{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:56:17Z","timestamp":1793318177655,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,7,8]],"date-time":"2015-07-08T00:00:00Z","timestamp":1436313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["99430"],"award-info":[{"award-number":["99430"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Traditionally, health systems in sub\u2010Saharan Africa have focused on acute conditions. Few data exist on the readiness of African health facilities (<jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>s) to address the growing burden of chronic diseases (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>s), specifically chronic, non\u2010communicable diseases (<jats:styled-content style=\"fixed-case\">NCD<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A stratified random sample of 28 urban and rural Ugandan <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>s was surveyed to document the burden of selected <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>s by analysing the service statistics, service availability and service readiness using a modified <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> Service Availability and Readiness Assessment questionnaire. Knowledge, skills and practice in the management of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>s of 222 health workers were assessed through a self\u2010completed questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among adult outpatient visits at hospitals, 33% were for <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>s including <jats:styled-content style=\"fixed-case\">HIV <\/jats:styled-content><jats:italic>vs<\/jats:italic>. 14% and 4% at medium\u2010sized and small health centres, respectively. Many <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>s lacked guidelines, diagnostic equipment and essential medicines for the primary management of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>s; training and reporting systems were weak. Lower\u2010level facilities routinely referred patients with hypertension and diabetes. <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> services accounted for most <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> visits and were stronger than <jats:styled-content style=\"fixed-case\">NCD<\/jats:styled-content> services. Systems were weaker in lower<jats:italic>\u2010<\/jats:italic>level <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>s. Non\u2010doctor clinicians and nurses lacked knowledge and experience in <jats:styled-content style=\"fixed-case\">NCD<\/jats:styled-content> care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with higher level <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>s, lower\u2010level ones are less prepared and little used for <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> care. Health systems in Uganda, particularly lower<jats:italic>\u2010<\/jats:italic>level <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>s, urgently need improvement in managing common <jats:styled-content style=\"fixed-case\">NCD<\/jats:styled-content>s to cope with the growing burden. This should include the provision of standard guidelines, essential diagnostic equipment and drugs, training of health workers, supportive supervision and improved referral systems. Substantially better <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> basic service readiness demonstrates that improved <jats:styled-content style=\"fixed-case\">NCD<\/jats:styled-content> care is feasible.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12560","type":"journal-article","created":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T10:30:11Z","timestamp":1434709811000},"page":"1385-1395","source":"Crossref","is-referenced-by-count":117,"title":["Readiness of Ugandan health services for the management of\u00a0outpatients with chronic diseases"],"prefix":"10.1111","volume":"20","author":[{"given":"David","family":"Katende","sequence":"first","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute Uganda Research Unit on AIDS Entebbe Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Mutungi","sequence":"additional","affiliation":[{"name":"Ministry of Health Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Baisley","sequence":"additional","affiliation":[{"name":"MRC Tropical Epidemiology Group London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Biraro","sequence":"additional","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute Uganda Research Unit on AIDS Entebbe Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ikoona","sequence":"additional","affiliation":[{"name":"Ministry of Health Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Peck","sequence":"additional","affiliation":[{"name":"Mwanza Intervention Trials Unit and Weill Bugando School of Medicine Mwanza Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Smeeth","sequence":"additional","affiliation":[{"name":"Department of Non\u2010communicable Disease Epidemiology London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Hayes","sequence":"additional","affiliation":[{"name":"MRC Tropical Epidemiology Group London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Munderi","sequence":"additional","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute Uganda Research Unit on AIDS Entebbe Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiner","family":"Grosskurth","sequence":"additional","affiliation":[{"name":"MRC Tropical Epidemiology Group London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2005.07.021"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2013.10.011"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/450494a"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0072554"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61404-X"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1744-8603-6-5"},{"key":"e_1_2_7_8_1","first-page":"231","article-title":"African experiences of humanitarian cardiovascular medicine: a Kenyan perspective","volume":"2","author":"Yuko\u2010Jowi CA","year":"2012","journal-title":"Cardiovasc Diagn Ther"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70033-6"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2009.02438.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2009.11.006"},{"key":"e_1_2_7_12_1","unstructured":"MOH.Uganda Health Sector Strategic Plan III (HSSP III) 2010\/11\u20102014\/15 Ministry of Health U 2010. 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