Population-level interventions targeting risk factors of diabetes and hypertension in South Africa: a document review

Jeannine Uwimana-Nicol,Taryn Young,Lynn Hendricks

doi:10.1186/s12889-021-11910-6

Abstract

BackgroundSouth Africa bears an increasing burden of non-communicable diseases (NCDs), particularly diabetes, cardiovascular diseases, and cancer. The objective of this study was to identify which population-level interventions, implemented at the level of governmental or political jurisdictions only, targeting risk factors of diabetes and hypertension were included in policies in South Africa. We also looked at whether these have been implemented or not.MethodsA review of relevant reports, journal articles, and policy documents was conducted. Documentation from government reports that contains information regarding the planning, implementation and evaluation of population-level interventions targeting diabetes and hypertension were considered, and various databases were searched. The identified population-level interventions were categorized as supportive policies, supportive programs and enabling environments according to the major risk factors of NCDs i.e., tobacco use, harmful consumption of alcohol, unhealthy diet/nutrition and physical inactivity, in accordance with the WHO ‘Best buys’. A content document analysis was conducted.ResultsThe source documents reviewed included Acts and laws, regulations, policy documents, strategic plans, case studies, government reports and editorials. South Africa has a plethora of policies and regulations targeting major risk factors for diabetes and hypertension implemented in line with WHO ‘Best buys’ since 1990. A total of 28 policies, legislations, strategic plans, and regulations were identified - 8 on tobacco use; 7 on harmful consumption of alcohol; 8 on unhealthy diet and 5 on physical inactivity - as well as 12 case studies, government reports and editorials. There is good progress in policy formulation in line with the ‘Best buys’. However, there are some gaps in the implementation of these policies and programs.ConclusionCurbing the rising burden of NCDs requires comprehensive strategies which include population-level interventions targeting risk factors for diabetes and hypertension and effective implementation with robust evaluation to identify successes and ways to overcome challenges.

Highlights

South Africa bears an increasing burden of non-communicable diseases (NCDs), diabetes, cardiovascular diseases, and cancer
We looked at whether current population-level interventions targeting NCDs with specific emphasis on diabetes and hypertension are in line with the recommended World Health Organisation (WHO) ‘Best buys’, and their implementation process
Documents reviewed included 28 policies, legislations, strategic plans, and regulations (Table 1) and 14 case studies, government reports and editorials (Table 2). These were grouped into two categories namely Supportive Policy interventions; and Supportive Programs and Enabling environments given that the interventions related to ‘Enabling environments’ were few and linked to programs

Summary

Introduction

South Africa bears an increasing burden of non-communicable diseases (NCDs), diabetes, cardiovascular diseases, and cancer. According to the recent report from the World Health Organisation (WHO), non-communicable diseases (NCDs) are increasing globally and are the leading cause of premature deaths with an estimation of 41 million people dying from cardiovascular diseases, cancer, diabetes among other NCDs globally [1]. The burden of deaths and prolonged disability related to NCDs has a considerable economic impact on households, industries, and societies through healthcare related cost and via losses in income, productivity, and human capital [7]. To curtail such human and economic losses, specific interventions must be implemented to effectively tackle NCDs and their underlying risk factors

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