A stakeholder analysis of noncommunicable diseases' multisectoral action plan in Bangladesh

2021 ◽  
Vol 10 (1) ◽  
pp. 37
Author(s):  
ReemMohyeldin Elfarra
2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Antonio Bernabé-Ortiz ◽  
Jessica H. Zafra-Tanaka ◽  
Miguel Moscoso-Porras ◽  
Rangarajan Sampath ◽  
Beatrice Vetter ◽  
...  

AbstractA key component of any health system is the capacity to accurately diagnose individuals. One of the six building blocks of a health system as defined by the World Health Organization (WHO) includes diagnostic tools. The WHO’s Noncommunicable Disease Global Action Plan includes addressing the lack of diagnostics for noncommunicable diseases, through multi-stakeholder collaborations to develop new technologies that are affordable, safe, effective and quality controlled, and improving laboratory and diagnostic capacity and human resources. Many challenges exist beyond price and availability for the current tools included in the Package of Essential Noncommunicable Disease Interventions (PEN) for cardiovascular disease, diabetes and chronic respiratory diseases. These include temperature stability, adaptability to various settings (e.g. at high altitude), need for training in order to perform and interpret the test, the need for maintenance and calibration, and for Blood Glucose Meters non-compatible meters and test strips. To date the issues surrounding access to diagnostic and monitoring tools for noncommunicable diseases have not been addressed in much detail. The aim of this Commentary is to present the current landscape and challenges with regards to guidance from the WHO on diagnostic tools using the WHO REASSURED criteria, which define a set of key characteristics for diagnostic tests and tools. These criteria have been used for communicable diseases, but so far have not been used for noncommunicable diseases. Diagnostic tools have played an important role in addressing many communicable diseases, such as HIV, TB and neglected tropical diseases. Clearly more attention with regards to diagnostics for noncommunicable diseases as a key component of the health system is needed.


Author(s):  
Charlotte Probst ◽  
Jakob Manthey ◽  
Maria Neufeld ◽  
Jürgen Rehm ◽  
João Breda ◽  
...  

Background: The Global Action Plan for the Prevention and Control of Noncommunicable Diseases set the target of an “at least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context”. This study investigated progress in the World Health Organization (WHO) European Region towards this target based on two indicators: (a) alcohol per capita consumption (APC) and (b) the age-standardized prevalence of heavy episodic drinking (HED). Methods: Alcohol exposure data for the years 2010–2017 were based on country-validated data and statistical models. Results: Between 2010 and 2017, the reduction target for APC has been met with a decline by −12.4% (95% confidence interval (CI) −17.2, −7.0%) in the region. This progress differed greatly across the region with no decline for the EU-28 grouping (−2.4%; 95% CI −12.0, 7.8%) but large declines for the Eastern WHO EUR grouping (−26.2%; 95% CI −42.2, −8.1%). Little to no progress was made concerning HED, with an overall change of −1.7% (−13.7% to 10.2%) in the WHO European Region. Conclusions: The findings indicate a divergence in alcohol consumption reduction in Europe, with substantial progress in the Eastern part of the region and very modest or no progress in EU countries.


2018 ◽  
Vol 4 (2) ◽  
pp. 46-50
Author(s):  
Gyambo Sithey ◽  
Anne Marie Thow ◽  
Jayendra Sharma ◽  
Karma Lhazin ◽  
Mu Li

