https://orcid.org/0009-0003-7651-4470
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ABSTRACT
Background
Noncommunicable diseases (NCDs) pose a significant global health challenge. Primary health centres are pivotal in addressing this challenge by providing essential care to NCD patients. The WHO Package of Essential Noncommunicable (PEN) disease interventions has been designed to enhance the quality of NCD consultations and ensure adherence to the protocol. This study investigates the effects of PEN training in Moldova.
Objectives
The primary objective of this study is to assess the effects of training on WHO PEN on the quality of NCD consultations and adherence to the PEN protocol in a real -world setting in primary health centres in Moldova.
Methods
An observational, cross-sectional study was conducted, comparing primary health centres where health personnel received PEN training, provided by the Healthy Life project, to those where such training was not provided. In total, 24 family doctors and 24 medical assistants were observed for 233 workdays and covering 2,166 NCD consultations.
Results
Intervention primary health centres (PHCs) showed longer NCD consultation durations, with family doctors and medical assistants spending an added 1 minute 43 seconds and 3 minutes 10 seconds, respectively. These PHCs also reported a higher proportion of primary NCD consultations, indicating better screening for new NCD patients. Medical assistants in the intervention group took on a more pronounced role in NCD care. However, the findings also highlight the necessity to refine aspects of the PEN training, especially concerning follow-up consultations, risk assessments, and task delegation.
Conclusions
The findings suggest that the PEN training contributed to improvement of both the quality of NCD consultations and adherence to the PEN protocol. Yet, there is a need for enhancing the identified aspects of the PEN training. The findings highlight the potential of PEN training in primary healthcare settings for improved NCD management.
Responsible Editor Jennifer Stewart Williams
Responsible Editor Jennifer Stewart Williams
Acknowledgments
The authors wish to thank the Moldovan Government, in particular the Ministry of Health and district authorities for their overall facilitation of the study. The time and commitment of the health workers and patients that agreed to participate is deeply appreciated. Professor Ghenadie Curocichin provided helpful comments on an earlier draft that helped to shape the discussion.
Author contributions
JK and AT designed the study. JK, AT, NZ and HP conceptualised the study questionnaire and study protocol. CR coordinated the data collection in Moldova and analysed the data. JK conceptualised the manuscript outline and wrote the paper, with contributions from all authors. NZ and AT aided in interpreting the results and provided contextual information. AC facilitated the collaborations with involved Moldovan partners and reviewed and commented on the manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
The Ethical Committee of the Ministry of Health granted ethical clearance (Decision Nr. 117) for this study on 25 August 2021.
Paper context
The WHO’s PEN protocol aims to improve the prevention, early diagnosis, and management of non-communicable diseases (NCDs). This study investigates the effects of PEN training in primary health centres in Moldova. The findings suggest that the PEN training contributed to improvement of the quality of NCD consultations and adherence to the PEN protocol. However, there are areas in the training, particularly follow-up consultations and task delegation, that require refinement.