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Int. J. Environ. Res. Public Health 2016, 13(4), 407; doi:10.3390/ijerph13040407

The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study

1
School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
2
Mongolian Association of Family Medicine Specialists, Ulaanbaatar 14210, Mongolia
3
Mongolian Public Health Professionals’ Association, Ulaanbaatar 210646A, Mongolia
4
Department for Health Systems Governance and Finance, World Health Organization, Geneva 1202, Switzerland
5
School of Health and Social Development, Deakin University, Geelong 3220, Australia
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Harry H.X. Wang
Received: 29 January 2016 / Revised: 23 March 2016 / Accepted: 5 April 2016 / Published: 7 April 2016
(This article belongs to the Special Issue Chronic Diseases and Multimorbidity in Primary Care)
View Full-Text   |   Download PDF [267 KB, uploaded 8 April 2016]

Abstract

(1) Background: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2) Methods: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3) Results: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4) Conclusions: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines. View Full-Text
Keywords: clinical guidelines; family health centre; primary care; role delineation; Mongolia clinical guidelines; family health centre; primary care; role delineation; Mongolia
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Chimeddamba, O.; Ayton, D.; Bazarragchaa, N.; Dorjsuren, B.; Peeters, A.; Joyce, C. The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study. Int. J. Environ. Res. Public Health 2016, 13, 407.

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