scholarly journals Protocol for establishing an Adaptive Diseases control Expert Programme in Tanzania (ADEPT) for integrating care of communicable and non-communicable diseases using tuberculosis and diabetes as a case study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041521
Author(s):  
Stellah G Mpagama ◽  
Kaushik Ramaiya ◽  
Troels Lillebæk ◽  
Blandina T Mmbaga ◽  
Marion Sumari-de Boer ◽  
...  

IntroductionMost sub-Saharan African countries endure a high burden of communicable infections but also face a rise of non-communicable diseases (NCDs). Interventions targeting particular epidemics are often executed within vertical programmes. We establish an Adaptive Diseases control Expert Programme in Tanzania (ADEPT) model with three domains; stepwise training approach, integration of communicable and NCDs and a learning system. The model aims to shift traditional vertical programmes to an adaptive diseases management approach through integrating communicable and NCDs using the tuberculosis (TB) and diabetes mellitus (DM) dual epidemic as a case study. We aim to describe the ADEPT protocol with underpinned implementation and operational research on TB/DM.Methods and analysisThe model implement a collaborative TB and DM services protocol as endorsed by WHO in Tanzania. Evaluation of the process and outcomes will follow the logic framework. A mixed research design with both qualitative and quantitative approaches will be used in applied research action. Anticipated implementation research outcomes include at the health facilities level for organising TB/DM services, pathways of patients with TB/DM seeking care in different health facilities, factors in service delivery that need deimplementation and the ADEPT model implementation feasibility, acceptability and fidelity. Expected operational research outcomes include additional identified patients with dual TB/DM, the prevalence of comorbidities like hypertension in patients with TB/DM and final treatment outcomes of TB/DM including treatment-related complications. Findings will inform the future policies and practices for integrating communicable and NCDs services.Ethics and disseminationEthical approval was granted by The National Research Health Ethical Committee (Ref-No. NIMR/HQ/R.8a/Vol.IX/2988) and the implementation endorsed by the government authorities. Findings will be proactively disseminated through multiple mechanisms including peer-reviewed journals, and engagement with various stakeholders’ example in conferences and social media.

2016 ◽  
Vol 7 (2) ◽  
pp. 1-13 ◽  
Author(s):  
Mohammad Rashemdul Islam ◽  
Shamima Parvin Laskar ◽  
Darryl Macer

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets.  A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.


Author(s):  
Wilfred Kok Hoe Mok ◽  
Noran Naqiah Hairi ◽  
Caryn Mei Hsien Chan ◽  
Feisul Idzwan Mustapha ◽  
Thamil Arasu Saminathan ◽  
...  

(1) Background: The prevalence of overweight and obesity among children has increased tremendously in the ASEAN region, including Malaysia. In Malaysia, the National Strategic Plan for Non-Communicable Diseases (2015–2025) provides the overall framework for its response to the non-communicable diseases (NCD) epidemic. Preventing childhood obesity is one of the key strategies for early intervention to prevent NCDs. The objective of this research is to examine the current status of policy interventions in addressing childhood obesity in Malaysia. (2) Methods: A panel of 22 stakeholders and experts from Malaysia, representing the government, industry, academia and non-governmental organizations, were sampled using a modified Delphi technique. Data were collected using a modified NCD scorecard under four domains (governance, risk factors, surveillance and research and health systems response). A heat map was used to measure the success of the four realms of the NCD scorecard. For each domain of the NCD scorecard, the final score was grouped in quintiles. (3) Results: A total of 22 participants responded, comprising of eight (36.4%) males and 14 (63.4%) females. All the domains measured in implementing policies related to childhood obesity were of low progress. Nine governance indicators were reported as 22.5% (low progress), four in the risk factors domain, and two in the surveillance. This shows that timely and accurate monitoring, participatory review and evaluation, and effective remedies are necessary for a country’s surveillance system. (4) Conclusion: Although Malaysia has published several key strategic documents relating to childhood obesity and implemented numerous policy interventions, we have identified several gaps that must be addressed to leverage the whole-of-government and whole-of-society approach in addressing childhood obesity in the country.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mohammed Khaled Al-Hanawi

Abstract Background Non-communicable diseases (NCDs) are increasingly becoming a challenge worldwide, causing high mortality and morbidity. Saudi Arabia has one of the highest rates of NCDs globally and the highest in the Arabian Gulf region. Epidemiological data indicate that NCDs are responsible for 70 % of all deaths in Saudi Arabia. The aim of this study was to examine the socioeconomic determinants and inequalities in the prevalence of NCDs in Saudi Arabia. Methods Data from the Saudi Family Health Survey conducted in 2018 by the General Authority for Statistics were used for this study. Univariate, bivariate, and multivariate logistic regression analyses were employed to examine the socioeconomic factors associated with the prevalence of NCDs. Moreover, the concentration curve and concentration indices were used to assess inequalities in the prevalence of NCDs. Results Among the 11,527 respondents, the prevalence of NCDs was 32.15 %. The prevalence of NCDs was higher among women and among elderly respondents aged ≥ 60 years. With respect to the determinants of the prevalence of NCDs, the logistic regression results showed that the likelihood of reporting NCDs was lower among people with a higher education (OR: 0.599, 95 % CI: 0.497–0.723, p < 0.01) compared with that of people with an education below the primary school level. Other factors significantly associated with the prevalence of NCDs were age, marital status, nationality, and region of residence. The inequality analysis showed that at the national level, the prevalence of NCDs was concentrated among less educated people (concentration index = − 0.338, p < 0.01), but with significant regional variations. Gender disaggregation showed that both income-based and education-based concentration indices were significantly negative among women, indicating that the prevalence of NCDs is concentrated among women with a lower income level and with less education. Conclusions The findings of this study are important for policymakers to combat both the increasing prevalence of and socio-economic inequalities in NCDs. The government should develop targeted intervention strategies to control NCDs and achieve health equality considering socio-economic status. Future policies should target women and the lower educated population in Saudi Arabia.


