scholarly journals Diagnostics and monitoring tools for noncommunicable diseases: a missing component in the global response

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Antonio Bernabé-Ortiz ◽  
Jessica H. Zafra-Tanaka ◽  
Miguel Moscoso-Porras ◽  
Rangarajan Sampath ◽  
Beatrice Vetter ◽  
...  
Keyword(s):  
Health System ◽  
New Technologies ◽  
Action Plan ◽  
Building Blocks ◽  
Communicable Diseases ◽  
Noncommunicable Disease ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Diagnostic Tools ◽  
Monitoring Tools

AbstractA key component of any health system is the capacity to accurately diagnose individuals. One of the six building blocks of a health system as defined by the World Health Organization (WHO) includes diagnostic tools. The WHO’s Noncommunicable Disease Global Action Plan includes addressing the lack of diagnostics for noncommunicable diseases, through multi-stakeholder collaborations to develop new technologies that are affordable, safe, effective and quality controlled, and improving laboratory and diagnostic capacity and human resources. Many challenges exist beyond price and availability for the current tools included in the Package of Essential Noncommunicable Disease Interventions (PEN) for cardiovascular disease, diabetes and chronic respiratory diseases. These include temperature stability, adaptability to various settings (e.g. at high altitude), need for training in order to perform and interpret the test, the need for maintenance and calibration, and for Blood Glucose Meters non-compatible meters and test strips. To date the issues surrounding access to diagnostic and monitoring tools for noncommunicable diseases have not been addressed in much detail. The aim of this Commentary is to present the current landscape and challenges with regards to guidance from the WHO on diagnostic tools using the WHO REASSURED criteria, which define a set of key characteristics for diagnostic tests and tools. These criteria have been used for communicable diseases, but so far have not been used for noncommunicable diseases. Diagnostic tools have played an important role in addressing many communicable diseases, such as HIV, TB and neglected tropical diseases. Clearly more attention with regards to diagnostics for noncommunicable diseases as a key component of the health system is needed.

Stewardship of noncommunicable diseases in Iran: a qualitative study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Taha Nasiri ◽  
Shahram Yazdani ◽  
Lida Shams ◽  
Amirhossein Takian
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Prevention And Control ◽  
Action Plan ◽  
World Health ◽  
Research Progress ◽  
Noncommunicable Diseases ◽  
National Action Plan ◽  
Content Type ◽  
And Control

PurposeNoncommunicable diseases (NCDs) count for over 80% of premature death worldwide. More than 76% of the total burden of diseases in Iran is devoted to NCDs. In line with the World Health Organization action plan, Iran has developed its national action plan that led to establishment of the National Committee for Prevention and Control of NCDs (INCDC), whose aim is 30% mortality reduction attributed to NCDs by 2030. The stewardship of health system is the cornerstone of performing and sustaining meaningful actions toward prevention and control of NCDs. The literature is tiny on how to materialize the stewardship and governance of health system. The purpose of this article is to report the findings of a national study that aimed to identity functions and subfunctions of stewardship of NCDs and its related risk factors in Iran.Design/methodology/approachThis is a qualitative study. The authors conducted interviews with 18 purposefully selected interviewees until the authors reached saturation. Thematic content analysis was used for analysis and MAXQDA 10 was employed for data management. The difficulty of coordinating with interviewers and health policymakers in the field slowed the process of research progress.FindingsThe authors identified seven themes and categorized them as main functions for appropriate stewardship of NCDs in Iran, including intelligence generation; strategic framework; evidence-based policies/decisions; system design; resource allocation/development; capacity-building and enforcement/alignment; and categorized them as important.Practical implicationsThe seven themes presented as stewardship functions include concepts and practical examples of the experiences and performance of leading countries in the field of NCDs control that can help policymakers and health managers for better descion-making.Originality/valueIran adopted its national action plan in 2015 and WHO selected Iran as a fast-track country in 2017. The study confirmed that to achieve the global targets, appropriate and contextual stewardship for any specific setting is fundamental. Iran needs to improve its stewardship for prevention and control of NCDs and implement its national action plan. Therefore, the functions and policies outlined in this article for the proper performance of NCDs can improve more meaningful practices in this area in Iran and many other countries.

scholarly journals Expanding the definition of noncommunicable disease

2016 ◽  
Vol 04 (02) ◽  
pp. 067-070 ◽  
Author(s):  
Ranabir Salam
Keyword(s):  
Liver Disease ◽  
Road Traffic ◽  
Public Health Problem ◽  
The United States ◽  
Noncommunicable Disease ◽  
World Health ◽  
Noncommunicable Diseases ◽  
World Population ◽  
The World ◽  
Definition Of