Noncommunicable diseases (NCDs) are major public health problem in Bhutan, accounting for 68% of total deaths. The growing epidemic of NCDs threatens the achievement of Gross National Happiness (GNH). NCDs are the results of complex interaction of social and economic risk factors and change in diet and lifestyle. Effective action to prevent and control these diseases requires a whole-of-government approach.In this paper we review new evidence to support political priority for NCDs in Bhutan. One third of the Bhutanese are overweight (33%) and hypertensive (35.7), and 6.4% are diabetic. The prevalence of modifiable risk factors is also very high. We also present the analysis of strategic policy opportunities for health sector to integrate the ‘Multisectoral national action plan for the prevention and control of NCDs, 2015-2020’ into policies across all relevant sectors. Our analysis has identified three specific opportunities for the health sector to engage strategically to strengthen action on NCDs and GNH, concurrently: 1) raising priority actions on NCDs within the existing GNH multisectoral committee, to achieve both health and happiness objectives; 2) identifying shared agenda between NCDs and GNH to achieve both health and happiness objectives; and 3) identifying shared GNH determinants between NCDs and GNH to enhance action on NCDs. Addressing NCDs aligns with the optimization of Gross National Happiness. It is imperative that the Government of Bhutan recognize that action on NCDs is an integral element for achieving GNH.


2021 ◽  

Sugar-sweetened beverage excise taxes are an effective evidence-based noncommunicable diseases (NCD) prevention policy. Along with tobacco and alcohol excise taxes, they are a tool to attain the Sustainable Development Goals, and are recommended by the World Health Organization to modify behavioral risk factors associated with obesity and NCDs, as featured in the WHO Global Action Plan. Taxes on sugar-sweetened beverages have been described as a triple win for governments, because they 1) improve population health, 2) generate revenue, and 3) have the potential to reduce long-term associated healthcare costs and productivity losses. Taxation of sugar-sweetened beverages has been implemented in more than 73 countries worldwide. In the Region of the Americas, 21 PAHO/WHO Member States apply national-level excise taxes on sugar-sweetened beverages and seven jurisdictions apply local sugar-sweetened beverage taxes in the United States of America. While the number of countries applying national excise taxes on sugar-sweetened beverages in the Region is promising, most of these taxes could be further leveraged to improve their impact on sugar-sweetened beverages consumption and health. This publication provides economic concepts related to the economic rationale for using sugar-sweetened beverage taxes and the costs associated with obesity; key considerations on tax design including tax types, bases, and rates; an overview of potential tax revenue and earmarking; evidence on the extent to which these taxes are expected to impact prices of taxed beverages, the demand for taxed beverages, and substitution to untaxed beverages; and responses to frequent questions about the economic impacts of sugar-sweetened beverage taxation. 


2021 ◽  
Vol 3 ◽  
pp. 62
Author(s):  
Kevin Volf ◽  
Liam Kelly ◽  
Enrique García Bengoechea ◽  
Blathin Casey ◽  
Anna Gobis ◽  
...  

Introduction: Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity contributes an estimated 9% to this figure. Global responses have included the Sustainable Development Goals (SDGs) and the Global Action Plan on Physical Activity (GAPPA). Both point to policy action on physical activity (PA) to address change, yet the impact of policy on PA outcomes is unknown.  The protocol described outlines the methodology for systematic literature reviews that will be undertaken by the Policy Evaluation Network (PEN) to address this knowledge gap. Methods: The seven best investments for promotion of population PA identified in the Toronto Charter highlighted seven policy domains (schools, transport, urban design, primary health care systems, public education, community-wide programmes and sport) which will form the basis of these PEN reviews. Seven individual scientific literature searches across six electronic databases will be conducted. Each will use the key concepts of policy, PA, evaluation and a distinct concept for each of the seven policy domains. This will be supplemented with a search of the reference list of included articles. Methodological quality will be assessed and overall effectiveness for each included study will be described according to pre-determined criteria. Conclusions: Each review will provide policy makers with a list of policy statements and corresponding actions which the evidence has determined impact on PA directly or indirectly. By collating the evidence, and demonstrating the depth of the science base which informs these policy recommendations, each review will provide guidance to policymakers to use evidence-based or evidence-informed policies to achieve the 15% relative reduction in physical inactivity as defined by GAPPA. Registration:  PROSPERO CRD42020156630 (10/07/2020).


