Implementation of an NCD prevention strategy

Author(s):  
Mike Rayner ◽  
Kremlin Wickramasinghe ◽  
Julianne Williams ◽  
Karen McColl ◽  
Shanthi Mendis

This chapter is about the implementation of an non-communicable disease (NCD) prevention strategy, which is a specified set of activities designed to put interventions or policies into practice. After an overview of the various types of implementation and the emerging type of research which focuses on this, this chapter describes frameworks which can be useful in guiding the planning and organization of implementation. The chapter then describes the role of national health systems in responding to NCDs. It provides case studies which illustrate the implementation of NCD prevention interventions from around the world. The chapter includes an important discussion about tackling social inequalities in health and provides examples of entry points and some possible interventions to address CVD inequalities. The chapter also discusses disadvantaged groups as key stakeholders in developing global and national strategies to prevent and control NCDs.

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Rita Suhuyini Salifu ◽  
Khumbulani W. Hlongwana

Abstract Objectives To explore the mechanisms of collaboration between the stakeholders, including National Tuberculosis Control Program (NTP) and the Non-Communicable Disease Control and Prevention Program (NCDCP) at the national, regional, and local (health facility) levels of the health care system in Ghana. This is one of the objectives in a study on the “Barriers and Facilitators to the Implementation of the Collaborative Framework for the Care and Control of Tuberculosis and Diabetes in Ghana” Results The data analysis revealed 4 key themes. These were (1) Increased support for communicable diseases (CDs) compared to stagnant support for non-communicable diseases (NCDs), (2) Donor support, (3) Poor collaboration between NTP and NCDCP, and (4) Low Tuberculosis-Diabetes Mellitus (TB-DM) case detection.


2020 ◽  
Author(s):  
Carol Wang ◽  
John Attia ◽  
Stephen Lye ◽  
Wendy Oddy ◽  
Lawrence Beilin ◽  
...  

Abstract Background: It is well established that genetics, environment, and interplay between them play crucial roles in adult disease. We aimed to evaluate the role of genetics, early life nutrition, and interaction between them, on optimal adult health. Methods: As part of a large international consortium (n~154,000), we identified 60 SNPs associated with both birthweight and adult disease. Utilising the Raine Study, we developed a birthweight polygenic score (BW-PGS) based the 60 SNPs and examined relationships between BW-PGS and adulthood cardiovascular risk factors, specifically evaluating interactions with early life nutrition. Findings: Healthy nutrition was beneficial for all individuals; longer duration of any breastfeeding was associated with lower BMI and lower Systolic Blood Pressure in those with higher BW-PGS. Interpretation: Optimal breastfeeding offers the greatest benefit to reduce adult obesity and hypertension in those genetically predisposed to high birthweight. This provides an example of how precision medicine in early life can improve adult health.


Author(s):  
Lynette Reid

Abstract Within-country social inequalities in health have widened while global health inequalities have (with some exceptions) narrowed since the Second World War. On commonly accepted prioritarian and sufficientist views of justice and health, these two trends together would be acceptable: the wealthiest of the wealthy are pulling ahead, but the worst off are catching up and more are achieving sufficiency. Such commitments to priority or sufficiency are compatible with a common “development” narrative about economic and social changes that accompany changes (“transitions”) in population health. I set out a very simple version of health egalitarianism (without commitment to any particular current theory of justice) and focus on two common objections to egalitarianism. Priority and sufficiency both address the levelling down and formalism objections, but these objections are distinct: giving content to equality (I argue here) places in question the claimed normative superiority of priority and sufficiency. Using examples of the role of antimicrobials in both these trends – and the future role of AMR – I clarify (first) the multiple forms and dimensions of justice at play in health, and (second) the different mechanisms at work in generating the two current patterns (seen in life course narratives and narratives of political economy). The “accelerated transition” that narrowed global health inequalities is fed by anti-microbials (among other technology transfers). It did not accelerate but replaced the causal processes by which current HICs achieved the transition (growing and shared economic prosperity and widening political franchise). The impact of AMR on widening social inequalities in health in HICs will be complex: inequality has been fed in part by tertiary care enabled by antimicrobials; AMR might erode the solidarity underlying universal health systems as the well-off seek to maintain current expectations of curative and rehabilitative surgery and chemotherapy while AMR mounts. In light of both speculations about the impact of AMR on social and global health inequalities, I close with practical and with theoretical reflection. I briefly indicate the practical importance of understanding AMR from the perspective of health justice for policy response. Then, from a broader perspective, I argue that the content by which I meet the formalism objection demonstrates that the two trends (broadening within-country inequality and narrowing global inequality) are selective and biased samples of a centuries-long pattern of widening social inequalities in health. We are not in the midst of a process of “catching up”. In light of the long-term pattern described here, is the pursuit of sufficiency or priority morally superior to the pursuit of equality as a response to concrete suffering – or do they rationalize a process more objectively described as the best-off continuing to take the largest share of one of the most important benefits of economic development?


2016 ◽  
Vol 5 (3) ◽  
pp. 294
Author(s):  
Yandrizal Yandrizal ◽  
Rizanda Machmud ◽  
Melinda Noer ◽  
Hardisman Hardisman ◽  
Afrizal Afrizal ◽  
...  

Non-Communicable disease has already been the main cause of death in many countries, as many as 57 million death in the world in 2008, 36 million (63 percent) is because of un-infectious disease, specifically heart illness, diabetes, cancer, and chronic respiratory diseases. Prevention and controlling efforts of un-infectious diseases developing in Indonesia is non-communicable disease integrated development post (Pospindu PTM). This research used combination method approach with exploratory design. Exploratory design with sequential procedure used combination consecutively, the first is qualitative and the second is quantitative method. Public Health Center formed Posbindu PTM has not disseminate yet to all stakeholders. Posbindu PTM members felt benefit by following this activity. Some of them did not know follow the activity because of unknown about it. There was  connection between coming behavior to Posbindu PTM to preventing behavior of non-communicable disease.Percentage for high blood pressure risk indicated 20-25 percent from all visitors. Formulation of its policy implementation started with stakeholder analysis; head of sub district, head of urban village, head of health department in regency/city, head of public health service, head of neighborhood Association, and the head of family welfare development.  Analysis of perception, power and authority found that every stakeholder had authority to manage the member directly or indirectly. It was not implemented because of the lack knowledge of stakeholders about the Posbindu PTM function.They would play a role after knowing the aim and advantage of the post by motivate the people to do early detection, prevention and control the non-communicable disease. The members were given wide knowledge about  early detection, preventing  and control the un-infectious disease, measuring and checking up their healthy continuously so that keep feeling the advantage of coming to the post.


Author(s):  
Mike Rayner ◽  
Kremlin Wickramasinghe ◽  
Julianne Williams ◽  
Karen McColl ◽  
Shanthi Mendis

This final chapter argues that the policy cycle should be seen as just that—a cycle, rather than a linear process with a defined start and finish. To generate effective policies, the stages need to be revisited over time. In revisiting these steps, it will be necessary to ask new questions about the problem and the solutions. The chapter includes case studies that illustrate how non-communicable disease (NCD) prevention and control interventions do not always follow the four steps of the policy cycle in a linear process. This chapter emphasizes that NCDs are multifactorial conditions with complex causal webs that require a sophisticated mix of solutions that reflect the specific context. The theoretical background, practical pointers, and case studies from this book should help to equip policy-makers, researchers, health advocates, and students with the knowledge and tools required to reduce the burden of death and disability from NCDs.


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