DETERMINANTS OF PREVENTIVE PRACTICES FOR NON-COMMUNICABLE DISEASES AMONG PRIMARY HEALTH CARE WORKERS IN BENUE STATE
Abstract
This study aimed to identify factors that influence how primary healthcare workers adopt and implement preventive measures for non-communicable diseases (NCDs) in Benue State. A quasi-experimental design involving 400 PHCWs was adopted, with the experimental group receiving WHO PEN training and the control group without training. Data were collected via structured questionnaires focusing on NCD-related and clinical practices. Statistical analyses included chi-square and multiple regression to explore sociodemographic influences. PHCWs demonstrated high baseline knowledge of NCD preventive practices related to lifestyle modifications, screening, pharmacological management, and patient self-care, consistent with national guidelines and prior sensitization efforts. Clinical practices showed mixed patterns: although routine blood pressure screening remained suboptimal, patient education and counseling activities improved markedly, with all trained PHCWs consistently integrating key preventive measures into care. Sociodemographic factors influenced outcomes; age and professional cadre were significantly associated with preventive practices, with older and higher-cadre workers demonstrating better implementation, whereas no significant effect was observed for sex and years of experience. This study concluded that age and professional cadre played a notable role while sex and years of experience were not significantly associated with NCD preventive practices. Specifically, older health care workers and those in clinical or public health-focused roles demonstrated stronger engagement in the prevention of NCD. Overall, the findings affirm that targeted interventions can significantly enhance the capacity of healthcare workers to prevent and manage NCDs at the primary health care level. This underscores the importance of continuous professional development and the integration of structured NCD prevention strategies into routine clinical practice to mitigate the growing burden of chronic diseases in the population. It was recommended amongst others that health centers should be adequately equipped with standardized, evidence-based tools for non-communicable disease (NCD) education and counseling, ensuring that healthcare workers have access to reliable resources for effective patient engagement.
Keywords:
Non-Communicable Disease (NCD) Prevention, Primary Health care Workers (PHCWs), Health Education and Awareness, WHO PEN Interventions, Policy Implementation in Primary Health care.Downloads
Published
DOI:
https://doi.org/10.5281/zenodo.15792393Issue
Section
How to Cite
License
Copyright (c) 2025 Zar, Vershima Daniel, Prof. Best Ordinioha, Clement, Emmanuel Etim, Yohana Wamanyi, Jibrin, M. D, Umar, Ibrahim, Umar Jibril El-Muqaddas , Bashir Idris
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Abdool-Gaffar, M. S., Calligaro, G., Wong, M. L., Smith, C., Lalloo, U. G., Koegelenberg, C. F. N., Dheda, K., Allwood, B. W., Goolam-Mahomed, A., & van Zyl-Smit, R. N. (2019). Journal of the American Medical Association. Management of chronic obstructive pulmonary disease-A position statement of the South African Thoracic Society: 2019 update. Journal of Thoracic Disease, 11(11), 4408–4427.
Agarwal, A. K., Raja, A., & Brown, B. D. (2021). Chronic Obstructive Pulmonary Disease.[Updated 2021 Aug 11]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.[diunduh 30 Oktober 2021].
Ajisegiri, W. S., Abimbola, S., Tesema, A. G., Odusanya, O. O., Peiris, D., & Joshi, R. (2022). The organization of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis. PLOS global public health, 2(7), e0000566. doi: 10.1371/journal.pone.0000566
Akinwumi, A. F., Esimai, O. A., Fajobi, O., Idowu, A., Esan, O. T., & Ojo, T. O. (2021). Knowledge of primary healthcare workers regarding the prevention and control of non-communicable diseases in Osun State, Nigeria: A rural-urban comparison. African Journal of Primary Health Care and Family Medicine, 13(1), e1–e8.
Amini, N., Rakhshanderou, S., Ramezankhani, A., Delavari, A., & Ghaffari, M. (2023). WHO-PEN intervention in Iran's health system based on 5As healthy lifestyle counseling model: A randomized-clinical trial. Journal of Education and Health Promotion, 12, 18.
