Package of essential noncommunicable disease (PEN) interventions in primary health-care settings of Bhutan: a performance assessment study
| dc.creator | Dukpa Wangchuk | |
| dc.creator | Navkiran Kaur Virdi | |
| dc.creator | Renu Garg | |
| dc.creator | Shanthi Mendis | |
| dc.creator | Nani Nair | |
| dc.creator | Dorji Wangchuk | |
| dc.creator | Rajesh Kumar | |
| dc.date | 2019-11-06T07:25:39Z | |
| dc.date | 2019-11-06T07:25:39Z | |
| dc.date | 2014-04-01 | |
| dc.date.accessioned | 2026-08-03T11:26:26Z | |
| dc.description | Background: A World Health Organization (WHO) package of essentialnoncommunicable (PEN) disease interventions was piloted in two districts ofBhutan by non-physician health workers. They conducted risk assessment amongpatients aged over 40 years who visited the outpatient department of healthinstitutions. Blood glucose was also measured among those who were overweight/obese (body mass index ≥23 kg/m2) or had a high waist circumference (>80 cmin women and >90 cm in men). Appropriate counselling, treatment and referralwere provided to the patients. The performance of the PEN project in detectingand managing noncommunicable diseases (NCDs) and their risk factors wasassessed.Methods: All health institutions of Paro (one district hospital and three basic healthunits [BHUs]) and Bumthang districts (one district hospital and four BHUs), wereincluded in the PEN pilot assessment study. All patients who had presented to theclinics in the pilot districts from 1 June to 31 August 2012 constituted the studypopulation. The data were collected from the clinical form, supervisor’s report andmonthly report of the PEN project. The characteristics of patients with an NCDat registration and at the third follow-up visit were compared in a before–afteranalysis. Absolute changes in the characteristics of patients were computed forthose who had completed the required followups during a 3-month assessmentperiod.Results: In a 3-month period, 39 079 patients had attended clinics in the pilotdistricts. About 10% of the clinic attendees (3818/39 079) were aged over 40 years;of these, 22.6% (864/3818) had a high blood pressure, and 49.7% (1896/3818)were overweight/obese or had a high waist circumference. Screening of overweight/obese/high waist circumference cases revealed that 26.1% (494/1896) had highblood sugar levels. Out of the 896 patients who were registered on PEN protocols,13% had >20% risk of developing cardiovascular diseases (CVDs) in next 10years as per the WHO/International Society of Hypertension risk-assessmentcharts. Among 444 who had three follow-up visits, high 10-year-CVD risk (>20%)had declined from 13% to 7.3%. Among 400 persons with hypertension, use ofmedication increased and high blood pressure declined from 42.3% to 21.5%.Among 115 persons with diabetes, use of anti-diabetes medication increased andhigh blood sugar declined from 68/100 to 51/100.Conclusion: Implementation of the PEN intervention in the primary health-caresetting of Bhutan led to improvement in blood pressure and diabetes control, andreduction in CVD risk | |
| dc.description | 154 | |
| dc.description | 160 | |
| dc.format | application/pdf | |
| dc.identifier | 2224-3151 (Print) | |
| dc.identifier | https://iris.who.int/handle/10665/329737 | |
| dc.identifier.uri | https://repo.dare.co.zw/handle/123456789/245675 | |
| dc.language | English | |
| dc.language | en | |
| dc.publisher | World Health Organization. Regional Office for South-East Asia | |
| dc.relation | WHO South-East Asia Journal of Public Health | |
| dc.relation | 2 | |
| dc.relation | 3 | |
| dc.subject | Bhutan | |
| dc.subject | intervention | |
| dc.subject | noncommunicable diseases | |
| dc.subject | primary health care | |
| dc.title | Package of essential noncommunicable disease (PEN) interventions in primary health-care settings of Bhutan: a performance assessment study | |
| dc.type | Journal articles |