Table 2.
Assessment of facilities’ readiness for diabetes and cardiovascular diseases
| Diabetes | Cardiovascular diseases | |||||
|---|---|---|---|---|---|---|
| Affiliation of facilities |
Publics n = 22 |
Privates n = 12 |
Total n = 34 |
Publics n = 22 |
Privates n = 12 |
Total N = 34 |
| Facilities with: | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) |
| Trained staff in diabetes-cardiovascular diseases the past two years and availability of copies of guidelines | ||||||
| Trained staff in the past two years | 3(13.6) | 1(8.3) | 4(11.8) | 2(9.1) | 3(25) | 5(14.7) |
| Diabetes/CVDs copy of guidelines | 7(31.8%) | 7(58.3%) | 14(41.2%) | 9(40.9%) | 8(66.7%) | 17(50%) |
| Domain score training/copy of guidelines | 5(22.7%) | 4(33.3%) | 9(26.5%) | 6(25%) | 6(45.9%) | 11(32.4%) |
| Diagnosis capacity and equipment | ||||||
| Blood glucose | 9(40.9%) | 8(66.7%) | 17(50%) | 9(40.9%) | 9(75%) | 18(52.9%) |
| Urine dipsticks protein | 4(18.2%) | 6(50%) | 10(29.4%) | 5(22.7%) | 7(58.3%) | 12(35.3%) |
| Urine dipsticks ketones | 3(13.6%) | 6(50%) | 9(26.5%) | 4(18.2%) | 6(50%) | 10(29.4%) |
| BP digital machine/sphygmomanometer | 18(81.8) | 12(100%) | 30(88.2%) | 18(81.8%) | 12(100%) | 30(88.2%) |
| Stethoscope | - | - | - | 21(95.5%) | 12(100%) | 33(97.1%) |
| Adult scale | 21(95.5%) | 12(100%) | 33(97.1%) | 21(95.5%) | 11(91.7%) | 32(94.1%) |
| Glucometer | 19(86.4%) | 12(100%) | 31(91.2%) | - | - | - |
| Diagnosis and equipment domain score | 12(56.1%) | 9(77.8%) | 22(63.7%) | 13(59.1%) | 10(79.2%) | 23(66.2%) |
| Essential medicines | ||||||
| Calcium channel blockers‡ | - | - | - | 2(9.1%) | 10(83.3%) | 12(35.3%) |
| Beta-blockers‡‡ | - | - | - | 14(63.6%) | 9(75%) | 23(67.7%) |
| Angiotensin-converting enzymes (ACE)† | - | - | - | 3(13.6%) | 6(50%) | 9(26.5%) |
| Adrenergic alpha-2 receptor agonists†† | - | - | - | 4(18.2%) | 4(33.3%) | 8(23.5%) |
| Diuretics ‡‡‡ | - | - | - | 11(50%) | 12(100%) | 23(67.7%) |
| Vasodilators¥ | - | - | - | 4(18.2%) | 5(41.7%) | 9(26.5%) |
| Antiplatelets¥¥ | - | - | - | 15(68.2%) | 12(100% | 27(79.4% |
| Lipid-lowering agents¥¥¥ | - | - | - | 1(4.6%) | 2(16.7%) | 3(8.8%) |
| Biguanides ††† | 7(58.3%) | 4(18.2%) | 11(32.4%) | - | - | - |
| Sulfonylurea†††† | 6(50%) | 6(27.3%) | 12(35.3%) | - | - | - |
| Soluble insulin | 3(25%) | 1(4.6%) | 4(11.8%) | - | - | - |
| IV Glucose solution 50% | 11(91.7%) | 12(54.6%) | 23(67.7%) | - | - | - |
| IV Glucose solution 5% | 12(100) | 22(100) | 34(100%) | - | - | - |
| Mean medicines’ domain score | 8(46.7%) | 9(40.9%) | 17(33.5%) | 6(30.7%) | 8(62.5%) | 14(41.9%) |
| Facilities with community services and education-counseling for diabetes and cardiovascular diseases | ||||||
| Schedule/roster of counseling | 2(9.1%) | 3.0(25.0%) | 5(14.7%) | 3(13.6%) | 6(50%) | 9(26.5%) |
| At least one Trained staffx2 years | 2(9.1%) | 2.0(16.7%) | 4(11.8%) | 3(13.6%) | 3(25%) | 6(17.7%) |
| Education materials on modifiable risk factors¥ | 1(4.6%) | 1.0(8.3%) | 2(5.9%) | 1(4.6%) | 0(0.0%) | 1(2.9%) |
| Education/counseling sessions on risk behaviours ‡ | 18(81.8%) | 9.0(75.0%) | 27(79.4%) | 21(95.5%) | 10(83.3%) | 31(91.2%) |
| Education for self-administration of insulin | 7(31.8%) | 6.0(50.0%) | 13(38.2%) | - | - | - |
| Education sessions on drugs | 16(72.7%) | 10(83.3%) | 26(76.5%) | 16(72.7%) | 10(83.3%) | 26(76.5%) |
| Education on self-management diabetes or CVDs | 17(77.3%) | 8(66.7%) | 25(73.5%) | 18(81.8%) | 10(83.3%) | 28(82.4%) |
| With community activities service | 0(0.0%) | 0(0.0%) | 0(0.0%) | 0(0.0%) | 0(0.0%) | 0(0.0%) |
| Readiness score index of education-counseling & CA | 8(35.8%) | 5(40.6%) | 13(37.5%) | 9(35.2%) | 6(46.4%) | 14(42.5%) |
| Readiness score diabetes and CVDs services | 8(48.4%) | 7(40.1%) | 15(40.3%) | 9(37.5%) | 8(58.5) | 16(45.8%) |
Notes: Mangochi DH, Mangochi District Hospital; CHAM, Christian Health Association in Malawi; SD, standard deviation ; n: number of facilities with all items within a specific domain in place; IQR, interquartile range; ‡, amlodipine and nifedipine; ‡‡, atenolol and propranolol; †, enalapril, captopril; ††, alpha-methyl alpha methyldopa dopamine; ‡‡‡, hydrochlorothiazide, furosemide, and spironolactone; ¥, dopamine; ¥¥, aspirin; and ¥¥¥: statin,*, CVDs; IQR, interquartile range; †††: metformin; †, and †††: glibenclamide, CA: community activities