Control Of Non-communicable Diseases Research Articles

Exploring the influence of health management processes on health outcomes among internally displaced persons (IDPs)

BackgroundDespite global action and policy initiatives, internally displaced persons (IDPs) experience poor living conditions and lack healthcare access compared to refugees. This study sought to understand the relationship between health management processes and health outcomes among camp-dwelling IDPs in northern Nigeria. Method73 individuals participated in either a focus group (n = 49) or one-to-one interview (n = 24), comprising IDPs (n = 49), camp managers (n = 9), health workers (n = 7) and government administrative authorities (n = 8). Interviews explored IDP health management processes, partners and perceptions around camp management. Data were analysed using an inductive thematic approach. ResultsFour main themes were identified: opinions about healthcare organisation and management, service availability, interventions and information management, and IDP health outcomes. Though many stakeholders, partnerships, and national and international government agencies were involved in the provision of healthcare services, respondents described efforts as disjointed. Reports suggested that the coordination and management of health services and resources were not tailored to the needs of those living in all camps. And because so many national and international agencies were involved, but under weak coordination, access to services was less than optimal and adequate management of critical public health interventions was lacking. Varied allocation of resources such as funding, medication and medically trained staff were viewed as key factors in the availability and the ability to access what was considered as essential healthcare services. ConclusionThe health of IDPs in camp-like settings was compromised by uncoordinated management, treatment, and control of communicable and non-communicable diseases. Government authorities need to be aware and consider the complexity of the multiagency involvement in the management and provision of IDP healthcare services. Introducing systems to streamline, monitor and support IDP healthcare management could be cost-effective strategies for achieving optimal health care.

Overcoming noncommunicable diseases during the coronavirus disease 2019 pandemic: update on noncommunicable disease control research through physical activity promotion for the 24th International Union for Health Promotion and Health Education World Conference

Overcoming noncommunicable diseases during the coronavirus disease 2019 pandemic: update on noncommunicable disease control research through physical activity promotion for the 24th International Union for Health Promotion and Health Education World Conference

Estilo de vida asociado al control de hipertensión arterial y diabetes mellitus en un centro de atención en Lima, durante la pandemia de COVID-19

Introduction: Hypertension and diabetes mellitus 2 are prevalent diseases. The COVID-19 pandemic has changed lifestyle and disease control, potentially triggering serious complications. Objectives: To determine the association between lifestyle and the control of chronic non-communicable diseases: arterial hypertension and diabetes mellitus 2 during the COVID-19 pandemic in patients of an Urgent Care Center. Materials and methods: Observational, cross-sectional, and analytical study. A sample of 158 patients, between 30 and 79 years old, was included. Control files and medical records were analyzed, anthropometric values ​​were measured, and lifestyle was evaluated through surveys. Results: 51.3% were male, an average of 61 years, 57.6% with married marital status, and 51.9% with higher educational level. In the multivariate analysis of patients with arterial hypertension, a significant association between the lack of control of the hypertensive disease and an unhealthy lifestyle is evidenced (PR = 2.538; p = 0.000; 95% CI = 1.608-4.006). On the other hand, the diabetic population obtained a significant association between the lack of control of type 2 diabetes mellitus with an unhealthy lifestyle (PR = 5.498; p = 0.013; 95% CI = 1.440-20.995), in addition to the prevalence of glycemic lack of control in patients with abnormal abdominal girth it was 1.6 times more than in people with normal abdominal girth (PR = 2.623; p = 0.038; 95% CI = 1.057-6.508). Conclusions: Lifestyle is significantly associated with the control of arterial hypertension and diabetes mellitus. There is a significant association between abdominal circumference and control of type 2 diabetes mellitus.

The European Food Regulatory Environment Index: a tool to monitor progress in implementing food environment policies.

