Challenges of non-communicable diseases research in Sudan : case study: hypertension and socioeconomic disparities among women

Abstract

Aim: To examine the non-communicable diseases (NCD) research agenda in Sudan and explore barriers and opportunities for NCD research. The prevalence of hypertension and its association with social and economic disparities are examined as a case study for knowledge generation.Methods: For the first objective, qualitative interviews were conducted with seven key informants, including stakeholders from the Federal Ministry of Health, research institutes, WHO and researchers in private and public universities. Thematic analysis was performed and recurrent themes identified. For the second objective, secondary analysis of the Sudan Household and Health Survey (SHHS) 2010 data was conducted, focusing on adult females aged 25 years and above (n=16430). Descriptive statistics and logistic regressions were performed.Results: Findings of the qualitative interviews identified four main barriers: 1) lack of funding; 2) inadequate research skills; 3) lack of political commitment; and 4) competing burden of communicable diseases. In parallel, seven opportunities for improvement were noted: 1) advocacy; 2) more funding opportunities; 3) recognition of NCD by policy makers; 4) capacity building; 5) strengthening of health information system; 6) building international partnerships; and 7) integrating NCD at primary health care. Analysis of the SHHS data revealed a low prevalence of hypertension among women (4.6percent). Hypertension was significantly associated in a dose-response manner with increasing wealth index. Geographical discrepancies were also noted between states with hypertension being less prevalent in Eastern states (OR: 0.6, 95percent CI: 0.4-0.8), Central States (OR: 0.75, 95percentCI: 0.6-0.97) and Darfur region (OR: 0.3, 95percent CI: 0.2-0.5) compared to Khartoum, the capital city.Conclusion: Sudan is in its early stage of epidemiological transition; its economy and political instability make it vulnerable for undesirable consequences of globalization. While findings need to be interpreted with caution, currently, affluent segments o