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Original Research

Quality of care for patients with non-communicable diseases in the Dedza District, Malawi

Rachel Wood, Vanessa Viljoen, Lisa Van Der Merwe, Robert Mash

African Journal of Primary Health Care & Family Medicine; Vol 7, No 1 (2015), 8 pages. doi: 10.4102/phcfm.v7i1.838

Submitted: 24 February 2015
Published:  15 June 2015


Introduction: In Malawi, non-communicable diseases (NCDs) are thought to cause 28% of deaths in adults. The aim of this study was to establish the extent of primary care morbidity related to NCDs, as well as to audit the quality of care, in the primary care setting of Dedza District, central Malawi.

Methods: This study was a baseline audit using clinic registers and a questionnaire survey of senior health workers at 5 clinics, focusing on care for hypertension, diabetes, asthma and epilepsy.

Results: A total of 82 581 consultations were recorded, of which 2489 (3.0%) were for the selected NCDs. Only 5 out of 32 structural criteria were met at all 5 clinics and 9 out of 29process criteria were never performed at any clinic. The only process criteria performed at all five clinics was measurement of blood pressure. The staff’s knowledge on NCDs was basic and the main barriers to providing quality care were lack of medication and essential equipment, inadequate knowledge and guidelines, fee-for-service at two clinics, geographic inaccessibility and lack of confidence in the primary health care system by patients.

Conclusion: Primary care morbidity from NCDs is currently low, although other studies suggest a significant burden of disease. This most likely represents a lack of utilisation, recognition, diagnosis and ability to manage patients with NCDs. Quality of care is poor due to a lack of essential resources, guidelines, and training.

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Author affiliations

Rachel Wood, Family Medicine and Primary Care, Stellenbosch University, South Africa
Vanessa Viljoen, Family Medicine and Primary Care, Stellenbosch University, South Africa
Lisa Van Der Merwe, Family Medicine and Primary Care, Stellenbosch University, South Africa
Robert Mash, Family Medicine and Primary Care, Stellenbosch University, South Africa


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ISSN: 2071-2928 (print) | ISSN: 2071-2936 (online)

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