BackgroundEvidence based health policy, such as that put forward in the European Food and Nutrition Action Plan 2015–2020 and the WHO Global Action Plan on the Prevention and Control of Noncommunicable Diseases, has a role in curbing the consumption of unhealthful foods and drink. We ask how countries are performing in the adoption of these policies and how the comprehensiveness of their food environment policies explains variations in consumption of unhealthful products across Europe.MethodsIn order to assess the state of policy adoption, we developed a composite indicator—the Food Regulatory Environment Index (FREI) for which we calculated unweighted and weighted formulations according to the strength of the evidence base. We used linear regression models to explain variations in the consumption of unhealthful products as well as variations in a composite indicator of obesogenic diets.ResultsOverall, wealthier countries in the Region perform better. The weighting of the constituent policies does not affect the rankings. We find negative associations between unweighted and weighted formulations of the Index and household consumption of sugary and carbonate drinks as well as with the composite indicator for obesogenic diets.ConclusionsThe main strength of this study is the comprehensiveness and comparability of the policy data across the relatively large number of countries covered. There is a negative association that is statistically significant, between all formulations of the FREI and the household consumption of sugary and carbonated drinks. There is also a negative association between some FREI formulations and obesogenic diets.

Lipid control in adult Chinese patients with type 2 diabetes: a retrospective analysis of time trends and geographic regional differences.

Lipid control in adult Chinese patients with type 2 diabetes: a retrospective analysis of time trends and geographic regional differences.

Data Resource Profile: China Chronic Disease and Risk Factor Surveillance (CCDRFS).

Reliable and timely information on chronic and non-communicable diseases (NCDs) and their risk factors are fundamental for informing the development, implementation and evaluation of NCDs-related health policy. The China Chronic Disease and Risk Factor Surveillance (CCDRFS) is series of ongoing periodical nationally representative cross-sectional surveys among Chinese adults on their chronic health conditions (e.g. hypertension, diabetes, dyslipidaemia, stroke, myocardial infarction, cancer and chronic obstructive pulmonary disease) and related risk factors (e.g. smoking, harmful drinking, physical inactivity and unbalanced diet). The CCDRFS is established and organized by the National Centre for Chronic and Noncommunicable Disease Control and Prevention (NCNCD), the Chinese Centre for Disease Control and Prevention (China CDC), incorporated into the national Disease Surveillance Points (DSPs) system. A DSP area covers one rural county or one urban district. The details of the DSPs system have been reported elsewhere.1,2 Since its establishment in 2004, the CCDRFS was incorporated into the DSPs system, using its surveillance point as the primary sampling unit (PSU) in a multistage sampling framework. At the time of writing this paper, six field surveys had been carried out in 2004 (79 DSPs), 2007 (161 DSPs), 2010 (161 DSPs), 2013 (298 DSPs), 2015 (298 DSPs) and 2018 (298 DSPs). Figure 1 shows the locations of the CCDRFS surveillance points before and after expansion.

Assessment of a Hotel-Based Protective Housing Program for Incidence of SARS-CoV-2 Infection and Management of Chronic Illness Among Persons Experiencing Homelessness

