The visibility of non-communicable diseases in Northern Uganda

Background: WHO and Uganda's Ministry of Health emphasize the need to address the growing burden of non-communicable diseases (NCDs). Treatment for these conditions is urgent in northern Uganda where war has negatively affected both health and the public health care system. Objectives: We aimed to explore the recognized presence of selected chronic conditions in the out-patient population and to relate this ` visibility' to the ability of health units to diagnose and treat them. Methods: At six health facilities we reviewed patient registers for one month to determine the frequency of hypertension, diabetes, depression, and post traumatic stress disorder (PTSD). We checked the availability of diagnostic instruments and medicines, and interviewed health workers. Results: The four conditions were rarely diagnosed in the outpatient population. Hypertension was the most common, but still constituted under 1% of diagnoses. Patterns of diagnosis were uneven, with higher frequency of particular diagnoses at some health facilities. Diagnostic equipment was not sufficient and screening was irregular. Medicine was mostly available although stockouts of some relevant drugs were reported. Conclusions: The four conditions are relatively invisible in the outpatient population. Greater visibility would be facilitated by regular clinic days for hypertension and diabetes, availability and regular use of diagnostic instruments, and a more reliable supply of the relevant medicines.