Global partnerships to support noncommunicable disease care in low and middle-income countries

This article describes the design, outcomes, challenges, and lessons learned from the ASian Collaboration for Excellence in Non-Communicable Disease (ASCEND) program, implemented between 2011 and 2015 in India, Sri Lanka, and Malaysia. The program involved a blended-delivery model, incorporating online and face-to-face training, mentoring, and supervision of trainees’ research projects. Evaluation data were collected at baseline, 6, 12, 18, and 24 months. Intended outcomes, lessons, and challenges were summarized using a logic model. During the program period, 48 participants were trained over 2 cohorts in June 2011 and 2012. The trainees published 83 peer-reviewed articles between 2011 and 2015. Additionally, 154 presentations were given by trainees at national and international conferences. Underutilization of the online learning management system was an important challenge. Utilizing a combination of intensive face-to-face and online learning and mentoring of early career researchers in low- and middle-income countries has great potential to enhance the research capacity, performance, and outputs.

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Gaps in Capacity in Primary Care in Low-Resource Settings for Implementation of Essential Noncommunicable Disease Interventions

International Journal of Hypertension ◽

10.1155/2012/584041 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 51

Author(s):

S. Mendis ◽

Igbal Al Bashir ◽

Lanka Dissanayake ◽

Cherian Varghese ◽

Ibtihal Fadhil ◽

...

Keyword(s):

Primary Care ◽

Medical Information ◽

Health Financing ◽

Noncommunicable Disease ◽

Noncommunicable Diseases ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Objective.The objective was to evaluate the capacity of primary care (PC) facilities to implement basic interventions for prevention and management of major noncommunicable diseases (NCDs), including cardiovascular diseases and diabetes.Methods.A cross-sectional survey was done in eight low- and middle-income countries (Benin, Bhutan, Eritrea, Sri Lanka, Sudan, Suriname, Syria, and Vietnam) in 90 PC facilities randomly selected. The survey included questions on the availability of human resources, equipment, infrastructure, medicines, utilization of services, financing, medical information, and referral systems.Results and Conclusions.Major deficits were identified in health financing, access to basic technologies and medicines, medical information systems, and the health workforce. The study has provided the foundation for strengthening PC to address noncommunicable diseases. There are important implications of the findings of this study for all low- and middle-income countries as capacity of PC is fundamental for equitable prevention and control of NCDs.

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Reflections on the use of the World Health Organization’s (WHO) OneHealth Tool: Implications for health planning in low and middle income countries (LMICs)

F1000Research ◽

10.12688/f1000research.13824.2 ◽

2018 ◽

Vol 7 ◽

pp. 157 ◽

Cited By ~ 2

Author(s):

John Q. Wong ◽

Nel Jason Haw ◽

Jhanna Uy ◽

Diana Beatriz Bayani

Keyword(s):

Health Insurance ◽

Priority Setting ◽

Health Planning ◽

Noncommunicable Disease ◽

World Health ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Service Coverage ◽

Low And Middle Income

The World Health Organization (WHO) launched the OneHealth Tool (OHT) to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC), the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH) and the Philippine Health Insurance Corporation (PHIC) conduct generalized cost-effective analyses (GCEA) of selected un-financed noncommunicable disease interventions using OHT. We collected epidemiological and cost data through health facility surveys, review of literature such as cost libraries and clinical practice guidelines, and expert consultations. Although we were unable to use GCEA results directly to set policy, we learnt important policy lessons which we outline here that might help inform other countries looking to inform service coverage decisions. Additionally, the entire process and GCEA visualizations helped high-level policymakers in the health sector, who have traditionally relied on ad hoc decision making, to realize the need for a systematic and transparent priority-setting process that can continuously provide the evidence needed to inform service coverage decisions.