Anand, U., Dey, A., Chandel, A. K. S., Sanyal, R., Mishra, A., Pandey, D. K., De Falco, V., Upadhyay, A., Kandimalla, R., Chaudhary, A., Dhanjal, J. K., Dewanjee, S., Vallamkondu, J., & Pérez de la Lastra, J. M. (2022). Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics. Genes & Diseases, 10(4), 1367–1401.
Aribike, O., Okafor, I., Roberts, A., & Odugbemi, T. (2019). Are Nigerian Women Pro-Active in Noncommunicable Disease Prevention? A Quantitative Survey. Annals of global health, 85(1), 38.
Bade, B. C., & Dela Cruz, C. S. (2020). Lung Cancer 2020: Epidemiology, Etiology, and Prevention. Clinics in Chest Medicine, 41(1), 1–24.
Bagheri-Hosseinabadi, Z., Bahreyni, A., Basirat, H., Khalili, P., Vakilian, A., & Amin, F. (2024). Occupational status and chronic respiratory diseases: a cross-sectional study based on the data of the Rafsanjan Cohort Study. BMC Pulmonary Medicine, 24(1), 151.
Brown, J. S., Amend, S. R., Austin, R. H., Gatenby, R. A., Hammarlund, E. U., & Pienta, K. J. (2023). Updating the definition of cancer. Molecular Cancer Research: MCR, 21(11), 1142–1147.
Budreviciute, A., Damiati, S., Sabir, D. K., Onder, K., Schuller-Goetzburg, P., Plakys, G., Katileviciute, A., Khoja, S., Kodzius, R. (2020). Management and prevention strategies for non-communicable diseases (NCDs) and their risk factors. Frontiers in Public Health, 8, 574111. https://doi.org/10.3389/fpubh.2020.574111
Busse, P. J.; Christiansen, S. C.; Riedl, M. A.; Banerji, A.; Bernstein, J. A.; Castaldo, A. J., ... & Zuraw, B. L. (2021). US HAEA medical advisory board 2020 guidelines for the management of hereditary angioedema. The Journal of Allergy and Clinical Immunology: In Practice, 9(1), 132-150.
Calcaterra, V., & Zuccotti, G. (2022). Non-communicable diseases and rare diseases: A current and future public health challenge within pediatrics. Children (Basel, Switzerland), 9(10), 1491. https://doi.org/10.3390/children9101491
Chennamadhavuni, A., Lyengar, V., Mukkamalla, S. K. R., & Shimanovsky, A. (2023). Leukemia. In StatPearls. 2023. StatPearls Publishing.
Dalal, S., Beunza JJ, Volmink, J., Adebamowo, C., Bajunirwe, F., Njelekela, M., Mozaffarian, D., Fawzi W, Willett W, Adami HO, Holmes MD. Non-communicable diseases in sub-Saharan Africa: what we know now. Int J Epidemiol. 2011 Aug;40(4):885-901. doi: 10.1093/ije/dyr050. Epub 2011 Apr 28. PMID: 21527446.
De Silva, F., & Alcorn, J. (2022). A tale of two cancers: A current concise overview of breast and prostate cancer. Cancers, 14(12), 2954.
Debela, D. T., Muzazu, S. G., Heraro, K. D., Ndalama, M. T., Mesele, B. W., Haile, D. C., Kitui, S. K., and Manyazewal, T. (2021). New approaches and procedures for cancer treatment: Current perspectives. SAGE Open Medicine, 9, 20503121211034366.
Ding, S., Deng, Y., Lu, S., Lamb, K. V., Zhang, Y., & Wu, Y. (2017). Knowledge and practice in cardiovascular disease prevention among hospital registered nurses: a cross-sectional study. Journal of Clinical Nursing, 26(21-22), 3318–3327.
Dorsey, J. F., Salinas, R. D., Dang, M., Alonso-Basanta, M., Judy, K. D., Maity, A., Lustig, R. A., Lee, J. Y. K., Phillips, P. C., & Pruitt, A. A. (2019). Cancer of the central nervous system. Journal of the American Medical Association. In Abeloff’s Clinical Oncology (pp. 906-967.e12).
