scholarly journals Noncommunicable diseases prevention in low- and middle-income countries: an overview of Health in All Policies (HiAP)

Author(s):  
Ndubuisi Ebele

NCD causes an estimated 35 million deaths annually and accounts for 60% of all deaths globally, 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 will be responsible for seven out of every ten deaths in LMIC, more than double the current trend today. NCD is no longer an emerging problem in developing countries, it is assuming an alarming dimension, and it's taking on the proportion of an epidemic. The known risk factors for significant NCDs is well documented. The critical risk factors are tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. To reverse the current trend that leads to an increase in poor dietary pattern, sedentary lifestyle, tobacco use, and harmful alcohol use- will requires policies that transcend the health sector and policy change in different areas such as finance, urban planning, education, agriculture, and transportation.

2019 ◽  
Author(s):  
Ndubuisi Ebele

NCD causes an estimated 35 million deaths annually and accounts for 60% of all deaths globally, 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 will be responsible for seven out of every ten deaths in LMIC, more than double the current trend today. NCD is no longer an emerging problem in developing countries, it is assuming an alarming dimension, and it's taking on the proportion of an epidemic. The known risk factors for significant NCDs are well documented. The critical risk factors are tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. To reverse the current trend that leads to an increase in poor dietary pattern, sedentary lifestyle, tobacco use, and harmful alcohol use- will require policies that transcend the health sector and policy change in different areas such as finance, urban planning, education, agriculture, and transportation.


2019 ◽  
Author(s):  
Ndubuisi Ebele

NCD causes an estimated 35 million deaths annually and accounts for 60% of all deaths globally, 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 will be responsible for seven out of every ten deaths in LMIC, more than double the current trend today. NCD is no longer an emerging problem in developing countries, it is assuming an alarming dimension, and it's taking on the proportion of an epidemic. The known risk factors for significant NCDs are well documented. The critical risk factors are tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. To reverse the current trend that leads to an increase in poor dietary pattern, sedentary lifestyle, tobacco use, and harmful alcohol use- will require policies that transcend the health sector and policy change in different areas such as finance, urban planning, education, agriculture, and transportation.


Author(s):  
Nweke Ebele Ndubuisi

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.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257385
Author(s):  
Gyambo Sithey ◽  
Li Ming Wen ◽  
Laigden Dzed ◽  
Mu Li

Background Bhutan is facing an epidemic of noncommunicable diseases; they are responsible for 53% of all deaths. Four main modifiable risk factors, including tobacco use, harmful use of alcohol, physical inactivity, and unhealthy diet, are the causes of most noncommunicable diseases (NCDs). This study aimed to assess 1) the prevalence of NCDs modifiable risk factors in Bhutan’s adult population and 2) associations between the sociodemographic factors and the NCDs modifiable risk factors with overweight or obesity, hypertension, and diabetes. Methods We used the 2014 Bhutan WHO Stepwise Approach to NCD Risk Factor Surveillance (STEPS) Survey dataset in this study. Data were analyzed using multiple logistic regressions, constructed with overweight or obesity, hypertension, and diabetes as outcome variables and modifiable risk factors as independent variables. Results The prevalence of tobacco use, harmful use of alcohol, unhealthy diet (low fruits and vegetables intake) and physically inactive was 24.8% (95% CI: 21.5, 28.5), 42.4% (95% CI: 39.4, 45.5), 66.9% (95% CI: 61.5, 71.8), and 6.2% (95% CI: 4.9, 7.8), respectively. The prevalence of overweight or obesity, hypertension and diabetes was 32.9% (95%CI: 30.0, 36.0), 35.7% (95% CI: 32.8, 38.7) and 6.4% (95% CI: 5.1, 7.9), respectively. Multiple logistic regression showed that older age groups were more likely to be overweight or obese, hypertensive, and diabetic. Our analysis also found that tobacco users were less likely to be overweight or obese (aOR 0.71, 95% CI 0.52, 0.96), and to be hypertensive (aOR 0.74, 95% CI 0.56, 0.97); but they were more likely to be diabetic (aOR 1.64, 95% CI 1.05, 2.56). Alcohol users were more likely to be hypertensive aOR 1.41 (95% CI 1.15, 1.74). Furthermore, vigorous physical activity could protect people from being overweight or obese, aOR 0.47 (95% CI 0.31, 0.70), and those consuming more than five serves of fruits and vegetables per day were more likely to be overweight or obese, aOR 1.46 (95% CI 1.17, 1.82). Conclusion The prevalence of NCDs modifiable risk factors and overweight or obesity and hypertension was high in Bhutan. We found strong associations between tobacco use and diabetes, alcohol use, hypertension, physically inactive, and overweight or obesity. The results suggest that the government should prioritize NCDs prevention and control programs, focusing on reducing modifiable risk factors. The health sector alone cannot address the NCDs epidemic in Bhutan, and we recommend the whole of government approach to tackle NCDs through the Bhutan Gross National Happiness framework.