Persons experiencing homelessness (PEH) are at higher risk for SARS-CoV-2 infection and severe illness due to COVID-19 because of a limited ability to physically distance and a higher burden of underlying health conditions. To describe and assess a hotel-based protective housing intervention to reduce incidence of SARS-CoV-2 infection among PEH in Chicago, Illinois, with increased risk of severe illness due to COVID-19. This retrospective cohort study analyzed PEH who were provided protective housing in individual hotel rooms in downtown Chicago during the COVID-19 pandemic from April 2 through September 3, 2020. Participants were PEH at increased risk for severe COVID-19, defined as (1) aged at least 60 years regardless of health conditions, (2) aged at least 55 years with any underlying health condition posing increased risk, or (3) aged less than 55 years with any underlying health condition posing substantially increased risk (eg, HIV/AIDS). Participants were housed in individual hotel rooms to reduce the risk of SARS-CoV-2 infection; on-site health care workers provided daily symptom monitoring, regular SARS-CoV-2 testing, and care for chronic health conditions. Additional on-site services included treatment of mental health and substance use disorders and social services. The main outcome measured was SARS-CoV-2 incidence, with SARS-Cov2 infection defined as a positive upper respiratory specimen using any polymerase chain reaction diagnostic assay authorized for emergency use by the Food and Drug Administration. Secondary outcomes were blood pressure control, glycemic control as measured by hemoglobin A1c, and housing placements at departure. Of 259 participants from 16 homeless shelters in Chicago, 104 (40.2%) were aged at least 65 years, 190 (73.4%) were male, 185 (71.4%) were non-Hispanic Black, and 49 (18.9%) were non-Hispanic White. There was an observed reduction in SARS-CoV-2 incidence during the study period among the protective housing cohort (54.7 per 1000 people [95% CI, 22.4-87.1 per 1000 people]) compared with citywide rates for PEH residing in shelters (137.1 per 1000 people [95% CI, 125.1-149.1 per 1000 people]; P = .001). There was also an adjusted change in systolic blood pressure at a rate of -5.7 mm Hg (95% CI, -9.3 to -2.1 mm Hg) and hemoglobin A1c at a rate of -1.4% (95% CI, -2.4% to -0.4%) compared with baseline. More than half of participants (51% [n = 132]) departed from the intervention to housing of some kind (eg, supportive housing). This cohort study found that protective housing was associated with a reduction in SARS-CoV-2 infection among high-risk PEH during the first wave of the COVID-19 pandemic in Chicago. These findings suggest that with appropriate wraparound supports (ie, multisector services to address complex needs), such housing interventions may reduce the risk of SARS-CoV-2 infection, improve noncommunicable disease control, and provide a pathway to permanent housing.

Prices, Availability And Affordability Of Essential Medicines For Non-Communicable Diseases: A Facility Based Survey In District Abbotabad

Background: Non communicable diseases (NCDs) are spreading like an epidemic worldwide. Essential medicines are crucial for prevention and control of NCDs. World Health Organization (WHO) has set a benchmark of 80% availability of essential medicines in public and private facilities. Availability being a predictor of access to medicines is low in Low and Middle income countries (LMICs). The objective of this study is to determine price, availability and affordability of essential medicines for NCDs in District Abbottabad. Methods: This study was based on the standardized protocol provided by WHO and Health Action International (HAI) for determination of availability, prices and affordability of medicines. A total of 50 medicines for NCDs that were enlisted in Essential Medicine List of district Khyber Pakhtun Khawa were selected for the study. Twenty seven medicine dispensing facilities belonging to public, private and other basic health units (BHUs) (managed by PPHI) sectors were surveyed in the district. Simple random sampling was employed to select facilities. Results: The mean overall percentage availability of essential medicines for NCDs was 0.1% for original brand and 1.9% for low price generic in public sector. Overall availability was better in private and other sectors (32.9% for OB and 13.8% for LPGs and 5.3% for OB and 11.1% for LPG respectively). The prices in public procurement sector were competitive. The median price ratio (MPR) in public procurement sector was 0.56. Prices were higher comparatively in private sector with MPR 2.83. Most of the medicines require less than a day wage to buy 30 days treatment. Conclusions: The availability of essential medicines for NCDs was poor in District Abbottabad. None of the sectors reached the benchmark of 80% with regard to availability of medicines. LPGs were not frequently available in the private sector. However, prices were reasonable in public sector and acceptable in private sector. Medicines were found to be affordable but affordability may differ for people living below poverty line of US $1.

Community Health Workers (CHWs) to Improve Primary Health Care Services Delivery: A Case of Female Community Health Volunteers (FCHV) Program in Nepal

Community health workers (CHWs) have played a vital role in improving primary healthcare services in different parts of the world, in particular, for those services related to the prevention and control of communicable diseases, immunization services, reproductive health, maternal and child health, HIV/AIDS prevention and care and nutrition promotion. The Female Community Health Volunteers (FCHVs) program, which was introduced in 1988 in Nepal, has now reached over 51,000 FCHVs. They are key community level CHWs in Nepal and have contributed significantly in achieving several health and related outcomes and meeting several Millennium Development Goals. In such, there is also a potential and needs for engaging them to prevent and control emerging health challenges such as non-communicable diseases prevention and control and re-emerging health issues. Their effective involvement to ongoing health programs would be critical to achieving Sustainable Development Goals, agenda in particular “SDG 3 – Health and Wellbeing” by 2030.

