Implementation of a non-communicable disease clinic in rural Sierra Leone: early experiences and lessons learned

J Public Health Policy. 2021 Sep;42(3):422-438. doi: 10.1057/s41271-021-00304-y. Epub 2021 Sep 8.

Abstract

This study is an evaluation of the first cohort of patients enrolled in an outpatient non-communicable disease clinic in Kono, Sierra Leone. In the first year, the clinic enrolled 916 patients. Eight months after the enrollment of the last patient, 53% were still active in care, 43% had been lost to follow-up (LTFU) and 4% had defaulted. Of the LTFU patients, 47% only came for the initial enrollment visit and never returned. Treatment outcomes of three patient groups [HTN only (n = 720), DM only (n = 51), and HTN/DM (n = 96)] were analyzed through a retrospective chart review. On average, all groups experienced reductions in blood pressure and/or blood glucose of approximately 10% and 20%, respectively. The proportions of patients with their condition controlled also increased. As NCDs remain underfunded and under-prioritized in low-income countries, the integrated program in Kono demonstrates the possibility of improving outpatient NCD care in Sierra Leone and similar settings.

Keywords: Chronic disease care; Diabetes; Hypertension; Non-communicable disease; Rural health; Sierra Leone.

MeSH terms

  • Blood Pressure
  • Humans
  • Noncommunicable Diseases* / epidemiology
  • Noncommunicable Diseases* / therapy
  • Retrospective Studies
  • Rural Population
  • Sierra Leone / epidemiology