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Noncommunicable Diseases Prevention In Low- and Middle-Income Countries: An Overview of Health in All Policies (HiAP)

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/0046958020927885 ◽

2021 ◽

Vol 58 ◽

pp. 004695802092788

Author(s):

Nweke Ebele Ndubuisi

Keyword(s):

Risk Factors ◽

Physical Inactivity ◽

Health Sector ◽

Noncommunicable Disease ◽

Noncommunicable Diseases ◽

Middle Income ◽

Middle Income Countries ◽

Unhealthy Diet ◽

Tobacco Usage ◽

Low And Middle Income

Noncommunicable disease (NCD) causes about 35 million deaths and accounts for 60% of all deaths, of which 80% is in low- and middle-income countries (LMIC). NCDs will account for 80% of the global burden of disease by 2020 and account for 7 out of every 10 deaths in LMIC. NCD is no longer an emerging problem in developing countries, it’s assuming an alarming dimension, and taking on the proportion of an epidemic. Several literatures document the known risk factors for significant NCDs. The critical risk factors are tobacco usage, unhealthy diet, physical inactivity, and detrimental usage of alcohol. To reverse the trend that leads to an increase in poor dietary patterns, sedentary lifestyle, tobacco use, and harmful alcohol use will need policies that transcend the health sector and policy change in different areas such as finance, urban planning, education, agriculture, and transportation.

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Roles for community health workers in diabetes prevention and management in low- and middle-income countries

Cadernos de Saúde Pública ◽

10.1590/0102-311x00287120 ◽

2021 ◽

Vol 37 (10) ◽

Author(s):

Masih A. Babagoli ◽

Ramfis Nieto-Martínez ◽

Juan P. González-Rivas ◽

Kavita Sivaramakrishnan ◽

Jeffrey I Mechanick

Keyword(s):

Chronic Disease ◽

Community Health ◽

Community Health Workers ◽

Health Systems ◽

Diabetes Care ◽

Health Workers ◽

Noncommunicable Disease ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Diabetes prevalence is increasing worldwide, especially in low- and middle-income countries (LMIC), posing the need for improved detection and management strategies. Chronic disease models and lifestyle medicine provide structures for action. Community health workers (CHWs) can significantly contribute to chronic disease care if they are trained and integrated into low-resource health systems. Although most current CHWs worldwide are performing maternal/child health and infectious disease-related tasks, other programs involving CHWs for noncommunicable disease prevention and management are increasing. In this article, we discuss the advantages, challenges, and questions regarding possible roles assigned to CHWs in the prevention and management of diabetes. These roles include performing simple screening tests, implementing lifestyle/behavioral interventions, and connecting patients with alternatives to biomedicine. Specifically, CHWs can aid diabetes epidemiological surveillance by conducting risk score-based screening or capillary glucose testing, and they can facilitate diabetes self-management by delivering interventions described in the transcultural diabetes nutrition algorithm. Furthermore, while this role has not formally been assigned, CHWs can leverage their intimate knowledge of local practices to provide decision-making support to patients in environments with pluralistic health systems. Ethnocultural differences in CHW functions and transcultural adaptations of their roles in diabetes care should also be considered. In summary, CHWs can improve diabetes care by screening high-risk individuals and implementing lifestyle interventions, especially in LMIC.

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Reflections on the use of the World Health Organization’s (WHO) OneHealth Tool: Implications for health planning in low and middle income countries (LMICs)

F1000Research ◽

10.12688/f1000research.13824.1 ◽

2018 ◽

Vol 7 ◽

pp. 157

Author(s):

John Q. Wong ◽

Nel Jason Haw ◽

Jhanna Uy ◽

Diana Beatriz Bayani

Keyword(s):

Health Insurance ◽

Priority Setting ◽

Health Planning ◽

Noncommunicable Disease ◽

World Health ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Service Coverage ◽

Low And Middle Income

The World Health Organization (WHO) launched the OneHealth Tool (OHT) to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC), the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH) and the Philippine Health Insurance Corporation (PHIC) conduct generalized cost-effective analyses (GCEA) of selected un-financed noncommunicable disease interventions using OHT. We collected epidemiological and cost data through health facility surveys, review of literature such as cost libraries and clinical practice guidelines, and expert consultations. Although we were unable to use GCEA results directly to set policy, we learnt important policy lessons which we outline here that might help inform other countries looking to inform service coverage decisions. Additionally, the entire process and GCEA visualizations helped high-level policymakers in the health sector, who have traditionally relied on ad hoc decision making, to realize the need for a systematic and transparent priority-setting process that can continuously provide the evidence needed to inform service coverage decisions.

Download Full-text