Challenges and opportunities for Iranian global health diplomacy: lessons learned from action for prevention and control of noncommunicable diseases

BackgroundThe steady rise in noncommunicable diseases (NCDs) worldwide has been a key global health challenge. Governments have the primary responsibility for taking action to prevent and control NCDs. Given the growing importance of globalization of healthcare as well as the increasing use of soft power, governments need to identify challenges and opportunities to enhance global health diplomacy (GHD) for NCD prevention and control. The purpose of this qualitative research was to explain the challenges and opportunities of GHD for NCDs in Iran.MethodsThis study was conducted in 2020 using a qualitative approach and through in-depth, semi-structured interviews with 21 experts and specialists in related fields such as health policy, healthcare management, epidemiology and other related specialties. The participants were selected from all levels of diplomacy, including global, regional and national levels, with at least 3 years of experience in managerial, executive and scientific activities. Data analysis was performed by content analysis with an inductive approach. Data were analysed using inductive content analysis.ResultsThe identified challenges were categorized into five main themes, including content challenges, structural challenges, process challenges, governance challenges and cultural challenges. Opportunities extracted from the interviews were also categorized into four main themes, including strong political will, utilizing the capacity of nongovernmental organizations (NGOs), multisectoral collaborations and a well-developed health system.ConclusionsNCD prevention and control requires a multilateral collaboration-based solution. Recognition of the challenges and opportunities in GHD can help draw significant lessons for building the necessary capacities and implementing more effective policies to prevent and control NCDs.

Stakeholders perspectives and influences on fruits and vegetables consumption among adolescents with hearing impairment in selected secondary schools in Nigeria

Rationale: Consumption of fruit and vegetables (FV) is one of the most important strategies for prevention and control of Non-communicable diseases (NCD). Although adolescence is a very important stage in life evidences show inadequate FV intake among this age group and those with hearing impairment are disproportionately vulnerable. Therefore, understanding the perspectives of stakeholders in the care of adolescents with hearing impairment in selected secondary schools in Nigeria would contribute to finding appropriate strategy to improving FV consumption among them

Assessment of health-related quality of life among patients with non-communicable diseases

Non-communicable diseases (NCDs) are a global challenge towards diminishing quality of life. Health related quality of life (HRQoL) is a widely accepted measure of burden of disease for individuals with chronic conditions. Due to paucity of data in Western Rajasthan, India, this study was planned to assess the HRQoL due to NCDs in Jodhpur, India. A descriptive cross-sectional study was planned in government NCD center of Jodhpur. Convenience sampling was used to select 398 respondents and socio demographic data was collected. Short Form–36 (SF-36) questionnaire was used to measure perceived effects due to NCDs across eight domains of analyzed using descriptive and inferential statistics. High combined mean scores were obtained in domains of Social Functioning (77.87) and Mental Health (75.36%) and lowest scores for General Health (54.70%), Bodily Pain (60.06%) and Role Emotional (60.33%). Males recorded higher mean scores than females across all domains with high statistical significance for Bodily Pain, Vitality, Role Physical and Mental Health. Findings suggested worst and least affected domains of regular life functions due to NCDs. Greater focus on emotional distress, active inclusion of females in national health programmes and integration of NCD control program with Mental Health Program would aid to improve overall HRQoL in affected individuals.

Risk Factors’ estimation of Non Communicable Diseases in Al-Basrah Province/ Iraq During 2020-2021

Background: Non communicable diseases such as cardiovascular disease, cancers, diabetes, and respiratory diseases are the leading causes of morbidity and mortality worldwide. They share risk factors such as unhealthy diet, physical inactivity, smoking, and harmful alcohol use. The share of these risk factors raises the probability of developing non-communicable diseases. The aim of study to assess non communicable diseases risk factors in Al-Basrah province during 2020-2021. Methods: A cross sectional study was implemented among 250 respondents aged from 18 years and above according to random sampling method. Data was collected according to face -face interviews with those attended to different primary health care centers in Al-Basrah province from September 2020 to February 2021.Results: The study found 134(53.6%) respondents suffering from at least one of selected non communicable diseases due to higher increase in behavioral risk factors. The proportion of participants with unhealthy diet was 211(84.4%) while for overall salt intake was 207 (82.8%). the prevalence of a currently smoker was 60 (24%) among participants and higher in males than females while for a currently alcohol consumption the prevalence was 1 (0. 4%).the prevalence of physical inactivity was 176 (70.4%) and this percentage higher among females. The prevalence of overweight and obesity (BMI>25 kg/m2) was 35.6% and 38% and this proportion was higher among females than males.Conclusion: Non communicable diseases risk factors were alarming increases among population of Al-Basrah and this increase due to social transition and eating habits without any affective programs for prevention of these risk factors and control of non-communicable diseases.

