STRATEGIES FOR IMPLEMENTING SELF-MANAGEMENT PROGRAMS FOR NON-COMMUNICABLE DISEASES IN DEVELOPING COUNTRIES: A SCOPING REVIEW

R.A. Ibrahim Nasir^1,2, A. Rhoda³, C. Joseph⁴, B.O. Adebiyi⁵

¹Universitry of the Western Cape, Physiotherapy Department, Cape Town, South Africa, ²Ahfad University for Women, Physiotherapy Department, Khartoum, Sudan, ³University of the Western Cape, Faculty of Community and Health Sciences, Physiotherapy Department, Cape Town, South Africa, ⁴Stellenbosch University, Department of Physiotherapy, Cape Town, South Africa, ⁵University of the Western Cape, Centre for Interdisciplinary Studies of Children, Family and Society, Cape Town, South Africa

Background: Non-communicable diseases (NCDs) are becoming more common in developing countries. This rise in the prevalence of NCDs has resulted in some socioeconomic challenges in the affected developing countries, including overcrowded clinics, higher healthcare costs, and lower economic productivity due to disability and mortality. Therefore, there is a need for innovative interventions to reduce the rising worldwide NCDs burden and its associated challenges. Improving the self-management of people living with NCDs is one type of intervention that has been in the interest of researchers in recent years. Any intervention that helps patients to manage their health condition(s) daily is considered self-management. However, information on strategies to implement self-management programs in developing countries remains limited.

Purpose: This scoping review describes the strategies used to implement self-management programs in non–communicable diseases in developing countries by describing the implementation procedures such as duration, intensity, components, timing, place, and challenges

Methods: The PRISMA-ScR framework was used in this scoping review. Ebscohost (Medline, CINAHL, health sources consumer edition, health sources nursing), Cochrane library, PubMed was systematically searched for relevant articles published between 2009 to 2021. The implemented search strategy comprised three major themes: self-management strategies/ implementation, NCDs and developing countries.

Results: Twenty-six original research articles were selected for inclusion. The selected studies focused on self-management implementation strategies of diabetes (N = 19), hypertension (N = 2), Asthma (N = 1), Physical activity (N = 1), chronic diseases (N = 1), Breast cancer (N = 1) and cancer (N = 1).Most interventions were delivered through face-to-face educational session (N = 11) or group educational session (N = 5), while others incorporated educational sessions with support (N = 1) or the use of digital devices (N = 5). Furthermore, phone calls (N = 2) or SMS (N = 2) were also used as implementation strategies. The recommended duration of the sessions was 4 to 6 weeks, with sessions ranging from 45 to 90 minutes. The self-management intervention (SMI) components included educational materials (such as videos and pamphlets), mobile application-based educational and supportive interventions, and daily or weekly telephonic reminders. The best time to deliver the interventions was during the sub-acute and chronic stages while the patient was at home. The challenges concerning the implementation of the SMI were the patients’ lack of understanding and acceptability of the program.

Conclusions: The strategies for implementing the interventions were either educational sessions individually or in groups, or the use of digital devices, SMS-or phone call-based.

Implications: This review provides a guide for developing countries in implementing the self-management program. In addition, it gives information for physiotherapists considering implementing self-management programs in developing countries.

Funding acknowledgements: I would like to thank the National research foundation, South Africa, Cape Town

Keywords:
Self-management
Non-communicable diseases
Developing countries

Topics:
Non-communicable diseases (NCDs) & risk factors
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: University of the Western Cape, South Africa , Cape Town.

Committee: Biomedical Science Research Ethics Committee

Ethics number: Ethic number: BM21/6/26.