Integrating noncommunicable diseases into antenatal care in Cameroon: A triangulated qualitative analysis

Abstract

Noncommunicable diseases (NCDs) have important implications for pregnancy outcomes and the subsequent health of women and their children. The aim of this study is to determine the status of NCD and maternal health program integration, identify barriers to integration, and explore what would be required to deepen integration of NCD care into antenatal care in Cameroon. We used two methods of data collection and synthesis: a desk review of policy documents and protocols and a series of key informant interviews with health system experts and managers working in public, private, and faith-based health facilities at central, regional, and district levels. Although screening for blood glucose and blood pressure occurs during antenatal care, post-diagnosis management is not well-integrated and often requires referral to specialists in higher-level health facilities. Key barriers to integration include lack of guidelines for the management of NCDs, financial constraints for facilities and patients, and shortages of health workers, medications, and supplies for laboratory investigations. Further integration of services for NCDs during pregnancy will require national guidelines backed up by system-wide strengthening of health information systems, insurance coverage, supply chain management, and human resource capacity, particularly in remote areas.