Nourishing our future: the Lancet Series on adolescent nutrition

Adolescence is a time of phenomenal growth. During adolescence height velocity is second only to the first 2 years of life 1 Patton G Sawyer S Santelli J et al. Our future: a Lancet Commission on adolescent health and wellbeing. Lancet. 2016; 387: 2423-2478 Summary Full Text Full Text PDF PubMed Google Scholar , 2 Depauw E Oxley D Toddlers, teenagers, and terminal heights: the importance of puberty for male adult stature, Flanders, 1800–76. Econ Hist Rev. 2019; 72: 925-952 Crossref Scopus (10) Google Scholar and every physiological system is transformed. 3 Prentice AM Ward KA Goldberg GR et al. Critical windows for nutritional interventions against stunting. Am Clin Nutr. 2013; 97: 911-918 Crossref PubMed Scopus (276) Google Scholar Yet adolescent growth and nutrition have been overlooked in the UN Decade of Action on Nutrition (2016–25). The Sustainable Development Goals for nutrition include no adolescent-specific targets. 4 WHOGlobal targets 2025 to improve maternal, infant and young children nutrition. World Health Organization, Geneva2017 Google Scholar WHO's global action plan for the prevention and control of non-communicable diseases similarly had no clearly specified targets for overweight and obesity in older children or adolescents. 5 WHOGlobal action plan for the prevention and control of noncommunicable diseases 2013–2020. World Health Organization, Geneva2013 Google Scholar Donor investments in adolescent nutrition remain woefully inadequate. 6 Li ZH Li MQ Patton GC Lu CL Global development assistance for adolescent health from 2003 to 2015. JAMA Netw Open. 2018; 1e181072 Crossref PubMed Google Scholar Adolescent underweight and micronutrient deficiencies persist in many places as the world faces increases in adolescent overweight and obesity. From 1990 to 2016, the number of adolescents affected by overweight and obesity globally more than doubled to almost one in five while the absolute number of adolescents with anaemia increased by 20% to almost one in four. 7 Azzopardi PS Hearps SJ Francis KL et al. Progress in adolescent health and wellbeing: tracking 12 headline indicators for 195 countries and territories, 1990–2016. Lancet. 2019; 393: 101-118 Summary Full Text Full Text PDF Scopus (89) Google Scholar Nutrition in adolescent growth and developmentDuring adolescence, growth and development are transformative and have profound consequences on an individual's health in later life, as well as the health of any potential children. The current generation of adolescents is growing up at a time of unprecedented change in food environments, whereby nutritional problems of micronutrient deficiency and food insecurity persist, and overweight and obesity are burgeoning. In a context of pervasive policy neglect, research on nutrition during adolescence specifically has been underinvested, compared with such research in other age groups, which has inhibited the development of adolescent-responsive nutritional policies. Full-Text PDF Food choice in transition: adolescent autonomy, agency, and the food environmentDietary intake during adolescence sets the foundation for a healthy life, but adolescents are diverse in their dietary patterns and in factors that influence food choice. More evidence to understand the key diet-related issues and the meaning and context of food choices for adolescents is needed to increase the potential for impactful actions. The aim of this second Series paper is to elevate the importance given to adolescent dietary intake and food choice, bringing a developmental perspective to inform policy and programmatic actions to improve diets. Full-Text PDF Strategies and interventions for healthy adolescent growth, nutrition, and developmentAdolescence is a pivotal point in the life course, characterised by transformative physical, cognitive, and emotional growth, an openness to change, and a drive to reshape the social environment. It offers unique opportunities to adopt changes in diet and physical activity that can persist into later life. Yet pre-existing nutritional problems, including micronutrient deficiencies, food insecurity, and poor-quality diets, persist at the same time as adolescents face the rapid emergence of an obesity epidemic. Full-Text PDF

A new global policy framework for adolescent nutrition?