Fares, J., Fares, M. Y., Khachfe, H. H., Salhab, H. A., & Fares, Y. (2020). Molecular principles of metastasis: a hallmark of cancer revisited. Signal Transduction and Targeted Therapy, 5(1), 28.
Garedow, A. W., Jemaneh, T. M., Hailemariam, A. G., & Tesfaye, G. T. (2023). Lifestyle modification and medication use among diabetes mellitus patients attending Jimma University Medical Center, Jimma zone, south west Ethiopia. Scientific Reports, 13(1), 4956.
H. N. Gouda, F. Charlson, K. Sorsdahl, S. Ahmadzada, A. J. Ferrari, H. Erskine, Whiteford, H. (2019). Burden of non-communicable diseases in sub-Saharan Africa, 1990–2017: results from the Global Burden of Disease Study 2017. The Lancet global health, 7(10), e1375-e1387.
Hausman, D. M. (2019). What is cancer? Perspectives in biology and medicine, 62(4), 778-784.
Jamil, A., & Mukkamalla, S. K. R. (2023). Lymphoma. In StatPearls. StatPearls Publishing.
Jumat, M. I., Hayati, F., Syed Abdul Rahim, S. S., Saupin, S., Awang Lukman, K., Jeffree, M. S., Lasimbang, H. B., & Kadir, F. (2021). Occupational lung disease: A narrative review of lung conditions from the workplace. Annals of Medicine and Surgery (2012), 64, 102245.
Khorrami, Z., Etemad, K., Yarahmadi, S., Khodakarim, S., Kameli, M., Hezaveh, A. M., et al. (2017). Urbanization and noncommunicable disease (NCD) risk factors: WHO STEPwise Iranian NCD risk factors surveillance in 2011. Eastern Mediterranean Health Journal, 23(7), 469.
Lee, Y. N., & Huda, M. S. (2021). Uncommon forms of diabetes. Clinical medicine (London, England), 21(4), e337–e341.
Lelijveld, N., Seal, A., Wells, J. C., Kirkby, J., Opondo, C., Chimwezi, E., ... & Kerac, M. (2016). Chronic disease outcomes after severe acute malnutrition in Malawian children (ChroSAM): a cohort study. Lancet Global Health, 4(9), e654-e662.
Lopez, E. O., Ballard, B. D., & Jan, A. (2024). Cardiovascular Disease. [Updated 2023 Aug 22]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Musoke, D., Atusingwize, E., Ikhile, D., Nalinya, S., Ssemugabo, C., Lubega, G. B., Omodara, D., Ndejjo, R., & Gibson, L. (2021). Community health workers’ involvement in the prevention and control of non-communicable diseases in Wakiso District, Uganda. Globalization and health, 17(1), 7.
Nugroho, B. S. (2025). The Analysis Study of Prevalence, Diagnosis and Management of Gestational Diabetes: A Comprehensive Year Systematic Review. The International Journal of Medical Science and Health Research, 8(4), 10-32.
Ochie, C. N., Aniwada, E. C., Uchegbu, E. K., Asogwa, T. C., Onwasoigwe, C. N. (2022). Infection prevention and control: knowledge, determinants and compliance among primary healthcare workers in Enugu Metropolis, South-East Nigeria. Infection prevention in practice, 4(2), 100214.
Olié, V., Grave, C., Helft, G., Nguyen-Thanh, V., Andler, R., Quatremere, G., Pasquereau, A., Lahaie, E., Lailler, G., Verdot, C., Deschamps, V., Vay-Demouy, J., Thomas, D., Paillard, F., Tuppin, P., Iliou, M. C., Blacher, J., & Gabet, A. (2024). Epidemiology of cardiovascular risk factors: Behavioral risk factors. Archives of Cardiovascular Diseases, 117(12), 770–784.
Oliveira, C. N., Galvão Oliveira, M., Wildes Amorim, W., Nicolaevna Kochergin, C., Mistro, S., de Medeiros, D. S., Oliveira Silva, K., Moraes Bezerra, V., Honorato Dos Santos de Carvalho, V. C., Bispo Júnior, J. P., Louzado, J. A., Lopes Cortes, M., & Arruda Soares, D. (2022). Physicians' and nurses' perspective on chronic disease care practices in Primary Health Care in Brazil: a qualitative study. BMC Health Services Research, 22(1), 673.
