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Understanding non-c...
Understanding non-communicable diseases : combining health surveillance with local knowledge to improve rural primary health care in South Africa
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Cowan, Eilidh (författare)
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- D'Ambruoso, Lucia (författare)
- Umeå universitet,Institutionen för epidemiologi och global hälsa,Aberdeen Centre for Health Data Science, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; RC/Wits Rural Public Health and Health Transitions Research Unit [Agincourt], School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; National Health Service, Grampian, UK
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van der Merwe, Maria (författare)
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Witter, Sophie (författare)
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- Byass, Peter (författare)
- Umeå universitet,Institutionen för epidemiologi och global hälsa,Aberdeen Centre for Health Data Science, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; RC/Wits Rural Public Health and Health Transitions Research Unit [Agincourt], School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Ameh, Soter (författare)
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- Wagner, Ryan G. (författare)
- Umeå universitet,Institutionen för epidemiologi och global hälsa,MRC/Wits Rural Public Health and Health Transitions Research Unit [Agincourt], School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Studies of Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS) – INDEPTH Network, Accra, Ghana
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Twine, Rhian (författare)
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(creator_code:org_t)
- 2020-12-24
- 2021
- Engelska.
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 14:1
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://www.tandfonl...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background: NCDs are non-infectious, long-term conditions that account for 40 million deaths per annum. 87% of premature NCD mortality occurs in low- and middle-income countries.Objective: The aims were:develop methods to provide integrated biosocial accounts of NCD mortality; and explore the practical utility of extended mortality data for the primary health care system.Methods: We drew on data from research programmes in the study area. Data were analysed in three steps: [a]analysis of levels, causes and circumstances of NCD mortality [n = 4,166] from routine census updates including Verbal Autopsy and of qualitative data on lived experiences of NCDs in rural villages from participatory research; [b] identifying areas of convergence and divergence between the analyses; and [c]exploration of the practical relevance of the data drawing on engagements with health systems stakeholders.Results: NCDs constituted a significant proportion of mortality in this setting [36%]. VA data revealed multiple barriers to access in end-of-life care. Many deaths were attributed to problems with resources and health systems [21%;19% respectively]. The qualitative research provided rich complementary detail on the processes through which risk originates, accumulates and is expressed in access to end-of-life care, related to chronic poverty and perceptions of poor quality care in clinics. The exploration of practical relevance revealed chronic under-funding for NCD services, and an acute need for robust, timely data on the NCD burden.Conclusions: VA data allowed a significant burden of NCD mortality to be quantified and revealed barriers to access at and around the time of death. Qualitative research contextualised these barriers, providing explanations of how and why they exist and persist. Health systems analysis revealed shortages of resources allocated to NCDs and a need for robust research to provide locally relevant evidence to organise and deliver care. Pragmatic interdisciplinary and mixed method analysis provides relevant renditions of complex problems to inform more effective responses.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- Non-communicable diseases
- verbal autopsy
- participatory research
- civil registration and vital statistics
- South Africa
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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