This new Lancet series on adolescent nutrition 1 Norris SA Frongillo EA Black MM et al. Nutrition in adolescent growth and development. Lancet. 2021; (published online Nov 29.)https://doi.org/10.1016/S0140-6736(21)01590-7 Summary Full Text Full Text PDF Google Scholar , 2 Neufeld LM Andrade EB Suleiman AB et al. Food choice in transition: adolescent autonomy, agency, and the food environment. Lancet. 2021; (published online Nov 29.)https://doi.org/10.1016/S0140-6736(21)01687-1 Summary Full Text Full Text PDF PubMed Google Scholar , 3 Hargreaves D Mates E Menon P et al. Strategies and interventions for healthy adolescent growth, nutrition, and development. Lancet. 2021; (published online Nov 29.)https://doi.org/10.1016/S0140-6736(21)01593-2 Summary Full Text Full Text PDF PubMed Google Scholar sets out the challenges and opportunities for addressing healthy adolescent nutrition and development. Adolescence is a time when the multiple faces of malnutrition clearly materialise, as exemplified by overweight adolescents who were stunted children, or obese children with micronutrient deficiencies. This is also a time of extreme plasticity of the body and of changing lifestyles and norms when unhealthy behaviours can be adopted or instead virtuous circles of healthy behaviours can be established. Nourishing our future: the Lancet Series on adolescent nutritionAdolescence is a time of phenomenal growth. During adolescence height velocity is second only to the first 2 years of life1,2 and every physiological system is transformed.3 Yet adolescent growth and nutrition have been overlooked in the UN Decade of Action on Nutrition (2016–25). The Sustainable Development Goals for nutrition include no adolescent-specific targets.4 WHO's global action plan for the prevention and control of non-communicable diseases similarly had no clearly specified targets for overweight and obesity in older children or adolescents. Full-Text PDF Nutrition in adolescent growth and developmentDuring adolescence, growth and development are transformative and have profound consequences on an individual's health in later life, as well as the health of any potential children. The current generation of adolescents is growing up at a time of unprecedented change in food environments, whereby nutritional problems of micronutrient deficiency and food insecurity persist, and overweight and obesity are burgeoning. In a context of pervasive policy neglect, research on nutrition during adolescence specifically has been underinvested, compared with such research in other age groups, which has inhibited the development of adolescent-responsive nutritional policies. Full-Text PDF Food choice in transition: adolescent autonomy, agency, and the food environmentDietary intake during adolescence sets the foundation for a healthy life, but adolescents are diverse in their dietary patterns and in factors that influence food choice. More evidence to understand the key diet-related issues and the meaning and context of food choices for adolescents is needed to increase the potential for impactful actions. The aim of this second Series paper is to elevate the importance given to adolescent dietary intake and food choice, bringing a developmental perspective to inform policy and programmatic actions to improve diets. Full-Text PDF Strategies and interventions for healthy adolescent growth, nutrition, and developmentAdolescence is a pivotal point in the life course, characterised by transformative physical, cognitive, and emotional growth, an openness to change, and a drive to reshape the social environment. It offers unique opportunities to adopt changes in diet and physical activity that can persist into later life. Yet pre-existing nutritional problems, including micronutrient deficiencies, food insecurity, and poor-quality diets, persist at the same time as adolescents face the rapid emergence of an obesity epidemic. Full-Text PDF

Childhood obesity on the rise during COVID-19: A request for global leaders to change the trajectory.

Childhood obesity has been rising in all world regions - 2019 estimates were that 158 million children aged 5-19 are living with obesity, of whom many live in LMICs1 . Yet there has been limited to no progress to halt the rise in more than 20 years and this number is projected to increase to 254 million by 20301 . NCD Child, a global multi-stakeholder coalition focused on the prevention and control of noncommunicable diseases (NCDs) in children, is concerned with the rising rates of obesity during childhood and its consequences.

