Policies for type 2 diabetes and non- communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: A desk review and views of decision-makers

Mohamed, S. F. et al. (2024) Policies for type 2 diabetes and non- communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: A desk review and views of decision-makers. BMJ Open, 14(3), e073261. (doi: 10.1136/bmjopen-2023-073261) (PMID:38531573) (PMCID:PMC10966805)

Abstract

Background The COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the pandemic. This study aimed to identify policy gaps, if any, in the management of NCDs, particularly diabetes, during COVID-19 in Kenya and Tanzania to inform recommendations for priority actions for NCD management during any future similar crises. Methods We undertook a desk review of pre-existing and newly developed national frameworks, policy models and guidelines for addressing NCDs including type 2 diabetes. This was followed by 13 key informant interviews with stakeholders involved in NCD decision-making: six in Kenya and seven in Tanzania. Thematic analysis was used to analyse the documents. Results Seventeen guidance documents were identified (Kenya=10; Tanzania=7). These included pre-existing and/or updated policies/strategic plans, guidelines, a letter, a policy brief and a report. Neither country had comprehensive policies/guidelines to ensure continuity of NCD care before the COVID-19 pandemic. However, efforts were made to update pre-existing documents and several more were developed during the pandemic to guide NCD care. Some measures were put in place during the COVID-19 period to ensure continuity of care for patients with NCDs such as longer supply of medicines. Inadequate attention was given to monitoring and evaluation and implementation issues. Conclusion Kenya and Tanzania developed and updated some policies/guidelines to include continuity of care in emergencies. However, there were gaps in the documents and between policy/guideline documents and practice. Health systems need to establish disaster preparedness plans that integrate attention to NCD care to enable them to better handle severe disruptions caused by emergencies such as pandemics. Such guidance needs to include contingency planning to enable adequate resources for NCD care and must also address evaluation of implementation effectiveness.

• Item Type: Articles
• Additional Information: Funding This work was supported by the Medical Research Council and by the National Institute for Health Research (NIHR) (grant number MR/V035924/1) using UK aid from the UK Government to support global health research.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Gray, Professor Cindy and Bunn, Dr Christopher and Mair, Professor Frances and Mtenga, Dr Sally
• Authors: Mohamed, S. F., Kisia, L., Mashiashi, I., Mair, F., Wisdom, J. P., Bunn, C., Gray, C., Kibe, P. M., Sanya, R. E., Karugu, C. H., Mtenga, S., Binyaruka, P., and Asiki, G.
• Subjects: H Social Sciences > H Social Sciences (General); R Medicine > R Medicine (General); R Medicine > RA Public aspects of medicine
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 25 March 2024
• Copyright Holders: Copyright: © Author(s) (or their employer(s)) 2024
• First Published: First published in BMJ Open 14(3): e073261
• Publisher Policy: Reproduced under a Creative Commons licence