Development of the Chronic Care Service

In Uganda, as in many low-income countries, the burden of Non-Communicable Disease (NCDs) such as Diabetes and Hypertension is increasing. This shift towards an increased burden of NCDs reflects improvements in control of infectious disease, longer life expectancy, increased urbanisation, and increased rates of cancer related to HIV. WHO data for Uganda (2016) suggests an increase in age-standardised prevalence of diabetes from 1% in 1980 to nearly 5% now, and proportional mortality due to NCDs to be 27%.

NCDs impose a significant burden of morbidity on the community, affecting quality of life and ability to work. The complications of NCDs are expensive and burdensome to the health system. The world bank says that ‘’by any measure, NCDs count for a large enough share of the disease burden of the poor to merit a serious policy response.’’ Development of services aimed at mitigating the increasing burden of Non-Communicable Diseases is part of the strategic plan for Bwindi Community Hospital.

Developing a community based Chronic Care service would enable people to receive a timely diagnosis of the condition and access management for the condition which would enable them to continue to live healthy and productive lives in their community, prevent complications of their disease and reduce the burden of mortality due to NCDs across the community. A community rather than hospital based focus for the service will allow equal access to care for those who cannot afford to travel into the hospital. BCH already has a good community outreach programme and positive relationships with community health workers so is ideally placed to move other services into the community such as chronic care.

Fundraising will be used for equipment for diagnosing conditions such as diabetes, hypertension, asthma and COPD and for training staff in the community in how to identify and manage these conditions. It will be used to fund treatment and allow mobilisation of staff into the community bringing healthcare to patients who most need it.