AbstractNoncommunicable diseases (NCDs) are responsible for 68% of all deaths in 2012. Eighty-two percent of these “premature” deaths occurred in low- and middle-income countries. Most of the NCD deaths are caused by cardiovascular diseases, cancer, diabetes, chronic respiratory diseases, mental health, road traffic accidents, and violence. The World Health Organization, several governments, and nongovernmental organizations have taken up numerous programs to curb the menace of NCDs. However, the present programs do not include some common chronic medical conditions which also lead to considerable morbidity and mortality. The present review highlights three important chronic disorders: chronic kidney disease (CKD), liver disease (cirrhosis and nonalcoholic fatty liver), and thyroid diseases. CKD is an internationally recognized public health problem affecting 5–10% of the world population. CKD resulted in 956,000 deaths in 2013 and proposes them to be included in the world wide accepted definition of NCD. Cirrhosis and chronic liver disease were the tenth leading cause of death for men and the twelfth for women in the United States in 2001. Moreover, 4–10% of the global population have thyroid dysfunction. This mini-review proposes to expand the definition of NCD to include these three major illnesses.

scholarly journals Assessment of care provision for hypertension at the emergency Department of an Urban Hospital in Mozambique

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Neusa BAY ◽  
Edna JUGA ◽  
Carlos MACUACUA ◽  
José JOÃO ◽  
Maria COSTA ◽  
...  
Keyword(s):  
Emergency Department ◽  
Risk Stratification ◽  
Health System ◽  
Health Facility ◽  
Essential Medicines ◽  
World Health ◽  
Diagnostic Tools ◽  
Clinical Protocols ◽  
Double Burden ◽  
Related Factors

Abstract Background Management of hypertension in Mozambique is poor, and rates of control are amongst the lowest in the world. Health system related factors contribute at least partially to this situation, particularly in settings where there is scarcity of resources to address the double burden of infectious and non-communicable diseases. This study aimed to assess the management of hypertension in an emergency department (ED). Methods During a pragmatic and prospective 30-day snapshot study (with 24 h surveillance) and random profiling of one-in-five presentations to the ED of Hospital Geral de Mavalane, Maputo, we assessed patient’s flow and care, as well as health facility’s infrastructure and resources through direct observation. Reports from pharmacy and laboratory stocks were used to assess availability of diagnostics and medicines needed for hypertension management. Results The 1911 hypertensive patients included in the study had several stops during their journey inside the health facility and followed a non-standardized care flow. No clinical protocols or algorithms for risk stratification of hypertension were available. Stock-outs of basic diagnostic tools for risk stratification and medicines were registered. The availability of medicines was 28% on average. Conclusions Critical gaps in health facility readiness to address arterial hypertension seen in ED were uncovered, including lack of clinical protocols, insufficient availability of diagnostics and essential medicines, as well as low affordability of the families to guaranty continuum of care. Innovative financing mechanisms are needed to support the health system to address hypertension.

scholarly journals Meeting the Global NCD Target of at Least 10% Relative Reduction in the Harmful Use of Alcohol: Is the WHO European Region on Track?

2020 ◽  
Vol 17 (10) ◽  
pp. 3423 ◽  
Author(s):  
Charlotte Probst ◽  
Jakob Manthey ◽  
Maria Neufeld ◽  
Jürgen Rehm ◽  
João Breda ◽  
...  
Keyword(s):  
Action Plan ◽  
Alcohol Exposure ◽  
Heavy Episodic Drinking ◽  
World Health ◽  
European Region ◽  
Noncommunicable Diseases ◽  
Relative Reduction ◽  
Harmful Use ◽  
Health Organization ◽  
Harmful Use Of Alcohol

Background: The Global Action Plan for the Prevention and Control of Noncommunicable Diseases set the target of an “at least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context”. This study investigated progress in the World Health Organization (WHO) European Region towards this target based on two indicators: (a) alcohol per capita consumption (APC) and (b) the age-standardized prevalence of heavy episodic drinking (HED). Methods: Alcohol exposure data for the years 2010–2017 were based on country-validated data and statistical models. Results: Between 2010 and 2017, the reduction target for APC has been met with a decline by −12.4% (95% confidence interval (CI) −17.2, −7.0%) in the region. This progress differed greatly across the region with no decline for the EU-28 grouping (−2.4%; 95% CI −12.0, 7.8%) but large declines for the Eastern WHO EUR grouping (−26.2%; 95% CI −42.2, −8.1%). Little to no progress was made concerning HED, with an overall change of −1.7% (−13.7% to 10.2%) in the WHO European Region. Conclusions: The findings indicate a divergence in alcohol consumption reduction in Europe, with substantial progress in the Eastern part of the region and very modest or no progress in EU countries.

