Skills In The Management Of Non-communicable Diseases

This article is an annotated bibliography on current global health issues in terms of the priorities and interventions to deal with this global health problem. The issue that I chose to focus on is the rise in the number and expertise of the specialists who prevent, treat and care for the various chronic non-communicable ailments particularly in most of the unindustrialized nations since this has been a great problem worldwide.

Running Head: SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 1
Skills In The Management Of Non-communicable Diseases
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SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 2
Introduction
This article is an annotated bibliography on current global health issues in terms of the
priorities and interventions to deal with this global health problem. The issue that I chose to
focus on is the rise in the number and expertise of the specialists who prevent, treat and care for
the various chronic non-communicable ailments particularly in most of the unindustrialized
nations since this has been a great problem worldwide. I decided to focus on this topic because
non-communicable diseases have brought a great burden, especially to the developing countries.
However, the number of experienced and qualified healthcare practitioners who are involved in
the management of this global health issue has seen an upward trend (Bauer, Briss, Goodman &
Bowman, 2014). Non-communicable diseases also commonly referred to as chronic diseases
take a long period of time which is due to a combination of environmental, physiological, genetic
and behavioural factors. These illnesses include cardiovascular diseases such as stroke and heart
attack, respiratory diseases like COPD and asthma, cancers and asthma (Muka et al. 2015).
Each year, around fifteen million people die from the non-communicable diseases from
the age of 30 years and 70 years and many of these demises happen in the unindustrialized
countries (Leeder, Jowsey & McNab, 2018). The health sector has had inventions and priorities
to deal with these diseases through extensive training of healthcare professionals who are
involved in the management of these illnesses (Ding et al. 2016). The healthcare professionals
are now being trained to acquire vital skills that are needed to enable them to help patients to
overcome non-communicable illnesses (Duckett & Willcox, 2015). This assistance is through
having the ability to advise patients against smoking, bodily inactivity, unwholesome diets and
extreme alcohol intake which increases the risk of dying from these illnesses especially in the
developing countries (Chaker et al. 2015). Therefore, the three articles that I chose focuses on the

SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 3
improvement in skills of healthcare professionals in terms of having the capabilities of early
detection, screening as well as effective treatment of non-communicable diseases which are the
main components of the response to non-communicable diseases.
Nurse Skills For Non-Communicable Disease Managing In The Primary Care Setting In
South Africa.
Fairall, L. R., Folb, N., Timmerman, V., Lombard, C., Steyn, K., Bachmann, M. O., ... &
Gaziano, T. (2016). Educational outreach with an integrated clinical tool for nurse-led non-
communicable chronic disease management in primary care in South Africa: a pragmatic cluster
randomised controlled trial. PLoS medicine, 13(11), e1002178.
Topic
In this article, the authors focus on the professional skills that are required by nurses to
manage different non-communicable disease in South Africa which is one of the developing
countries with this health problem. According to this article, non-communicable ailments have
been the leading reason of death especially in the third world countries and therefore the health
professionals should develop new skills so as to be able to deal with this global issue through
prioritization, interventions and innovations in the primary care setting. Training of health
professionals on effective and affordable treatment prevents the complications that would arise
due to these illnesses. The authors state that in the underdeveloped countries, the upkeep for
patients with is mostly given by the nurses. There are numerous importance of nurse substitution,
supplementation and training in the high-income countries while in the low-income countries it
is inadequate. The Primary Care 101 (PC 101) is a program that has been designed so as to
support and expand the role and skills of the nurse in non-communicable disease care. This

SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 4
model involves training nurses in the medical managing with improved prescribing requirements.
The authors of this article evaluate the effect of this program on the improvement of the primary
care nurses’ skills and capacity to manage non-communicable diseases.
Methods
The trial design comprised 38 public primary care hospitals in South Africa. The nurses
involved in the managing of non-communicable sicknesses were competent to use the PC 101
administration device and given the skill, authority and abilities to be able to prescribe a wide
range of medication for most of the non-communicable illnesses. The control clinics were
allowed to continue using the old skills and the Practical Approach.
Findings
According to this article, the study results showed that in the clinics where the nurses
were given new skills and training and the authority to dispense a wide range of drugs, the
treatment of the non-communicable diseases was superior and there was a great improvement in
the health of the patients as compared to the control clinics. Therefore, it is evident that
multimorbidity, deprived recognition and lack of appropriate skills that are necessary to control
non-communicable ailments are the common source of the many problems brought about by
these illnesses. Therefore, the physicians should have the right skills to give the interventions
that are needed to limit the adverse effects that could be caused by the non-communicable
diseases on the individual’s personal health and the quality of life.
Conclusion and Relevance
The authors conclude that the skills gained by the healthcare professionals through
training in the managing of non-communicable ailments were safe, feasible and led to improved

SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 5
patient outcomes. The relevance of this study is that it added important literature and information
on the topic of the rise in the sum and skills of the specialists who stop, treat and manage the
various chronic non-communicable illnesses specially in most of the undeveloped nations and
the importance of these new skills.
Limitations/Critique
The main limitations of this study are that the research was dependence on self-reported
diagnosis, limited information on the uptake of PC 101 by the users, limited resources to
measure significant health outcomes and the reliance on the process outcome.
Opinions By Health Experts On The Receptiveness Of Community Health Stations
Concerning Non-Communicable Ailments In Vietnam
Kien, V. D., Van Minh, H., Giang, K. B., Ng, N., Nguyen, V., & Eriksson, M. (2018). Views by
health professionals on the responsiveness of commune health stations regarding non-
communicable diseases in urban Hanoi, Vietnam: a qualitative study. BMC health services
research, 18(1), 392.
Topic
This study aims at the role that the health professionals play in the delivery of health care
in dealing with the problem of non-communicable sicknesses in both the low and middle-income
states. The article argues that the development of new skills among the healthcare professionals
and increase in personnel have positively impacted on the deterrence, treatment and management
of chronic non-communicable illnesses in Vietnam which is one of the developing countries. The
rapid urbanization has led to the development of new skills and training of more health workers

SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 6
to deal with these illnesses. This study explores the opinions of the specialists on the openness of
primary health care to the increased number and skills of healthcare professionals.
Methods
This is a qualitative study conducted in Hanoi in the year 2015. 19 detailed interviews
were carried out among health experts in selected community health centres and an inventory of
the existing non-communicable diseases at these centres taken while assessing the impact that
the new skills and increased number of health workers have had on the handling, managing and
controlling of non-communicable sicknesses. The NCD directors at the state, provincial and
district levels were interviewed concerning these developments. The interview guides had the six
mechanisms of the World Health Organization outline which include proper service distribution
by health professionals, the health workforce, accessibility of affordable essential medications,
inventions in the health info arrangements, financing as well as governance in the healthcare
system. The study used a thematic approach to analyze data from the interviews in this study.
Findings
The findings showed that there is an upward trend in the development of new skills and
the number of healthcare workers hence has led to the reduction of the problem of the non-
communicable illnesses in Vietnam. The study also found out that the health staff was not
conscious of the state approach for the non-communicable ailments which aimed at training and
equipping health professionals so as to eradicate the burden of these illnesses.
Conclusion and Relevance
The authors of this article concluded that although there are varied perceptions on NCD
by health professionals, there is an upward increase in the skills and number of healthcare

SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 7
professionals which has reduced the burden of NCD, especially in the developing countries. The
relevance of this study is that it can be used to determine the availability of non-communicable
disease programs and also assess the position and opinion of the healthcare professionals on the
NCD programs that ensure proper service delivery through training health workers new skills in
treatment, managing and control of non-communicable sicknesses.
Limitations
The most significant limitation in this study is that the method that was used to sample
the health professionals to be interviewed was random and the population interviewed was not
significant enough to represent the whole population of the healthcare workers hence the
findings could not have been entirely precise.
Task Shifting For Non-Communicable Sickness Administration In Low And Middle Income
Nations
Joshi, R., Alim, M., Kengne, A. P., Jan, S., Maulik, P. K., Peiris, D., & Patel, A. A. (2014). Task
shifting for non-communicable disease management in low and middle-income countries–a
systematic review. PloS one, 9(8), e103754.
Topic
This is a systemic review in which the authors suggest that the possible resolution to the
limited health care availability in developing countries is task-shifting. The article states that the
increase in the skills and the number of healthcare professionals who deal with non-
communicable diseases has been a result of task-shifting whereby there is the training and
education of non-physician healthcare workforces to carry out the treatment, management and
disease control tasks that were traditionally for physicians. The systemic review consists of the

SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 8
various studies that are involved in task-shifting for the management of non-communicable
diseases.
Methods
The method used by the authors of this article in the systemic review involved a search
approach that comprised the following terms; “task-shifting by non-healthcare workers,
communicable disease management, civic health care worker, improved professional skills and
number of professionals in NCD, non-communicable disease in developing countries” that was
conducted using Medline through Cochrane Library and PubMed. There were two reviewers
who separately reviewed these databases and collected the data.
Findings
The authors of this article did the search that gave them 7176 articles and used 22 of
these to compile the article. Seven studies were of randomized but controlled trials while the
remaining 15 were observational studies. The tasks that were performed by the non-physician
health workers included screening patients for non-communicable ailments and offering them
healthcare. Most of these studies showed improved health outcomes as compared with the usual
healthcare due to increased skills and number of health professionals in terms of reduced blood
pressure, lowered depression score and increased uptake of drugs. Training, delivery of
algorithms and the protocols of screening and curing of these diseases.
Conclusion and Relevance
The authors of this systemic review concluded that task-shifting when accompanied by
the restructuring, can ensure an effective and affordable strategy for the improvement of
healthcare for patients with non-communicable diseases. The relevance of this article is that the

SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES 9
information that was gained can be used to encourage the use of task-shifting to ensure effective
treatment, management and control of non-communicable diseases.
Limitations
The main limitation of this systemic review was the numerous restrictions on the
prescribing drugs as well as the availability of the needed medications. The other limitation is
that only two studies suggested that task-shifting was cost-effective.

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References
Bauer, U. E., Briss, P. A., Goodman, R. A., & Bowman, B. A. (2014). Prevention of chronic
disease in the 21st century: elimination of the leading preventable causes of premature
death and disability. The Lancet, 384(9937), 45-52.
Chaker, L., Falla, A., van der Lee, S. J., Muka, T., Imo, D., Jaspers, L., ... & Pazoki, R. (2015).
The global impact of non-communicable diseases on macro-economic productivity: a
systematic review. European Journal of Epidemiology, 30(5), 357-395.
Ding, D., Lawson, K. D., Kolbe-Alexander, T. L., Finkelstein, E. A., Katzmarzyk, P. T., Van
Mechelen, W., ... & Lancet Physical Activity Series 2 Executive Committee. (2016). The
economic burden of physical inactivity: a global analysis of major non-communicable
diseases. The Lancet, 388(10051), 1311-1324.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford
University Press.
Fairall, L. R., Folb, N., Timmerman, V., Lombard, C., Steyn, K., Bachmann, M. O., ... &
Gaziano, T. (2016). Educational outreach with an integrated clinical tool for nurse-led
non-communicable chronic disease management in primary care in South Africa: a
pragmatic cluster randomised controlled trial. PLoS medicine, 13(11), e1002178.
Joshi, R., Alim, M., Kengne, A. P., Jan, S., Maulik, P. K., Peiris, D., & Patel, A. A. (2014). Task
shifting for non-communicable disease management in low and middle income
countries–a systematic review. PloS one, 9(8), e103754.

SKILLS IN THE MANAGEMENT OF NON-COMMUNICABLE DISEASES
11
Kien, V. D., Van Minh, H., Giang, K. B., Ng, N., Nguyen, V., & Eriksson, M. (2018). Views by
health professionals on the responsiveness of commune health stations regarding non-
communicable diseases in urban Hanoi, Vietnam: a qualitative study. BMC health
services research, 18(1), 392.
Leeder, S. R., Jowsey, T., & McNab, J. W. (2018). The experiences of patients and carers living
with multimorbid, non-communicable diseases. Australian journal of general
practice, 47(1/2), 24.
Muka, T., Imo, D., Jaspers, L., Colpani, V., Chaker, L., van der Lee, S. J., ... & Pazoki, R.
(2015). The global impact of non-communicable diseases on healthcare spending and
national income: a systematic review. European Journal of Epidemiology, 30(4), 251-
277.