Disease Management Programs: Challenges and Perspectives
Oryngul Jumagaziyeva, Ainur Kumar, Nurgul Alekenova, Moldir Akhmetzhanova, Zarina Zhaksybaeva
A
BSTRACT
Introduction:
Noncommunicable diseases are a leading cause of premature death. The World Health Organization supports nurses as a key solution for chronic disease management (DM) to achieve universal health coverage by 2030. In Kazakhstan, DM Programs were first piloted in 2013 and expanded nationwide in 2016. The aim is to examine the existing practices of disease management program (DMP) implementation among nurses working at the primary healthcare (PHC) level in Almaty city.
Methods:
A qualitative study conducted from November 2024 to February 2025 targeted primary care nurses in Almaty to explore their experiences with DMP. Interviews covered demographics, roles, knowledge, training, patient education, challenges, technology use, and more. Nurses responsible for DMP from PHC facilities in each district of Almaty were selected, and the data were thematically analyzed following participant validation.
Results:
The interview involved 13 nurses with an average work experience of 9.6 years, and 6 years in PHC. Nurses highlighted their main tasks as conducting timely examinations, providing first aid, preventing complications, and providing health education. Seven nurses expressed the need for additional training, while others update their knowledge through annual training, seminars, and online resources. Nurses educate patients on diet, monitoring, physical activity, and medication adherence. Tools used include glucometers, tonometers, and visual aids. Challenges include patient non-compliance and limited time. Nurses emphasized the importance of an automated measurement system, particularly through Electronic Health Records. Their readiness and confidence varied, with many expressing a need for training in personalized patient care.
Conclusion:
Nurses highlighted the need for additional training in chronic disease management, addressing patient non-compliance, limited time, and the importance of an automated system. Managers should invest in training and improve adherence solutions.