2020 ◽  
Vol 16 (1) ◽  
pp. 22-30
Author(s):  
V.P. Shypulin ◽  
N.G. Melnyk

Relevance. The «Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020» approved by the WHO is dedicated to noncommunicable diseases. Among them - diabetes mellitus, which is a consequence of overweight \ obesity and lack of exercise. Pioglitazone is the only drug on the pharmacological market for the treatment of non-alcoholic steatohepatitis (NASH), regardless of diabetic mellitus status. Currently, the treatment of early NASH in the prevention of both type 2 diabetes and CVD, and amelioration of NASH progression is a priority task. Objective – to study the effectiveness of treatment with pioglitazone in patients with obesity and non-alcoholic fatty liver disease (NAFLD). Materials that methods. 123 patients with obesity 1, 2, 3 classes in combination with NAFLD were included in our research during 3 months. The randomization method of patients was divided into two groups, comparable in age, sex, and body mass index. All patients were offered drug-free treatment that included lifestyle modification: a reduction in diet of 500 kcal from the physiological daily energy expenditure and its physical activity for 150-200 min per week, the problems of adherence to recommendations were additionally discussed during the visits. The patients of the case group adhered to the basic recommendations and received pioglitazone 15 mg / day additionally as a drug treatment. Patients in the control group adhered only to principles of drug-free treatment. Overall, the program consisted of 5 visits over 3 months period. All patients underwent anthropometric measurements, laboratory and instrumental examinations (Ultrasound steatometry) before and after 12 weeks of treatment. Also studied adherence to treatment in two groups of patients using self-report questionnaire. Results. A comparative analysis of the data obtained in patients with obesity and NAFLD from the group of pioglitazone (daily dose of 15 mg) revealed the best major metabolic markers, such as significantly decreased values in waist circumference (p<0,0001), uric acid (p=0,001), thriglycerides (p=0,02) and very low density lipoproteins cholesterol(p=0,003), atherogenic coefficient (p=0,002), fasting insulin (p=0,004) and C-peptide, HOMA-IR index (p=0,01) and increased level of high density lipoproteins cholesterol (p=0,009), respectively. A significant association was found between the target reduction of controlled attenuation parameter and treatment with pioglitazone 15 mg (OR 0,27, 95% CI 0,13–0,56, p=0,001). The dynamics of steatosis had a medium correlation with the final adherence level (r=0,52), regardless of the method of treatment. Conclusions. It was found that in Ukrainians with obesity and NAFLD, moderate steatosis occurs in 73% of cases. Pioglitazone is a significantly highly effective drug for the adjuvant therapy of NAFLD.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Taha Nasiri ◽  
Shahram Yazdani ◽  
Lida Shams ◽  
Amirhossein Takian

PurposeNoncommunicable diseases (NCDs) count for over 80% of premature death worldwide. More than 76% of the total burden of diseases in Iran is devoted to NCDs. In line with the World Health Organization action plan, Iran has developed its national action plan that led to establishment of the National Committee for Prevention and Control of NCDs (INCDC), whose aim is 30% mortality reduction attributed to NCDs by 2030. The stewardship of health system is the cornerstone of performing and sustaining meaningful actions toward prevention and control of NCDs. The literature is tiny on how to materialize the stewardship and governance of health system. The purpose of this article is to report the findings of a national study that aimed to identity functions and subfunctions of stewardship of NCDs and its related risk factors in Iran.Design/methodology/approachThis is a qualitative study. The authors conducted interviews with 18 purposefully selected interviewees until the authors reached saturation. Thematic content analysis was used for analysis and MAXQDA 10 was employed for data management. The difficulty of coordinating with interviewers and health policymakers in the field slowed the process of research progress.FindingsThe authors identified seven themes and categorized them as main functions for appropriate stewardship of NCDs in Iran, including intelligence generation; strategic framework; evidence-based policies/decisions; system design; resource allocation/development; capacity-building and enforcement/alignment; and categorized them as important.Practical implicationsThe seven themes presented as stewardship functions include concepts and practical examples of the experiences and performance of leading countries in the field of NCDs control that can help policymakers and health managers for better descion-making.Originality/valueIran adopted its national action plan in 2015 and WHO selected Iran as a fast-track country in 2017. The study confirmed that to achieve the global targets, appropriate and contextual stewardship for any specific setting is fundamental. Iran needs to improve its stewardship for prevention and control of NCDs and implement its national action plan. Therefore, the functions and policies outlined in this article for the proper performance of NCDs can improve more meaningful practices in this area in Iran and many other countries.