Author(s):  
Jacqueline Pitchforth ◽  
Dougal Hargreaves

Four non-communicable diseases (NCDs): cardiovascular disease, cancer, diabetes, and chronic respiratory conditions, are responsible for 63% of deaths worldwide. Most of these deaths (86%) occur in low and middle-income countries, where the highest proportion of adolescents live. Four shared behavioural risk factors for NCDs (tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol) are usually acquired during adolescence and persist throughout life. For example, globally 100,000 young people start smoking each day and over 90% of adults who smoke started during childhood or adolescence. This chapter will explore each of these risk factors, the impact on adolescent health and what steps are being taken to address these problems, as well as the contribution of chronic disease to the NCDs.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 195s-195s
Author(s):  
P. Kipkorir

Background: Rationally, tobacco use is enemy number one among risk factors for noncommunicable diseases. It is a widely and broadly established cause of cancer and also responsible for cardiovascular and chronic respiratory diseases. It has been estimated that there are >1.3 billion smokers worldwide, with ∼80% residing in low- and middle-income countries. More than 10% of all deaths resulting from noncommunicable diseases including cancer, cardiovascular, chronic respiratory diseases and diabetes are related to tobacco and most of these occur in these low- and middle-income countries. In Kenya, >2.5 million of the population are adult smokers. Aim: Objectively, this abstract analyzed the price, tax and income elasticity effects on smoking intensities among the urban cigarette smokers for effective tobacco control in Kenya. Methods: The data used was sourced form the household and individual survey questionnaires from the Kenya Global Adult Tobacco Survey 2014. Double-hurdle model was used where the first part of the technique was to distinguish between the urban smokers and urban nonsmokers. The second part was to determine the smoking intensities among those who smoke and also to analyze the effect of price, tax and income elasticity on the individual consumption. Results: The study revealed that price of cigarette had a reducing (β = −2.2343) and very significant ( P < 0.001) elastic effect on smoking intensities among urban smokers while disposable income had a significant ( P < 0.010) but positive (β = −0.0366) inelastic effect on smoking levels of the urban cigarette smokers. Particularly, tax on cigarette has also been depicted to have a significant ( P < 0.001) yet positive and elastic (β = 1.7044) effect on smoking intensities on the urban cigarette smokers. Time spent in education has a significant ( P < 0.001) and negative (β = −3.2240) elastic effect on the smoking intensities of urban smokers. Notably, those who are married (β = −0.6320, P < 0.001) and employed (β = −0.5498, P < 0.010) have significant and negative though inelastic effect on their smoking intensities as compared with the unmarried and unemployed. Conclusion: Summarily, this implies that urban smokers have more income where the proportion spent on smoking is very small. Also, since tax is a function of income, it thus calls for the need to increase the rate of excise tax on cigarette so as to discourage consumption of cigarettes among the urban smokers and thus ultimately realizing and sustaining the health policy goals of reducing and averting the cancer risk factors. Furthermore, continuous use of cost-effective sensitization methods to create awareness and educate people on economic, social and health effects and impacts of tobacco use.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
A. Olalekan Uthman ◽  
Latifat Ibisomi

AbstractSeveral studies have documented the burden and risk factors associated with diarrhoea in low and middle-income countries (LMIC). To the best of our knowledge, the contextual and compositional factors associated with diarrhoea across LMIC were poorly operationalized, explored and understood in these studies. We investigated multilevel risk factors associated with diarrhoea among under-five children in LMIC. We analysed diarrhoea-related information of 796,150 under-five children (Level 1) nested within 63,378 neighbourhoods (Level 2) from 57 LMIC (Level 3) using the latest data from cross-sectional and nationally representative Demographic Health Survey conducted between 2010 and 2018. We used multivariable hierarchical Bayesian logistic regression models for data analysis. The overall prevalence of diarrhoea was 14.4% (95% confidence interval 14.2–14.7) ranging from 3.8% in Armenia to 31.4% in Yemen. The odds of diarrhoea was highest among male children, infants, having small birth weights, households in poorer wealth quintiles, children whose mothers had only primary education, and children who had no access to media. Children from neighbourhoods with high illiteracy [adjusted odds ratio (aOR) = 1.07, 95% credible interval (CrI) 1.04–1.10] rates were more likely to have diarrhoea. At the country-level, the odds of diarrhoea nearly doubled (aOR = 1.88, 95% CrI 1.23–2.83) and tripled (aOR = 2.66, 95% CrI 1.65–3.89) among children from countries with middle and lowest human development index respectively. Diarrhoea remains a major health challenge among under-five children in most LMIC. We identified diverse individual-level, community-level and national-level factors associated with the development of diarrhoea among under-five children in these countries and disentangled the associated contextual risk factors from the compositional risk factors. Our findings underscore the need to revitalize existing policies on child and maternal health and implement interventions to prevent diarrhoea at the individual-, community- and societal-levels. The current study showed how the drive to the attainment of SDGs 1, 2, 4, 6 and 10 will enhance the attainment of SDG 3.


Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.


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