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Table 4 Summary of content analyses – Improvements and barriers in implementing NCD prevention strategies learned at the training

From: Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine

Main category Healthcare professional Code
 Organisation and working conditions All Focus on NCD prevention (and not only treatment) and assessment of risk factors
General risk assessment instead of focus on single risk factors
Access to laboratory testing improved and test were more often done
Taking measures “in a right way”
doctors/nurses Improved teamwork, distribution of responsibilities (mostly, nurses do all preparatory work (measurements, tests) and doctors evaluate risk factors, and give lifestyle and treatment counseling)
Establishing pre-medical office
Availability of equipment on the sites
managers Complementary priorities (health care reform as window of opportunity for NCD prevention)
Patient access to medicines improved
 Interaction with patient doctors/nurses/feldshers Improved communication skills (motivational interviewing)
 Emotional improvements managers/doctors/nurses Feeling motivated and inspired
nurses/feldshers Increased confidence and self-esteem due to training
 Organisation and working conditions doctors/nurses/feldshers Lack of systematic approach to selection of the training participants (instead of training for teams of mangers, doctors, and nurses/feldshers for improved implementation)
Lack of refresher training and possibility to share experience
Lack of time per patient
Lack of management support
Insufficient equipment on the sites
Lack of pre-medical office
nurses/feldshers Lack of regular training during career
Workload, too much paperwork
feldshers Poor working conditions (e.g. temperature in winter)
Workload, working alone, too many tasks (e.g. cleaning)
Basic equipment is missing
managers Lack of resources
Competitive priorities (prevention work postponed due to health care reform)
Lack of unified forms for monitoring project implementation (patient level and facility level)
Lack of laboratory onsite
 Interaction with patient doctors Lack of communication skills (motivational interviewing not applied)
Lack of health culture in patients
nurses/feldshers “Patients trust the doctor more” (lifestyle counseling)
feldshers Social barrier to address unhealthy habits in small rural community setting
 Emotional barriers Nurses/feldshers Feeling of inferiority, lack of trust
feldshers Feeling of embarrassment to discuss lifestyle with patients in their community
Feeling overlooked/neglected (focus only on doctors and nurses)