases (NCDs) which contributed to 73% of worldwide deaths in 2017. The ability and limitations in primary care to meet the rising burden of NCDs remain unknown, nevertheless. The goal of this study was to evaluate the availability of primary health care facilities and their preparedness for NCDs in one block of UT Chandigarh. Methodology: This cross-sectional survey was conducted in 10 health facilities in Manimajra block of UT Chandigarh using the World Health Organization service availability and readiness assessment standard tool with local adaptations. We defined facility readiness along six domains: basic equipment, essential services, diagnostic capacity, NCD trainings, counseling services, and essential medicines. For each domain, an index as the mean score of items expressed as percentage was calculated. Results: The results highlight important gaps in service delivery that are obstacles to universal access to health services. Overall, among all health facilities offering service for NCDs, the availability of diagnosis and/or management of diabetes, cardiovascular disease, chronic respiratory disease, and cervical cancer were 89%, 77%, 44%, and 25%, respectively. Of all the health facilities that were providing screening or management of cervical cancer, none of them had all four items. Conclusion: The study found that the existing level of service preparedness and accessibility for NCDs at health-care institutions is inadequate and requires improvement. Some health facilities had poorer rankings as a result of inadequate drug supplies, a lack of skilled staff, and a lack of advice on NCD screening and treatment. Therefore, an emphasis on infrastructure, services, and health-care workers ready for NCD services is necessary to ensure efficacy.