Adaptation of non-communicable disease services in Health Region 10 during the COVID-19 situation

Abstract

This research is a qualitative study aimed at extracting lessons learned from adapting non-communicable disease (NCDs) services and assessing the sustainability of healthcare services in the context of the COVID-19 situation in Health Service Region 10, consisting of 9 facilities. The main data providers were individuals involved in NCDs services, totaling 62 people. Data were collected from June to November 2022 and analyzed through document analysis, semi-structured interviews, group discussions, content and structural analysis, and summarization of key findings. The research findings revealed that NCDs are a significant problem with many patients, despite the impact of new service arrangements. The results showed that the service outcomes remained unchanged. The service system adjustments included, 1) service delivery: expanding service channels, 2) health workforce: human resource capacity development in non-communicable disease services, 3) information systems: information systems utilizing the software at all levels but lacking in linkage, 4) medical products, vaccines, and technologies: medical technology advancements in medication delivery through private companies, private pharmacies, postal services, and village health volunteers, 5) financing: budget management, which was found to be sufficient for effective administration, 6) leadership and governance: system leadership and governance found that leaders initiated service adjustments and allocated resources adequately, and 7) community health system: the interconnected community health system. Sustainability can be achieved through five aspects: 1) health service area policies, 2) facility management, 3) collaboration networks at the district level, 4) interconnected data systems, and 5) community participation. Areas for development include: 1) enhancing information systems connectivity, 2) telemedicine systems, 3) expanding cooperation with community pharmacies, and 4) self-monitoring of patients at home.