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N. Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to offer geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross-section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of critical items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level, and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8–26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores concerning; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher-level HFs were statistically significantly friendlier than lower-level HFs (p = 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p = 0.025). Conclusion There is a low readiness for public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for older adults if the 2020 global healthy ageing goal is to be met.

scholarly journals Sugar-sweetened beverage taxation in the Region of the Americas

2021 ◽  
Keyword(s):  
Action Plan ◽  
National Level ◽  
The United States ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Sugar Sweetened Beverages ◽  
Sugar Sweetened Beverage ◽  
Excise Taxes ◽  
Sweetened Beverage ◽  
Sweetened Beverages

Sugar-sweetened beverage excise taxes are an effective evidence-based noncommunicable diseases (NCD) prevention policy. Along with tobacco and alcohol excise taxes, they are a tool to attain the Sustainable Development Goals, and are recommended by the World Health Organization to modify behavioral risk factors associated with obesity and NCDs, as featured in the WHO Global Action Plan. Taxes on sugar-sweetened beverages have been described as a triple win for governments, because they 1) improve population health, 2) generate revenue, and 3) have the potential to reduce long-term associated healthcare costs and productivity losses. Taxation of sugar-sweetened beverages has been implemented in more than 73 countries worldwide. In the Region of the Americas, 21 PAHO/WHO Member States apply national-level excise taxes on sugar-sweetened beverages and seven jurisdictions apply local sugar-sweetened beverage taxes in the United States of America. While the number of countries applying national excise taxes on sugar-sweetened beverages in the Region is promising, most of these taxes could be further leveraged to improve their impact on sugar-sweetened beverages consumption and health. This publication provides economic concepts related to the economic rationale for using sugar-sweetened beverage taxes and the costs associated with obesity; key considerations on tax design including tax types, bases, and rates; an overview of potential tax revenue and earmarking; evidence on the extent to which these taxes are expected to impact prices of taxed beverages, the demand for taxed beverages, and substitution to untaxed beverages; and responses to frequent questions about the economic impacts of sugar-sweetened beverage taxation. 

scholarly journals Fairness evaluation of health financing between 2007 to 2010 in China

2020 ◽  
Author(s):  
Guan Wang ◽  
Qing Shen
Keyword(s):  
Health Behavior ◽  
Health System ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Health Financing ◽  
The Elderly ◽  
Communicable Diseases ◽  
World Health ◽  
Health Conditions ◽  
Non Communicable Diseases

Abstract Background: Population aging and the increasing burden of non-communicable diseases (NCDs) are increasingly a strain on health systems. The World Health Organization (WHO) uses fairness of health financing as one of the criteria for assessing health system performance. The Chinese government has undertaken a series of health reforms to reduce the pace of disease transition towards non-communicable diseases, as well as protecting people from catastrophic health expenditures. The aim of this study was to assess the fairness of health financing among the elderly with different health conditions in China during the year of 2007 to 2010. Methods: The data source was the WHO Study on global AGEing and adult health (SAGE) Wave 1, a national weighted data collected from adults older than 50 years. In this study, 10099 respondents were included for analysis. Chi-square and partial proportional odds model test were applied to assess the distribution of socioeconomic and health behavior factors among different chronic conditions. Fairness of healthcare financing analysis was used to evaluate how the burden of health financing is distributed according to the household ability to pay (ATP). Dominance tests were applied for comparing different ways of health financing among health conditions. Results: More than half of the elderly had at least one chronic condition, and around 20% people suffered from multi-morbidity. Several socioeconomic as well as health behavior factors were found associated with developing NCDs. Out-of-pocket payment dominated other health finance sources in Non-NCD, single morbidity and multi-morbidity groups with a regressive pattern. Even though mandatory insurance had covered more than 70% of the elder population in China, due to the relative lower proportion reimbursement for chronic diseases, people still had to pay a lot for seeking healthcare between 2007 to 2010. Conclusion: When reimbursement for chronic diseases is relatively low, high mandatory insurance coverage does not ensure fairness of health financing. The Chinese health system should be developed further in order to meet the needs of elderly with different chronic conditions.

scholarly journals Assessing health system challenges and opportunities for better noncommunicable disease outcomes: the case of Mauritius

2019 ◽  
Author(s):  
Laurent Musango ◽  
Maryam TIMOL ◽  
Premduth BURHOO ◽  
Faisal SHAIKH ◽  
Philippe DONNEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health System ◽  
Health Systems ◽  
Community Empowerment ◽  
Noncommunicable Disease ◽  
Coordination Mechanism ◽  
World Health ◽  
Health Management Information System ◽  
Malignant Neoplasms ◽  
Challenges And Opportunities

