Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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This volume on CVDs, renal, and respiratory disorders has particularly high value. It carries the potential to become the most effective game-changer in global health by helping all countries to combat, contain, and control the biggest killer presently prowling the globe and by enabling us to reach ...the 2030 goals for NCDs and health overall. As one who has witnessed the epidemic of CVDs advance menacingly across the world in the past four decades, I fervently hope that the clear and convincing messages conveyed by the extensively researched and elegantly communicated analyses in this volume will be heard, heeded, and harmonized with policy and practice in all countries.
Large file: 33 MB. Please download directly from the website link.
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Case Manangement Training Modules
There is growing understanding and high-level endorsement of the importance of strong collaborative multisectoral approaches to address a broad range of social, economic and governance issues for the prevention and control of noncommunicable disease (NCDs) and mental health conditions. In 2019, Worl...d Health Organization (WHO) Member States requested the WHO Director-General to provide an analysis across countries of successful approaches for the prevention and control of NCDs that used multisectoral action. This WebAnnex to the Global mapping report on multisectoral actions to strengthen the prevention and control of noncommunicable diseases and mental health conditions details experiences from around the world.
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A handbook for leaders and managers
Desde Atencion primaria de salud
Organizing and Delivering High Quality Care for Chronic Noncommunicable Diseases in the Americas
Effective implementation of WHO PEN, combined with other very cost effective population-wide interventions, will help even resource constrained settings to attain the global voluntary targets related to reduction of premature mortality and preventionof heart attacks and strokes.
Los módulos que conforman el paquete técnico HEARTS están dirigidos a los formuladores de políticas públicas y gerentes, directores o coordinadores de programas a diferentes niveles dentro de los ministerios de salud cuyo trabajo influye sobre la prestación de servicios de salud a nivel primar...io para la atención de las enfermedades cardiovasculares. Dentro de cada módulo existen secciones dirigidas a actores en niveles específicos de los sistemas de salud, así como a diferentes grupos de profesionales. En ese sentido, todos los módulos requieren ser adaptados al contexto de cada país.
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There is growing understanding and high-level endorsement of the importance of strong collaborative multisectoral approaches to address a broad range of social, economic and governance issues for the prevention and control of noncommunicable disease (NCDs) and mental health conditions. In 2019, Worl...d Health Organization (WHO) Member States requested the WHO Director-General to provide an analysis across countries of successful approaches for the prevention and control of NCDs that used multisectoral action.This report describes the experiences of different countries, areas and territories in implementing multisectoral actions to tackle NCDs and is the first step to address their request for an analysis of such efforts
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The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding..., knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
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The recommendations cover the level of blood pressure to start medication, what type of medicine or combination of medicines to use, the target blood pressure level, and how often to have follow-up checks on blood pressure. In addition, the guideline provides the basis for how physicians and other h...ealth workers can contribute to improving hypertension detection and management.
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Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh...ich may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. (2) Some amount of task shifting/team-based care is already taking place in many settings; this module provides further guidance on how to maximize this approach for greater impact.
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This report compiles data for the first time on the far-reaching consequences of uncontrolled hypertension, including heart attacks, strokes and premature death, along with substantial economic losses for communities and countries. It also contains information on the global, regional and country-lev...el burden of hypertension and progress of control efforts.
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L’objectif général de ce cadre est de permettre à l’OMS et à ses États Membres d’assurer la participation significative des personnes vivant avec des maladies non transmissibles, des problèmes de santé mentale et neurologiques, via un processus de cocréation et de renforcement des poli...tiques, programmes et services connexes. Sur la base de données factuelles en constante évolution, ce cadre contribuera à faire mieux comprendre la participation significative, et les mesures liées aux approches participatives connexes. Ce cadre expose des directives et les mesures pratiques à prendre pour traduire le concept de participation significative en action qui la mettra en œuvre. L’objectif de ce cadre est d’orienter les personnes travaillant à l’OMS et dans les États Membres dans le processus de participation significative des personnes ayant une expérience vécue. Ce faisant, l’OMS préconise la mise en œuvre de ce cadre à trois niveaux (Siège, bureaux régionaux et bureaux de pays), et fournit une assistance technique aux États Membres à la mise en œuvre de ce cadre au niveau national via les procédures établie
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Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance
The recommendations cover the level of blood pressure to start medication, what type of medicine or combination of medicines to use, the target blood pressure level, and how often to have follow-up checks on blood pressure. In addition, the guideline provides the basis for how physicians and other h...ealth workers can contribute to improving hypertension detection and management.
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Executive summary On 27th and 28th April 2021, the division of Disease Control and Prevention in collaboration with Public Health England, organized a virtual consultative meeting as part of the consultations with Member States and partners for the development of the Africa CDC five years strategic ...plan for the prevention and control of Non-communicable Diseases … Report: Expert and stakeholder virtual consultation meeting to develop the Africa CDC Non-Communicable Diseases and Mental Health Strategy
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Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an...d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
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