Onagbiye, S. O., Tsolekile, L. P., & Puoane, T. (2020). Knowledge of non-communicable disease risk factors among community health workers in South Africa. Open Public Health Journal, 13 (2020).
Onyenwenyi, A. O. C., & Mchunu, G. G. (2019). Primary health care workers’ understanding and skills related to cervical cancer prevention in Sango PHC center in south-western Nigeria: a qualitative study. Primary health care research & development, 20, e93.
Oyebode, O., Pape, U. J., Laverty, A. A., Lee, J. T., Bhan, N., Millett, C. (2015). Rural, urban and migrant differences in non-communicable disease risk-factors in middle income countries: a cross-sectional study of WHO-SAGE data. PloS one, 10(4), e0122747.
Popovich, J. R., Kashyap, S., Gasalberti, D. P., & Cassaro, S. (2023). Sarcoma. In StatPearls. StatPearls Publishing.
Rahman, M. S., Hossain, K. S., Das, S., Kundu, S., Adegoke, E. O., Rahman, M. A., Hannan, M. A., Uddin, M. J., and Pang, M. G. (2021). Role of insulin in health and disease: An update. International Journal of Molecular Sciences, 22(12), 6403.
Roglic, G., & Norris, S. L. (2018). Medicines for treatment intensification in type 2 diabetes and type of insulin in type 1 and type 2 diabetes in low-resource settings: Synopsis of the World Health Organization guidelines on second- and third-line medicines and type of insulin for the control of blood glucose levels in non-pregnant adults with diabetes mellitus. Annals of Internal Medicine, 169(6), 394-397.
Sapra, A., & Bhandari, P. (2024). Diabetes. [Updated 2023 Jun 21]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Sarfati, D., & Gurney, J. (2022). Preventing cancer: the only way forward. Lancet (London, England), 400(10352), 540–541.
Swed, S., Sawaf, B., Al-Obeidat, F., Hafez, W., Rakab, A., Alibrahim, H., Nasif, M. N., Alghalyini, B., Zia Zaidi, A. R., Alshareef, L., Alqatati, F., Zamrath Zahir, F., Ahmed, A. I., Alom, M., Sultan, A., AlMahmoud, A., Bakkour, A., & Cherrez-Ojeda, I. (2024). Asthma prevalence among the United States population: Insights from NHANES data analysis. Scientific Reports, 14(1), 8059.
Tajudeen, W. A., Adesina, K. A., Fakorede, J. L., Muraina, O. A., Ikotun, B. M., Adesiyan, H. J., Olayinka, A. O., and Omisore, A. G. (2023). Knowledge, Attitudes and Practices of Disease Prevention among Health Talk-Giving Healthcare Workers in Primary Health Centers at Osogbo. Research Journal of Health Sciences, 11(3), 224–237.
Tekalign, T., & Teshome, M. (2022). Prevalence and determinants of late-stage presentation among cervical cancer patients, a systematic review and meta-analysis. PloS one, 17(4), e0267571.
Tesema, A., Joshi, R., Abimbola, S., Ajisegiri, W. S., Narasimhan, P., & Peiris, D. (2020). Addressing barriers to primary health-care services for noncommunicable diseases in the African Region. Bulletin of the World Health Organization, 98(12), 906–908.
Turé, R., Damasceno, A., Djicó, M., & Lunet, N. (2022). Prevalence, awareness, treatment, and control of hypertension in Bissau, Western Africa. The Journal of Clinical Hypertension, 24(3), 358-361.
World Health Education [WHO]. (2018). Non-communicable diseases country profiles 2018. Geneva: World Health Organization.
World Health Education [WHO]. (2025). Cancer. Retrieved from https://www.who.int/news-room/fact-sheets/detail/cancer
World Health Organization [WHO]. (2021). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
World Health Organization [WHO]. (2024). Non-communicable diseases. Retrieved from http ps://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases#:~:text=Non communicable%20diseases%20(NCDs)%20killed%20at,%2D%20and%20middle%2Dincome%20countries.
