ArticleBMJ public health2026
Addressing dual health threats: development and pilot of an integrated acute NCD and IPC training programme in Tanzania.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Tanzania faces a significant gap in training healthcare workers (HCWs) to manage acute non-communicable disease (NCD) presentations while maintaining infection prevention and control (IPC). In 2021, median IPC compliance was only 50%, with some facilities as low as 24%, and 53% of COVID-19 patients in private tertiary hospitals had NCD comorbidities. In response, the Tanzania Diabetes Association, Ministry of Health, President's Office Regional Administration and Local Government, supported by the World Diabetes Foundation, developed and piloted a 5-day integrated IPC-acute NCD training course. This study evaluates its development, implementation and early outcomes, and considers its scalability. Methods: Using Kern's six-step curriculum development model, we designed a curriculum (14 April to 16 April 2021) incorporating national and international guidelines. The pilot course was delivered in Dar es Salaam (19 April to 24 April 2021) to 87 HCWs from public, private and faith-based facilities. We documented course development and delivery as primary outcomes. Secondary outcomes included knowledge gains, assessed via pretest and post-test scores analysed with paired t-tests and Cohen's d for significance and effect size. Participant feedback was summarised with descriptive statistics. Results: Knowledge scores improved significantly from 57.19±11.50 pretraining to 67.10±9.17 post-training (mean gain 9.91±10.01, p<0.001; Cohen's d=0.99), indicating a large effect. All professional cadres demonstrated improvement in mean knowledge scores, with no significant differences in change across groups (p=0.63). Feedback was highly positive: all participants rated the training as relevant; 93% highly rated teaching methods; 74% reported overall satisfaction. However, 74% recommended longer hands-on sessions due to limited practical resources. Conclusions: This integrated IPC-NCD training pilot effectively addressed a critical gap during a public health emergency. It demonstrated feasibility, acceptability and preliminary effectiveness in boosting HCW knowledge. Scaling up will require strengthening practical components and improving resource availability. This model offers a replicable blueprint for addressing dual infectious and chronic disease burdens.
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