Skip to main content
Home / Public Health Action, Volume 9, Number 3

Open Access Non-communicable disease clinics in rural Ethiopia: why patients are lost to follow-up

Download Article:
Background: Providing medical care for non-communicable diseases (NCDs) in rural sub-Saharan Africa has proved to be difficult because of poor treatment adherence and frequent loss to follow-up (LTFU). The reasons for this are poorly understood.

Objective: To investigate LTFU among patients with two different but common NCDs who attended rural Ethiopian health centres.

Method: The study was based in five health centres in southern Ethiopia with established NCD clinics run by nurses and health officers. Patients with epilepsy or hypertension who were lost to follow-up and non-LTFU comparison patients were identified and traced; a questionnaire was administered enquiring about the reasons for LTFU.

Results: Of the 147 LTFU patients successfully located, 62 had died, moved away or were attending other medical facilities. The remaining 85 patients were compared with 211 non-LFTU patients. The major factors associated with LTFU were distance from the clinic, associated costs and a preference for traditional treatments, together with a misunderstanding of the nature of NCD management.

Conclusions: The delivery of affordable care closer to the patients' homes has the greatest potential to address the problem of LTFU. Also needed are increased levels of patient education and interaction with traditional healers to explain the nature of NCDs and the need for life-long management.

Keywords: Ethiopia; LTFU; NCD clinics; epilepsy; hypertension; rural

Document Type: Research Article

Affiliations: 1: Jimma University Chronic Disease Project, Jimma, Ethiopia 2: Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, UK 3: Barts and the London School of Medicine, Queen Mary University of London, London, UK 4: Hospital for Tropical Diseases, University College, London, UK 5: Queen Elizabeth Hospital, Woolwich, London, UK 6: Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK 7: London School of Hygiene & Tropical Medicine, London, UK 8: School of Humanities, University of Southampton, Southampton, UK

Publication date: 01 September 2019

More about this publication?

  • Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.

    The Editors will consider any manuscript reporting original research on quality improvements, cost-benefit analysis, legislation, training and capacity building, with a focus on all relevant areas of public health (e.g. infection control, nutrition, TB, HIV, vaccines, smoking, COVID-19, microbial resistance, outbreaks etc).

  • Editorial Board
  • Information for Authors
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • Ingenta Connect is not responsible for the content or availability of external websites

Share Content

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content