Author(s):  
Rizal Sanif

Health problems in Indonesia are very serious challenges. The main problem is that there is a triple burden or three important health problems related to the eradication of infectious diseases, an increase in cases of non-communicable diseases and the re-emergence of types of diseases that should have been successfully resolved. Infectious diseases such as diarrhea, tuberculosis and dengue fever were the most common health cases; now there has been a marked change in the number of cases of non-communicable diseases such as diabetes, cancer and coronary heart disease. The Government of the Republic of Indonesia at the Ministry of Health in 2017 launched GERMAS or Healthy Living Community Movement. GERMAS is a movement that aims to promote a culture of healthy living and leave unhealthy habits and behavior of society. The GERMAS action was also followed by promoting hygiene and healthy living habits and support for community-based infrastructure programs. This program has several focuses, such as building access to meet drinking water needs, community health installations and the construction of habitable settlements. The three of them are the basic infrastructure that is the foundation of the healthy life movement.


Author(s):  
Rohit Dhaka ◽  
Ramesh Verma ◽  
Ginni Agrawal ◽  
Gopal Kumar

India in a state of epidemiological health transition i.e shifting from communicable to non-communicable diseases. The annually 3.2% Indians falling below the poverty line and three forth Indians spending their entire income on health care and purchasing drugs. The government of India announced a Ayushman Bharat Yojana- National Health Protection Scheme (AB-NHPM) in the year 2018.  The aim of this programme is to providing a service to create a healthy, capable and content new India and two goals are to creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services and to provide health insurance cover to at least 40% of India's population which is deprived of secondary and tertiary care services. This Yojana will be implemented through Health and Wellness Centres that are to be developed in the primary health centre or sub-centre in the village and that will provide preventive, promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc. These centres would be equipped with basic medical tests for hypertension, diabetic and cancer and they are connected to the district hospital for advanced tele-medical consultations. The government has aims to set up 1,50,000 health and wellness centres across the country by the year 2022.


Author(s):  
Muhammad Muhammad

Global competition among universities in the world has become more challenging over years. This makes it demanding not only for universities in Indonesia to create positive improvements but also for the government to adapt with its innovations and policy initiatives. Meanwhile, New Public Management approach which was initially introduced in 1990s has been proposing administrative reforms on the old inefficient bureaucracy. In response to this, universities along with the government have been incorporating some aspects of The New Public Management theory in order for them to strive in global competition. This study seeks to analyze the changing status of Indonesian universities. It further discusses how some aspects of New Public Management are incorporated in university’s administration. This Indonesian case study argues that NPM values has influenced the changing system of universities in Indonesia. NPS still exists partially if not fully, in Indonesian universities despite the problem of public acceptance responding to the government’s policy on university reforms.


2022 ◽  
Author(s):  
Anung Ahadi Pradana

BACKGROUND Dementia is a serious terminal and irreversible disease that often does not receive attention from the public compared to other non-communicable diseases. This disease causes a decline in cognitive function in individuals and makes them have to depend on others for 5-20 years of their life span. OBJECTIVE The purpose of this paper is to provide an overview of dementia and other things related to this disease. METHODS The writing method in this article uses a narrative review on several scientific sources and journal articles published in 2011-2021 from several databases such as Google Scholar, CINAHL, ProQuest, PubMed, and EBSCO. RESULTS Dementia is one of the non-communicable diseases that can cause a high burden on individuals, families, communities, and countries as a result of the unproductiveness and total dependence of people with dementia on their surrounding environment due to the decline in body functions that occur. The caregiver burden experienced by caregivers includes physical, psychological, social and financial burdens. Support and assistance from professional health workers for people with dementia as well as caregivers and families can be provided through several efforts such as providing information related to illness, assistance in the care provided, providing counseling to prevent caregiver burdens and other problems, forming support groups for dementia caregivers, and advocacy for people with dementia and their families to get their rights. CONCLUSIONS Change efforts and policy making by the government that are more pro-people with dementia can change the perception that has been in society so far to be more positive and can potentially contribute to people with dementia.


2019 ◽  
Vol 16 (3) ◽  
pp. 213-226 ◽  
Author(s):  
Samir Helmy Assaad Khalil ◽  
Sulaf Ibrahim Abdelaziz ◽  
Affaf Al Shammary ◽  
Ali Al Zahrani ◽  
Ashraf Amir ◽  
...  

Most data on the burden of diabetes and prediabetes are from countries where local infrastructure can support reliable estimates of the burden of non-communicable diseases. Countries in the Middle East and Africa, together with Russia, have a total population of almost 2 billion, but have been relatively overlooked by authors in this field. We reviewed the prevalence and drivers of prediabetes and diabetes across this large region. A large, and variable, burden of dysglycaemia exists, especially in Middle Eastern and North African countries, associated with high levels of obesity and sedentariness, with a generally lower prevalence in most other parts of Africa. The design and size of studies are highly variable, and more research to quantify the scale of the problem is needed. Local barriers to care relating to issues concerned with gender, consanguinity, lack of understanding of diabetes, lack of understanding of obesity as a health issue, and limited resource at a national level for tracking and intervention for diabetes and other non-communicable diseases. Lifestyle interventions with proven local cost-effectiveness, enhanced access to pharmacologic intervention, and societal interventions to promote better diet and more activity will be an important element in strategies to combat these adverse trends.


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