Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in t...he design and implementation of a cascade training of trainers (ToT) intervention to strengthen the prevention and control of cardiovascular disease.
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Together we can Prevent and Control the World's Most Common Diseases
Objectives of the training manual
(1) To improve knowledge of NCD trends, burdens, as well as systems for management and monitoring of NCD services for Township Medical Officers (TMOs), Township Public Health Officers (TP...HOs), Medical Officers (MOs). The manual can also be used for training of Basic Health staff (BHS), TMOs, TPHOs and MOs,
(2) To equip trainers to train BHS to conduct PEN protocols at the primary care level health centers,
(3) To equip trainers to train in processes to conduct PEN scaling up monitoring , supervision and evaluation activities.
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The policy brief focuses on four key areas for intervention - air pollution, energy, transport and food systems. Air pollution causes 7 million deaths annually, and is a leading cause of both NCDs and climate change, thus all interventions to reduce air pollution have a positive impact on both human... and planetary health. In the energy sector, transition from fossil fuels to renewable energy is if vital importance to improving health, with mortality rates due to coal-generated electricity 1,000 times higher than for wind-generated electricity.
Promoting active transport such as walking and cycling in place of motorised transport has the dual benefit of reducing both air pollution and physical activity. Livestock production alone accounts for 18% of greenhouse gas emissions, with added emissions from food which are highly process and transported over long distances, and thus locally sourced plant based diets both prevent NCDs and promote human and planetary health.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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The course aims to cover the types of NCDs and risk factors, the challenges of delivering NCD services in primary health care, elements of WHO technical packages (PEN and HEARTS) for NCDs and how to adapt these packages in primary health care.
SEARO NCD PEN-HEARTS is a series of four courses with... the other three courses focusing on NCDs interventions, diabetic foot care and palliative care that will enable the learner to plan and deliver NCD services.
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Technical Meeting Report, 14-15 July 2020, Geneva
Chronic Dis Int - Volume 3 Issue 1 - 2016
ISSN 2379-7983
Noncommunicable diseases (NCDs) such as cancer, cardiovascular diseases, diabetes and chronic respiratory diseases and their risk factors are an increasing public health and development challenge in Kyrgyzstan. This report provides evidence through three analyses that NCDs reduce economic outp...ut and discusses potential options in response, outlining details of their relative returns on investment. An economic burden analysis shows that economic losses from NCDs are equivalent to 3.9% of gross domestic product. An intervention costing analysis provides an estimate of the funding required to implement a set of policy interventions for prevention and clinical interventions. A cost–benefit analysis compares these implementation costs with the estimated health gains and identifies which policy packages would give the greatest returns on investment.
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The new guidelines provide public health guidance on pharmacological agents for managing hyperglycaemia in type 1 and type 2 diabetes for use in primary health-care in low-resource settings. These guidelines update the recommendations for managing hyperglycaemia in the WHO Package of Essential NCD I...nterventions (WHO PEN) for primary care in low-resources settings, reviewing several newer oral agents as second- and third-line treatment: dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter 2 inhibitors and thiazolidinediones. The guidelines also present recommendations on the selection of type of insulin (analogue versus human insulin) for adults with type 1 and type 2 diabetes.
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HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of... CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
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The study analyzes the global burden of cancer in 2020 attributable to alcohol consumption. Using data from the GLOBOCAN 2020 database and alcohol consumption patterns, it estimates that 4.1% of all new cancer cases globally (approximately 741,300 cases) were caused by alcohol. The most affected can...cers include esophageal, liver, and breast cancer, with heavy drinking contributing the most cases, followed by risky and moderate drinking. The study highlights regional differences, with the highest attributable fractions in Eastern Asia and Central and Eastern Europe. It underscores the need for policies to raise awareness about alcohol-related cancer risks and reduce alcohol consumption globally.
