Prevention and control of non-communicable diseases: report of the Secretary-General

Non-communicable diseases represent a new frontier in the fight to improve global health. Worldwide, the increase in such diseases means that they are now responsible for more deaths than all other causes combined. Commonly known as chronic or lifestyle-related diseases, the main non-communicable diseases are cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. While the international community has focused on communicable diseases such as HIV/AIDS, malaria and tuberculosis, the four main non-communicable diseases have emerged relatively unnoticed in the developing world and are now becoming a global epidemic. However, such diseases could be significantly reduced and prevented, with millions of lives saved and untold suffering avoided, through proven and affordable measures, many of which are complementary to global health efforts already under way. The knowledge and technology to fight the onset and effects of non-communicable diseases already exist. It’s time to act to save future generations from the ...

Advocacy: the silence of Europe’s public health associations is deafening

National public health associations (PHAs) have a key role to play in advocating for effective, evidence-based policies (in both the public and private spheres) and practices that have positive impacts on population health and health equity. In some instances, PHAs are the only civil society voice for public health.

Implementation and clinical effectiveness of a community-based non-communicable disease treatment programme in rural Mexico: a difference-in-differences analysis

Non-communicable diseases (NCDs) account for the five largest contributors to burden of disease in Mexico, with diabetes representing the greatest contributor. However, evidence supporting chronic disease programmes in Mexico is limited, especially in rural communities. Compañeros En Salud (CES) partnered with the Secretariat of Health of Chiapas, Mexico to implement a novel community-based NCD treatment programme. This article describe the implementation of this programme and conducted a population-based, retrospective analysis, using a difference-in-differences regression approach to estimate the impact of the programme

Barriers to, and opportunities for, palliative care development in the Eastern Mediterranean Region

The 22 countries of WHO's Eastern Mediterranean Region are experiencing an increase in the burden of non-communicable diseases (NCDs), including cancer. Of the six WHO regions, the Eastern Mediterranean Region is projected to have the greatest increase in cancer incidence in the next 15 years. Furthermore, most cancers are diagnosed at a late stage, resulting in a lower cancer survival rate than in the European Region and the Region of the Americas. With increasing numbers of deaths from cancer, palliative care should be available to relieve suffering in patients with advanced disease and at the end of life. However, in the Eastern Mediterranean Region, the palliative care available is variable and inconsistent. Several barriers exist to the development and expansion of palliative care delivery in this region, including the absence of palliative care in national policies, little partnership working, insufficient palliative care education for health-care professionals and volunteers, poor ...

WHO European High-level Conference on Noncommunicable Diseases “Achieving Sustainable Development Goal targets in the WHO European Region through prevention and management of noncommunicable diseases over the life-course”

The year 2018 witnessed incredible global mobilization for the prevention and management of noncommunicable diseases (NCDs). Member States, WHO and partners expanded their commitments and the scope of their work to achieve ambitious targets. The third United Nations high-level meeting on NCDs and a series of high-level international meetings and conferences on the health system response to NCDs, primary health care, global mental health and air pollution will serve as context and background for the WHO European High-level Conference on Noncommunicable Diseases. The event will take place in Ashgabat, Turkmenistan, on 9–10 April 2019.

Non-communicable diseases in sub-Saharan Africa: a scoping review of large cohort studies

Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. The aim of this study was to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA.

Non-communicable diseases in sub-Saharan Africa: a scoping review of large cohort studies

Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. The aim of this study was to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA.

Evaluation of the primary care for chronic diseases in the high coverage context of the Family Health Strategy

This cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012 and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil.

Human-centered design as a guide to intervention planning for non communicable diseases: the BIGPIC study from Western Kenya

Non-communicable disease (NCD) care in Sub-Saharan Africa is challenging due to barriers including poverty and insufficient health system resources. Local culture and context can impact the success of interventions and should be integrated early in intervention design. Human-centered design (HCD) is a methodology that can be used to engage stakeholders in intervention design and evaluation to tailor-make interventions to meet their specific needs.

Context matters: a qualitative study of the practicalities and dilemmas of delivering integrated chronic care within primary and secondary care settings in a rural Malawian district

With the increasing double burden of communicable and non-communicable diseases (NCDs) in sub-Saharan Africa, health systems require new approaches to organise and deliver services for patients requiring long-term care. There is increasing recognition of the need to integrate health services, with evidence supporting integration of HIV and NCD services through the reorganisation of health system inputs, across system levels. This study investigates current practices of delivering and implementing integrated care for chronically-ill patients in rural Malawi, focusing on the primary level.

Integrating care for non-communicable diseases into routine HIV services: key considerations for policy design in sub-Saharan Africa

There is great interest for integrating care for non-communicable diseases (NCDs) into routine HIV services in sub-Saharan Africa (SSA) due to the steady rise of the number of people who are ageing with HIV. Suggested health system approaches for intervening on these comorbidities have mostly been normative, with little actionable guidance on implementation, and on the practical, economic and ethical considerations of favouring people living with HIV (PLHIV) versus targeting the general population.The authors summarize opportunities and challenges related to leveraging HIV treatment platforms to address NCDs among PLHIV. It is emphasized key considerations that can guide integrated care in SSA and point to possible interventions for implementation.