2019 ◽  
Vol 45 (3) ◽  
pp. 131-132
Author(s):  
Shah Md Mahfuzur Rahman ◽  
Shah Monir Hossain ◽  
Mahmood Uz Jahan

Noncommunicable diseases (NCDs) are the leading cause of mortality and morbidity, and posing significant challenges both in developed and developing countries including Bangladesh. In 2016, of the total 56.9 million global deaths, 71.0%, were due to NCDs. Some 85.0% of premature deaths from NCDs, are in low and middle income countries, where greater burden of undernutrition and infectious diseases exist.1-3 Evidence suggests a higher age specific mortality for NCDs among Bangladeshi population compared to Western populations, which putting burden on healthcare systems. 4 Bangladesh NCD Risk Factors Survey, 2018 showed that among the adult population, the mean salt intake was 16.5 gram per day and the prevalence of dislipidaemia was 28.4 %.5 Sugar consumption also continues to rise, driven by increased intake of beverages, biscuits, sweets and confectionary items. Industrially produced transfat in some food items is also an important issue in the country. Malnutrition is a key risk factor for NCDs. Globally, nearly one in three people has at least one form of malnutrition, and this will reach one in two by 2025, based on current trends.6-8 All forms of malnutrition are caused by unhealthy, poor quality diets. Unhealthy diets that include high sugar, salt and fat intake, malnutrition, and NCDs are closely linked. Not only on the health, malnutrition and diet related NCDs pose a substantial burden on the economy and development. Food systems worldwide face major challenges, such as population growth, globalisation, urbanisation, and climate change. Today’s food systems are broken and do not deliver nutritious, safe, affordable, and sustainable diets; they undermine nutrition in several ways, particularly for vulnerable and marginalised populations. Billions of dollars are spent annually marketing foods high in calories, fats, sugars, and salt, and intake has increased globally, including in low income countries.8 United Nations (UN) is well committed to prevent and control noncommunicable diseases through adopting series of resolutions in its General Assembly.  In 2013, Member States of the World Health Organization (WHO) resolved to develop and implement national action plans, in line with the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013–2020).9 NCDs are also embedded in sustainable development goal (SDG) target 3.4, that is, to reduce by one-third the premature mortality from noncommunicable diseases by 2030. NCDs are also linked to other SDGs, notably SDG 1 to end poverty. In 2017, the WHO Global Conference on Noncommunicable Diseases reaffirmed noncommunicable diseases as a sustainable development priority in the Montevideo roadmap 2018–2030.10 Bangladesh has also developed the Multisectoral Action Plan for Prevention and Control                             of Noncommunicable Diseases 2018-2025, with a three-year operational plan.11 Earlier the country has developed National Nutrition Policy, 2015, Second National Plan of Action for Nutrition, 2016-2025, Dietary Guidelines and other policies, strategies and action plan. The country is putting efforts for the prevention and control of malnutrition and NCDs. Furthermore,  to prevent and control the diet related noncommunicable diseases across the life cycle nutrition labelling, re-formulation of food standards with limiting high sugar, salt and fat, and banning industrial transfats; restriction of food advertising particularly marketing of unhealthy foods to children, imposing tax on sugar sweetened drinks, junk food etc. Aimed at behavior change communication, mass-media campaigns, nutritional advice and nutrition education on NCDs in general and diet related NCDs in particular are thus recommended.


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