Global strategies to prevent non-communicable diseases: A view for the low-income societies

2005 ◽  
Vol 18 (2) ◽  
pp. 182-185 ◽  
Author(s):  
Noel Solomons
Keyword(s):  
Low Income ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Global Strategies

scholarly journals Integrated management of non-communicable diseases in low-income settings: palliative care, primary care and community health synergies

2018 ◽  
pp. bmjspcare-2018-001579 ◽  
Author(s):  
Daniel Munday ◽  
Vandana Kanth ◽  
Shadrach Khristi ◽  
Liz Grant
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Community Health ◽  
Low Income ◽  
Integrated Management ◽  
Premature Mortality ◽  
Communicable Diseases ◽  
Health Coverage ◽  
Non Communicable Diseases ◽  
Care Community

Palliative care is recognised as a fundamental component of Universal Health Coverage (UHC), which individual countries, led by the United Nations and the WHO, are committed to achieving worldwide by 2030—Sustainable Development Goal (SDG) 3.8. As the incidence of non-communicable diseases (NCD) in low-income and middle-income countries (LMICs) increases, their prevention and control are the central aspects of UHC in these areas. While the main focus is on reducing premature mortality from NCDs (SDG 3.4), palliative care is becoming increasingly important in LMICs, in which 80% of the need is found. This paper discusses the challenges of providing comprehensive NCD management in LMICs, the role of palliative care in addressing the huge and growing burden of serious health-related suffering, and also its scope for leveraging various aspects of primary care NCD management. Drawing on experiences in India and Nepal, and particularly a project on the India–Nepal border in which palliative care, community health and primary care-led NCD management are being integrated, we explore the synergies arising and describe a model where palliative care is integral to the whole spectrum of NCD management, from promotion and prevention, through treatment, rehabilitation and palliation. We believe this model could provide a framework for integrated NCD management more generally in rural India and Nepal and also other LMICs as they work to make NCD management as part of UHC a reality.

scholarly journals Indirect cost of non-communicable diseases deaths in the World Health Organization African Region

10.3823/2304 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Joses Muthuri Kirigia ◽  
Germano M Mwabu ◽  
James Machoki M'Imunya ◽  
Rosenabi Deborah Karimi Muthuri ◽  
Lenity Honesty Kainyu Nkanata ◽  
...  
Keyword(s):  
Human Capital ◽  
Low Income ◽  
Communicable Diseases ◽  
Total Loss ◽  
Human Capital Approach ◽  
World Health ◽  
African Region ◽  
Non Communicable Diseases ◽  
Management Interventions ◽  
The Impact

Background: In 2012, a total of 9 398 809 deaths from all causes occurred in the WHO African Region; out of which 2 788 381 (29.67%) were due to non-communicable diseases (NCD). The objective of this study was to estimate future gross domestic product (GDP) losses associated with NCD deaths in the African Region for use to advocate for increased investments into prevention and management of NCDs. Methods: Human capital approach is used to estimate non-health GDP losses associated with NCD deaths. Future non-health GDP losses were discounted at 3%. The analysis was done for three income groups of countries and six age groups. One-way sensitivity analysis at 5% and 10% discount rates was undertaken to assess the impact on expected non-health GDP loss estimates.Results: The 2 788 381 NCD deaths that occurred in the African Region in 2012 are estimated to have resulted in a total discounted GDP loss of Int$ 61 302 450 005. Out of that total loss, 20.36% was borne by those aged 0-4 years; 12.76% by 5-14 years; 16.64% by 15-29 years; 44.93% by 30-59 years; 2.99% by 60-69 years; and 2.33% by those aged 70 years and above. Thus, those aged between 15 and 59 years bore 61.57% of the GDP losses.Approximately 47.4%, 33.1% and 19.5% of the total loss was borne by high and upper middle-, lower middle- and low-income countries respectively. The average total non-health GDP loss was Int$ 21 985 per NCD death. The average non-health GDP lost per NCD death was Int$ 54 534 for Group 1, Int$ 21 492 for Group 2 and Int$ 9 096 for Group 3. Conclusion: Premature NCD deaths are associated with substantive GDP losses in countries of the African Region. Therefore, unless African countries and their development partners bolster their investments to assure universal population coverage of cost-effective promotive, preventive and management interventions for NCDs, prospects of achieving the United Nations General Assembly Sustainable Development Goals (SDG) might be greatly undermined in Africa.Key words: Non-communicable diseases, non-health GDP loss, NCD prevention and management, human capital approach

scholarly journals Setting up a nurse-led model of care for management of Hypertension and Diabetes Mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study

