Premature mortality from chronic non-communicable diseases according to social vulnerability

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.

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Multimorbidity of chronic non-communicable diseases: burden, care provision and outcomes over time among patients attending chronic outpatient medical care in Bahir Dar, Ethiopia—a mixed methods study protocol

BMJ Open ◽

10.1136/bmjopen-2021-051107 ◽

2021 ◽

Vol 11 (9) ◽

pp. e051107 ◽

Cited By ~ 1

Author(s):

Fantu Abebe Eyowas ◽

Marguerite Schneider ◽

Shitaye Alemu ◽

Fentie Ambaw Getahun

Keyword(s):

Quantitative Study ◽

Qualitative Data ◽

Premature Mortality ◽

Evidence Base ◽

Communicable Diseases ◽

Bahir Dar ◽

Multiple Sources ◽

Cross Sectional ◽

Non Communicable Diseases ◽

Over Time

IntroductionMultimorbidity refers to the presence of two or more chronic non-communicable diseases (NCDs) in a given individual. It is associated with premature mortality, lower quality of life (QoL) and greater use of healthcare resources. The burden of multimorbidity could be huge in the low and middle-income countries (LMICs), including Ethiopia. However, there is limited evidence on the magnitude of multimorbidity, associated risk factors and its effect on QoL and functionality. In addition, the evidence base on the way health systems are organised to manage patients with multimorbidity is sparse. The knowledge gleaned from this study could have a timely and significant impact on the prevention, management and survival of patients with NCD multimorbidity in Ethiopia and in LMICs at large.Methods and analysisThis study has three phases: (1) a cross-sectional quantitative study to determine the magnitude of NCD multimorbidity and its effect on QoL and functionality, (2) a qualitative study to explore organisation of care for patients with multimorbidity, and (3) a longitudinal quantitative study to investigate disease progression and patient outcomes over time. A total of 1440 patients (≥40 years) on chronic care follow-up will be enrolled from different facilities for the quantitative studies. The quantitative data will be collected from multiple sources using the KoBo Toolbox software and analysed by STATA V.16. Multiple case study designs will be employed to collect the qualitative data. The qualitative data will be coded and analysed by Open Code software thematically.Ethics and disseminationEthical clearance has been obtained from the College of Medicine and Health Sciences, Bahir Dar University (protocol number 003/2021). Subjects who provide written consent will be recruited in the study. Confidentiality of data will be strictly maintained. Findings will be disseminated through publications in peer-reviewed journals and conference presentations.

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Gender losses from premature mortality after non-communicable diseases in Russia

10.19181/konf.978-5-89697-357-7.2021.19 ◽

2021 ◽

pp. 81-83

Author(s):

N.E. Rusanova ◽

Keyword(s):

Premature Mortality ◽

Communicable Diseases ◽

Non Communicable Diseases

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A comprehensive capacity assessment tool for non-communicable diseases in low- to middle-income countries: development and results of pilot testing

Global Health Promotion ◽

10.1177/1757975916647008 ◽

2016 ◽

Vol 25 (1) ◽

pp. 43-53 ◽

Cited By ~ 1

Author(s):

Isabel Garcia de Quevedo ◽

Felipe Lobelo ◽

Loren Cadena ◽

Madalena Soares ◽

Michael Pratt

Keyword(s):

Assessment Tool ◽

Public Health Problem ◽

Premature Mortality ◽

Communicable Diseases ◽

Middle Income ◽

Non Communicable Diseases ◽

Middle Income Countries ◽

Care Services ◽

Primary Care Services ◽

Challenges And Opportunities

Non-communicable diseases (NCDs) are the leading causes of death worldwide, with higher rates of premature mortality in low- and middle-income countries (LMICs). This places a high economic burden on these countries, which usually have limited capacity to address this public health problem. We developed a guided self-assessment tool for describing national capacity for NCD prevention and control. The purpose of this tool was to assist countries in identifying key opportunities and gaps in NCD capacity. It was piloted in three countries between 2012 and 2013: Mozambique, Colombia, and the Dominican Republic. The tool includes details about NCD burden; health system infrastructure and primary care services; workforce capacity; surveillance; planning, policy, and program management; and partnerships. In the three pilot countries, the tool helped to identify differences in capacity needs pertaining to staff, training, and surveillance, but similarities were also found related to NCD challenges and opportunities. The NCD tool increased our understanding of needs and critical capacity elements for addressing NCDs in the three pilot countries. This tool can be used by other LMICs to map their efforts toward addressing NCD goals and defining priorities.

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Making primary healthcare responsive to non-communicable diseases in sub-Saharan Africa

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/traa004 ◽

2020 ◽

Vol 114 (4) ◽

pp. 229-231 ◽

Cited By ~ 1

Author(s):

Frank Baiden

Keyword(s):

Primary Healthcare ◽

Communicable Disease ◽

Premature Mortality ◽

Communicable Diseases ◽

Sub Saharan Africa ◽

Community Based ◽

Non Communicable Diseases ◽

Formal Integration ◽

Sub Saharan ◽

Non Communicable Disease

Abstract Primary healthcare (PHC) meets the needs of people's health throughout their lives and empowers individuals and communities to oversee their own health. Most of the community-based activities currently undertaken in PHC in sub-Saharan Africa (SSA) address child and maternal health. Non-communicable diseases are now major causes of morbidity and premature mortality in SSA. In this paper, I propose the formal integration of community-based, non-communicable disease prevention and early detection into PHC activities. I offer practical suggestions on how this can be achieved to ensure a continuum of care.

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Trends in premature mortality due to chronic non-communicable diseases in Brazilian federal units

Ciência & Saúde Coletiva ◽

10.1590/1413-81232015203.15342014 ◽

2015 ◽

Vol 20 (3) ◽

pp. 641-654 ◽

Cited By ~ 5

Author(s):

Carla Guimarães Alves ◽

Otaliba Libânio de Morais Neto

Keyword(s):

Mortality Rate ◽

Action Plan ◽

Premature Mortality ◽

Federal District ◽

Chronic Respiratory Disease ◽

Communicable Diseases ◽

Middle Income ◽

Mato Grosso ◽

Non Communicable Diseases ◽

Rate Of Increase

Chronic non-communicable diseases (NCDs) have a high mortality rate, mainly in lower and middle income countries. The major groups are cardiovascular disease (CVD), chronic respiratory disease (CRD), cancer and diabetes. The Action Plan to reduce NCDs in Brazil, 2011-2022 established a 2% yearly reduction in the NCD premature mortality rate as a goal. The aim of the study was to analyze trends in premature mortality rates and also show goal achievement scenarios for each Federal Unit (FU). A time series analysis of the standardized mortality rate between2000-2011 was performed using the linear regression model. The average annual rate of increase and the 95% confidence interval were estimated. Each FU was classified as being likely or unlikely to achieve the goal. The FUs likely to achieve the goal were: for CVD - Federal District, Santa Catarina, Mato Grosso, Rio Grande do Sul, Minas Gerais, Bahia, Espírito Santo and Paraná states; for CRD - Amazonas, Federal District and Paraná. For neoplasms and diabetes, none of the FUs are likely to achieve the goal. The articulation of the three levels of government will allow the strengthening of interventions to reduce the determinants of NCDs and to improve access and quality in health care.

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