Abstract Background This study provides an overview of NCD mortality, morbidity and risk factors; rates coverage of core population NCD interventions and individual NCD services in Mauritius; assesses health systems challenges and opportunities for better NCD outcomes; and recommends priority action areas to accelerate gains in NCD outcomes in Mauritius. Methods The Mauritius country assessment applied the guidelines developed by the World Health Organization Regional Office for Europe for systematically assessing health system challenges and opportunities for improving NCD outcomes. The assessment used mixed approaches to provide a fuller picture of the health system. Results In 2016, Mauritius sustained a total of 10 022 deaths from all causes. About 8,893 (88.7%) were from NCDs. Of the deaths due to NCDS, 6,935 (78%) were caused by cardiovascular diseases (CVD), diabetes and malignant neoplasms (cancers). Majority of NCDs are attributed to alcohol abuse, tobacco use, physical inactivity, and unhealthy diet. Of the 24-core population-based interventions for addressing these risk factors, 16.7% were rated extensive, 37.5% moderate and 45.8% limited. Three (20%), 8 (53%) and 4 (27%) of the 15 individual/personal CVD, diabetes and cancer services were rated extensive, moderate and limited respectively. Some of the challenges hindering NCD intervention scale-up include: lack of a government-led coordination mechanism; limited community empowerment for behavioural change; inefficient primary health care; insufficiently integrated health management information system; lack of explicit processes for prioritizing public health expenditures; and weak health workforce management. Conclusion There is urgent need to establish a high-level multisectoral/multistakeholder committee to oversee implementation of multisectoral activities for strengthening national health systems and other systems that address NCD risk factors and social determinants of health.

scholarly journals Implementation of the Integrated Care of Older People (ICOPE) App in Primary Care: New Technologies in Geriatric Care during Quarantine of COVID-19 and Beyond

2020 ◽  
pp. 1-2
Author(s):  
D. Sanchez-Rodriguez ◽  
C. Annweiler ◽  
S. Gillain ◽  
B. Vellas
Keyword(s):  
New Technologies ◽  
Health Care Systems ◽  
Action Plan ◽  
Credible Interval ◽  
Therapeutic Interventions ◽  
World Health ◽  
Global Priority ◽  
Care Systems ◽  
Novel Coronavirus ◽  
Health Organization

The COVID-19 pandemic due to a novel coronavirus (SARS-CoV-2) in December 2019 has rapidly spread worldwide. The mortality rate is about 2.3% in general population, with high human-to-human transmission of 0.41 (credible interval [0.27, 0.55]), and nasopharyngeal asymptomatic carriers act as vectors within the population (1). The World Health Organization (WHO) declared the pandemic on March 2020, and established objectives and action plan. First, WHO aimed at limiting the transmission of SARS-CoV-2, which required large isolation actions (country borders lockdown and individual quarantine). Second, WHO aimed at guiding and supporting the different health care systems across countries. Finally, developing therapeutic interventions appeared as a global priority as available evidence were still scarce (1). More than 860 clinical trials are ongoing worldwide.

scholarly journals The process of prioritization of non-communicable diseases in the global health policy arena

2019 ◽  
Vol 34 (5) ◽  
pp. 370-383 ◽  
Author(s):  
Olivia Heller ◽  
Claire Somerville ◽  
L Suzanne Suggs ◽  
Sarah Lachat ◽  
Julianne Piper ◽  
...  
Keyword(s):  
Civil Society ◽  
Global Health ◽  
Global Governance ◽  
Action Plan ◽  
Governance Structure ◽  
Communicable Diseases ◽  
World Health ◽  
Non Communicable Diseases ◽  
Policy Community ◽  
Political Priority

Abstract Although non-communicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide, the global policy response has not been commensurate with their health, economic and social burden. This study examined factors facilitating and hampering the prioritization of NCDs on the United Nations (UN) health agenda. Shiffman and Smith’s (Generation of political priority for global health initiatives: a framework and case study of maternal mortality. The Lancet 370: 1370–9.) political priority framework served as a structure for analysis of a review of NCD policy documents identified through the World Health Organization’s (WHO) NCD Global Action Plan 2013–20, and complemented by 11 semi-structured interviews with key informants from different sectors. The results show that a cohesive policy community exists, and leaders are present, however, actor power does not extend beyond the health sector and the role of guiding institutions and civil society have only recently gained momentum. The framing of NCDs as four risk factors and four diseases does not necessarily resonate with experts from the larger policy community, but the economic argument seems to have enabled some traction to be gained. While many policy windows have occurred, their impact has been limited by the institutional constraints of the WHO. Credible indicators and effective interventions exist, but their applicability globally, especially in low- and middle-income countries, is questionable. To be effective, the NCD movement needs to expand beyond global health experts, foster civil society and develop a broader and more inclusive global governance structure. Applying the Shiffman and Smith framework for NCDs enabled different elements of how NCDs were able to get on the UN policy agenda to be disentangled. Much work has been done to frame the challenges and solutions, but implementation processes and their applicability remain challenging globally. NCD responses need to be adapted to local contexts, focus sufficiently on both prevention and management of disease, and have a stronger global governance structure.

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