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. 2024 Nov 5;12(11):278.
doi: 10.3390/diseases12110278.

Service-Delivery Models to Increase the Uptake of Non-Communicable Disease Screening in South-Central Ethiopia: A Difference-In-Differences Analysis

Bezawit Ketema  1   2   3 , Adamu Addissie  1   3 , Sarah Negash  2   3 , Mosisa Bekele  3 , Andreas Wienke  2   3 , Mirgissa Kaba  1   3 , Eva Johanna Kantelhardt  2   3
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Service-Delivery Models to Increase the Uptake of Non-Communicable Disease Screening in South-Central Ethiopia: A Difference-In-Differences Analysis

Bezawit Ketema et al. Diseases. .

Abstract

Background: Screening for non-communicable diseases (NCDs) is a critical step for early detection and the prevention of consequent morbidity and mortality. To facilitate NCD screening, the Ethiopian Ministry of Health has developed screening guidelines. However, like other low- and middle-income countries, interventions to increase the uptake of NCD-screening services in Ethiopia remain ineffective. Thus, this study aimed to determine the effectiveness of service delivery models to increase NCD-screening service uptake in south-central Ethiopia.

Method: A health-facility-based quasi-experimental study design was employed to determine the effectiveness of providing a multiple-NCD-screening service in addition to social- and behavioral-change communication (SBCC) intervention to increase the uptake of NCD-screening services. The interviewer-administered structured questionnaire was adapted from previously published research and used to collect data during the baseline and end-line survey periods. A difference-in-differences analysis was used to determine the effectiveness of the intervention.

Results: Compared with routine care, the availability of a multiple-NCD-screening service, together with SBCC intervention, was found to significantly increase the uptake of cervical cancer screening, clinical breast examination, blood pressure measurement, and blood glucose-measurement services, by 18, 9, 44 and 23 percent points, respectively. However, the availability of a multiple-NCD-screening service without SBCC intervention increased clinical breast-examination service uptake by 9% point and blood glucose-measurement service uptake by 18% point without increasing the uptake of cervical cancer-screening or blood pressure-measurement services.

Conclusion: The integration of multiple-NCD-screening services accompanied by SBCC intervention that promotes them is an important approach for improving the uptake of NCD-screening services.

Keywords: difference-in-differences; effectiveness; non-communicable disease; screening; social- and behavioral-change communication.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
(a) Proportion of cervical cancer-screening service uptake; (b) proportion of clinical breast-examination service uptake; (c) proportion of BP-measurement service uptake; and (d) proportion of blood glucose-measurement service uptake. The component-intervention arm included a multiple-NCD-screening service plus social- and behavioral-change communication intervention. The single-intervention arm included the multiple-NCD-screening service only.
Figure 2
Figure 2
NCD-screening service uptake among participants eligible for all target NCDs during the endline-survey visit (n = 293).
See this image and copyright information in PMC

References

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