Alzheimer’s Disease and Related Dementias: A Qualitative Assessment of Perceived Training Needs of Primary Healthcare Providers in Rural Southwestern Uganda

Abstract

Background: Alzheimer’s disease and related dementias (ADRD)are the third leading cause of years lived with disability, yet patients presenting with ADRD rarely receive proper care at primary healthcare centres (PHC). PHC providers are expected to be at the frontline of ADRD care and are often the first point of contact for patients with concerns about cognitive function; however, PHC providers may not have the knowledge and skills required to deliver person-centred care to patients. We therefore sought to identify the perceived training needs of PHC providers in recognizing, managing, and referring people with ADRD. Methodology: This was a cross-sectional qualitative study that was conducted in four districts in south western Uganda (Mbarara, Isingiro, Rukungiri, and Kabale). A semi-structured interview guide based on the WHO guide (toolkit) for community-based management and care of people with dementia was used to collect data from PHC providers (medical officers, clinical officers, nurses and midwives) districts. Results: The key training needs identified included awareness about ADRD among the PHC providers, knowledge on how to recognize, diagnose, manage and refer people with ADRD and in-service continuous medical education for ADRD, which would in turn lead to improved PHC providers’ attitude towards elderly people with ADRD. Discussion: Results from the study show a lack of knowledge and inability to identify, diagnose and care for people with ADRD by PHC providers at HC III and HC IVs in rural South Western Uganda. However, The Kyoto Declaration of Alzheimer´s Disease International (ADI) provides sufficient guidelines for streamlining dementia care in the primary healthcare system in low- and middle-income countries, which can be operationalized using the WHO toolkit. Conclusion: The lack of knowledge by PHCPs in rural south-western Uganda in identifying and managing persons with ADRD is an indication of the need to provide in-service training to improve the identification and management and sensitization of patients with signs of dementia