Healthcare providers\u2019 perspectives on integrating NCDs into primary healthcare in Thailand: a mixed method study

BackgroundIn response to an increased health burden from non-communicable diseases (NCDs), primary health care (PHC) is effective platform to support NCDs prevention and control. This study aims to assess Thailand’s PHC capacity in providing NCDs services, identify enabling factors and challenges and provide policy recommendations for improvement.MethodsThis cross-sectional mixed-method study was conducted between October 2019 and May 2020. Two provinces, one rich and one poor, were randomly selected and then a city and rural district from each province were randomly selected. From these 4 sites in the 2 provinces, all 56 PHC centres responded to a self-administrative questionnaire survey on their capacities and practices related to NCDs. A total of 79 participants from Provincial and District Health Offices, provincial and district hospitals, and PHC centres who are involved with NCDs participated in focus group discussions or in-depth interviews.ResultsStrong health infrastructure, competent staff (however not with increased workload), essential medicines and secured budget boost PHC capacity to address NCDs prevention, control, case management, referral and rehabilitation. Community engagement through village health volunteers improves NCDs awareness, supports enrolment in screening and raises adherence to interventions. Village health volunteers, the crucial link between the health system and the community, are key in supporting health promotion and NCDs prevention and control. Collaboration between provincial and district hospitals in providing resources and technical support enhance the capacity of PHC centres to provide NCDs services. However, inconsistent national policy directions and uncertainty related to key performance indicators hamper progress in NCDs management at the operational level. The dynamic of urbanization and socialization, especially living in obesogenic environments, is one of the greatest challenges for dealing with NCDs.ConclusionPHC centres play a vital role in NCDs prevention and control. Adequate human and financial resources and policy guidance are required to improve PHC performance in managing NCDs. Implementing best buy measures at national level provides synergies for NCDS control at PHC level.

Opportunities and challenges of global health diplomacy for prevention and control of noncommunicable diseases: a systematic review

Background and aimThe growing globalization has changed the goals and methods of diplomacy. Due to the challenges and complexities of dealing with noncommunicable diseases (NCDs) at the national and international levels, policy makers require global health diplomacy (GHD) to achieve the goals of prevention and control of NCDs. The purpose of this systematic review was to identify the challenges and opportunities in GHD for NCDs.MethodsA systematic review of articles was conducted by searching MEDLINE via PubMed, Web of Science, Scopus, and Embase and by using Google and Google Scholar search engines. Additional articles were identified by reviewing reference lists and a number of special journals. The inclusion criteria include literature published in English from 2007 to 2020, and the exclusion criteria are literature published in any language other than English, absence of full text, dissertations, and duplicates. Overall, 32 articles met the requirements for inclusion in this review and were analyzed using content analysis in MAXQDA 10.FindingsThere are 32 published articles on GHD for NCDs. Identified challenges were classified into three levels: global (global health governance), national (Governance at the state level, health sector, and civil society), and industry. The progress on global health issues has created opportunities for the development of GHD for the prevention and control of NCDs. These opportunities were divided into three levels: international, national, and individual level.ConclusionVarious challenges at the global level, national level, and industry led to less engagement of policymakers in GHD for prevention and control of NCDs and, as a consequence, a less coordinated approach to address prevention and control of NCDs worldwide. So, there is a need for more efforts of collective action and negotiation for tackling NCDs. Policymakers and managers of the health system should increase the advocacy, building a coalition with civil society, use negotiation and diplomacy to engage with other sectors and organizations, manage industry conflicts, and leverage foreign policy to promote health and welfare.

Para-sectoral Collaboration for the Control and Prevention of Non-Communicable Diseases in the Islamic Republic of Iran: Structures, Policies and Achievements

Para-sectoral Collaboration for the Control and Prevention of Non-Communicable Diseases in the Islamic Republic of Iran: Structures, Policies and Achievements

Results of non-communicable diseases prevention and control program in Isfahan province

Results of non-communicable diseases prevention and control program in Isfahan province