Evaluating Large-Scale Integrated Care Projects: The Development of a Protocol for a Mixed Methods Realist Evaluation Study in Belgium

The twelve Integrated Care Program pilot projects (ICPs) created by the government plan 'Integrated Care for Better Health' aim to achieve four outcome types (the Quadruple Aim) for people with chronic diseases in Belgium: improved population health, improved patient and provider experiences and improved cost efficiency. The aim of this article is to present the development of a mixed methods realist evaluation of this large-scale, whole system change programme.

Integrated health and care systems in England: can they help prevent disease?

The National Health Service (NHS) in England plans for the entire country to be covered by integrated care systems (ICSs) by April 2021. The aims of these local health and care partnerships are broad and include improving disease prevention and population health while maintaining NHS financial sustainability. Yet, the evidence for more integrated care leading to better disease prevention is weak.

Although nearly all of the 2016 sustainability and transformation partnership (STP) plans included a prevention or population health strategy, the content varied widely, often lacked detail, and had little on population-level interventions affecting the social determinants of health.

The 2019 STP and ICS 5-year strategic plans, and the roll out of ICSs across England by April 2021, provide an opportunity for local health and care services to work together more effectively to prevent disease and improve population health. In light of limited evidence on the relationship between integrated care ...

Leadership in integrated care networks: A literature review and opportunities for future research

This article reviews research on leadership in integrated care networks. It is timely as scholars and policy makers regard integrated care as a key part in reforming healthcare systems to cope with demographic aging, the rising prevalence of chronic diseases and the growing demand for long-term care.

In many countries, elderly patients with chronic conditions require a web of services delivered by several providers collaborating in inter-organisational networks. In view of their global importance, it is surprising how little we know how these networks are led. Like traditional organisations, networks require leadership to function effectively. This paper reviews central characteristics of leadership in integrated care networks and proposes opportunities for future research.

In this article, 73 studies published in the main academic journals are analyzed. This article consolidates the research on means, practices, activities and results of leadership, covering the levels of analysis of networks, policies and organizations.

Use of Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) for the screening of frailty and components of comprehensive geriatric assessment

Comprehensive geriatric assessment (CGA)—a key tool for geriatric medicine—is commonly used to assess older people’s health status and frailty. However, performing CGA in outpatient clinics is difficult because the assessment of cognition, activities of daily living (ADLs), depression, quality of life (QoL), nutrition, medications and social conditions is time consuming and requires the cooperation of medical staff. Frailty—an aspect of geriatric medicine that indicates the weakness of the body—is a critical measure of older adults’ physical function.

The Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) is a validated and simple rating scale, developed for the classification of setting glycemic targets based on cognition and ADL for older adults with diabetes mellitus. As cognitive function and ADL are key elements of frailty in a broad sense and in CGA, we examined whether the DASC-8 category is useful for the ...

Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine

Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in prevention and care. The aim of this study was to evaluate the effect of an interprofessional capacity building intervention carried out in Ukraine to improve the management non-communicable diseases in primary health care.

Prevalence of non-communicable chronic conditions, multimorbidity and its correlates among older adults in rural Nepal: a cross-sectional study

The population of older adults is increasing globally and is projected to increase to over 1.5 billion by 2050. A similar demographic transition is occurring in Nepal. While we celebrate longevity, health and quality of life are two crucial agendas for the older population. Older adults have a higher prevalence of non-communicable chronic conditions, and with longevity, the likelihood of experiencing more than one non-communicable chronic condition also increases.

This study’s objectives were to estimate the prevalence of major non-communicable conditions and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioural risk factors.

Nothing for us, without us: opportunities for meaningful engagement of people living with NCDs

People living with NCDs (PLWNCDs) are experts in their own right and if meaningfully engaged can be key partners and drivers in the co-creation, implementation and evaluation of NCD policies, programs, and services. 

This report is a result of the WHO Informal Consultation on PLWNCDs and outlines the participatory methods, main themes discussed and key next steps to further support meaningful engagement.

Treatment outcomes among adults with HIV/non-communicable disease multimorbidity attending integrated care clubs in Cape Town, South Africa

The growing burden of the HIV and non-communicable disease (NCD) syndemic in Sub- Saharan Africa has necessitated introduction of integrated models of care in order to leverage existing HIV care infrastructure for NCDs.

A mixed-method study on the provision of remote consultations for non-communicable disease patients during the first wave of the COVID-19 pandemic in Latvia: lessons for the future

he COVID-19 pandemic has challenged the ability of healthcare systems to ensure the continuity of health services for patients with non-communicable diseases (NCDs). The issue of remote consultations has emerged. Before the COVID-19 pandemic, remote consultations were not routinely provided or covered by public health funding in Latvia. This study aimed to describe the dynamics of consultations and the volume of remote consultations provided for patients with particular NCD and explore clinicians’ experiences of providing remote consultations during the first wave of the COVID-19 pandemic in Latvia.

The acceptability of integrated healthcare services for HIV and non-communicable diseases: experiences from patients and healthcare workers in Tanzania

In sub-Saharan Africa, the prevalence of non-communicable diseases (NCDs) has risen sharply amidst a high burden of communicable diseases. An integrated approach to HIV and NCD care offers the potential of strengthening disease control programmes. We used qualitative methods to explore patients’ and care-providers’ experiences and perspectives on the acceptability of integrated care for HIV-infection, diabetes mellitus (DM), and hypertension (HT) in Tanzania.