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In this systematic review, we aimed to examine the feasibility and acceptability of social media interventions targeting physical activity and/or diet for people with NCDs, the effectiveness of improving exercise and diet behaviours, specific design components used to promote user engagement and the... effectiveness on other health outcomes.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium ...term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and diabetes, identifying the most impactful NCD interventions within their context, closing the gaps in ca...ncer care services through regional collaboration and integrating NCD services in when responding to emergencies.
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In this version of the compendium, each guidance is coded using the International Classification of Health Interventions (ICHI).
The compendium provides a systematic compilation of published guidance from WHO and other UN organizations on health and environment. Guidance on policies and actions a...s well as awareness raising and capacity building interventions is presented for all major areas of health and environment. Guidance referring to priority settings for action such as cities and other urban settlements, housing, workplaces and health care facilities is also listed. For greater practical relevance, each guidance is classified according to principally involved sectors, level of implementation and instruments for implementation.
The compilation of guidance for each area of health and environment or priority setting for action is accompanied, as available, by information on main sources, exposure assessment and existing guideline values. Important tools and further resources are presented alongside.
This compilation of published guidance on health and environment highlights that a large number of actions across main topics of health and environment, concerning various sectors, and applicable to various levels are available to improve health and reduce environmental risks. This compendium is intended to serve as a repository and easy-to-use and useful resource for decision and policy makers in health and environment at various levels.
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The Government of the Republic of Zambia has placed priority on ensuring that Zambians are healthy and productive as a catalyst to the attainment of socioeconomic development . The Vision 2030 aims to transform Zambia into a prosperous middle-income country as articulated also in the 7th National De...velop-ment Plan (7NDP) and National Health Strategic Plan 2017 – 2021 (NHSP 2017-2020). However, this aspiration is threatened by the double burden of Communicable and Non-Communicable Diseas¬es. Zambia has been recording an increase in morbidity and mortality due to Non-Communicable Diseases (NCDs) such as cancers, diabetes, chronic respiratory and cardiovascular diseases. According to the 2016 WHO NCD country profiles, 29% of all deaths in Zambia are attributed to NCDs. This is unacceptably high, considering that most of these diseases can be reduced by modifying four main behavioural risk factors for NCDs which are tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity.
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WHO has developed a new health kit to support treatment for chronic disease patients in emergency settings. The prevalence of NCDs is increasing worldwide, including in emergency/crisis-prone areas. Yet current humanitarian response has not accounted for this emerging burden. The NCD kit attends to ...cover this gap by providing essential medicines and medical devices for the management of hypertension and cardiac conditions, diabetes and endocrine conditions, chronic respiratory diseases, and mental health and neurological conditions and neurological conditions for outpatient care in primary health care settings.
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Oral diseases are among the most common chronic diseases worldwide and constitute a major public health problem due to the huge health and economic burden on individuals, families, societies, and health care systems. The recent emphasis on the role of determinants of health, common risk factors and ...their recognition in the context of the growing burden of noncommunicable diseases (NCDs) provides good opportunities for integrating oral health into NCD prevention and control efforts. This Strategy for oral health in South-East Asia, 2013-2020, presents guidance to Member States in developing national policy and action plans to improve oral health within existing socioeconomic, cultural, political and health system contexts. It expresses the consensus on major strategies in the area of oral health promotion as well as oral disease prevention and control for the South-East Asia Region aiming at reducing the health and socioeconomic burden resulting from oral diseases, reducing oral health inequities, and improving the quality of life of the population.
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WHO Package of Essential NCD Interventions (PEN)
Accessed March 18,2019
Key stakeholders must be involved in the planning, implementation, monitoring and evaluation of NCD plans and programmes. Within a ministry of health there will be different types of stakeholders, such as programme managers and senior managers in departments of prevention, health promotion, and hosp...ital and health services. Other stakeholders may come from ministries for transport, economics, agriculture, and education, funding partners, nongovernmental organizations, civil society and community members. It is critical to ensure that there are clear and accurate descriptions of the policies, plans and programmes, so that all interventions, activities and desired outcomes are clearly understood by all involved in their evaluation.
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