2019 ◽  
Author(s):  
Marthe Marie Frieden ◽  
Blessing Zamba ◽  
Nisbert Mukumbi ◽  
Patron Titsha Mafaune ◽  
Brian Makumbe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Low Income ◽  
Descriptive Study ◽  
Communicable Diseases ◽  
Hiv Prevalence ◽  
Sub Saharan Africa ◽  
Income Country ◽  
Model Of Care ◽  
Non Communicable Diseases ◽  
Low Income Country

Abstract Background In light of the increasing burden of non-communicable diseases on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, context adapted cost effective service delivery models are now required as a matter of urgency. Multiple models have thus been trialled across Africa with varying degrees of success. Zimbabwe is a low-income country with unique socio-economic challenges but similar dual disease burden of infectious chronic diseases such as HIV and non-communicable diseases. We aim to describe the experience of setting up and organising a nurse-led Diabetes Mellitus (DM) and Hypertension (HTN) model of care in a rural context of a low-income country from July 2016 to June 2019.Methods A descriptive study based on a conceptual framework successfully applied in the roll-out of antiretroviral therapy in Manicaland Province, Zimbabwe. Attempting to mirror the HIV experience, we describe the key enablers in the design and implementation of the model: decentralization of services, integration of care, simplification of management guidelines, mentoring and task-sharing, provision of affordable medicines, quality assured laboratory support, patient empowerment, a dedicated monitoring and evaluation system, and a robust referral system.Results 11 out of 51 health facilities were selected in Chipinge district, of which nine were primary health care (PHC) clinics and two were hospitals. DM/HTN services were set up and integrated into the general out-patient department or pre-existing HIV clinics. In one hospital, an integrated chronic care clinic was established. Through structured intensive mentoring, including simplified protocols, nurses in seven PHC facilities and one hospital developed sufficient knowledge and skills to diagnose, initiate treatment and monitor DM/HTN patients. Overall, more than 3000 patients were registered in a dedicated recording system and offered education. Free medication with differentiated periodic refills and regular monitoring of blood pressure and/or blood glucose with the use of glycosylated haemoglobin were provided.Conclusion Our experience shows that it is feasible to implement nurse-led decentralized integrated DM/HTN care in a high HIV prevalence rural, low-income context. Developing a context-adapted efficient model of care is a dynamic process.

scholarly journals Setting up a nurse-led model of care for management of Hypertension and Diabetes Mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study

2020 ◽  
Author(s):  
Marthe Marie Frieden ◽  
Blessing Zamba ◽  
Nisbert Mukumbi ◽  
Patron Titsha Mafaune ◽  
Brian Makumbe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Low Income ◽  
Communicable Diseases ◽  
Hiv Prevalence ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Model Of Care ◽  
Integration Of Care ◽  
Non Communicable Diseases ◽  
Design And Implementation

Abstract Background In the light of the increasing burden of non-communicable diseases on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, context-adapted, cost-effective service delivery models are required urgently. Multiple models have been trialled across Africa with varying degrees of success. Zimbabwe is a low-income country with unique socio-economic challenges and a dual disease burden of infectious chronic diseases such as HIV and non-communicable diseases. We describe the experience of setting up and organising a nurse-led Diabetes Mellitus (DM) and Hypertension (HTN) model of care in rural Zimbabwe from July 2016 to June 2019. Programme design and implementation We used a conceptual framework successfully applied in the roll-out of antiretroviral therapy in Zimbabwe. Mirroring the HIV experience, we describe key enablers in the design and implementation of the model: decentralization of services, integration of care, simplification of guidelines, mentoring and task-sharing, provision of affordable medicines, quality assured laboratory support, patient empowerment, a dedicated monitoring and evaluation system, and a robust referral system. DM and HTN services were set up in 9 primary health care (PHC) facilities and two hospitals in Chipinge district, and integrated into the general out-patient department or pre-existing HIV clinics. In one hospital, an integrated chronic care clinic (ICCC) emerged. We provided mentoring for staff using simplified protocols, and patient education. Free medication and monitoring with point of care (POC) glycosylated haemoglobin (HbA1c) were provided. Nurses in 7 PHC facilities and one hospital developed sufficient knowledge and skills to diagnose and manage DM and HTN patients, and 3094 patients were registered. Major lessons learned include: the value of POC devices in the management of diabetes; the pressure on services due to added caseload, exacerbated by the availability of free medications; and the importance of leadership in successful programme implementation. Conclusion Our experience demonstrates a model for nurse-led decentralized integrated DM and HTN care in a high HIV prevalence rural, low-income context. Developing a context-adapted model of care is a dynamic process. We present our lessons learned with the intention of sharing experience which may be of value to other public health programme managers.

Sign in / Sign up

Export Citation Format

Share Document