Control Of Non-communicable Diseases Research Articles

Interrelationship between noncommunicable diseases, COVID-19 and sociodemographic index in the economic community of West African States

Background: Noncommunicable diseases (NCD) increase COVID-19 morbidity and mortality. Objective: This study aimed to describe the interrelationship between NCD, COVID-19, and sociodemographic index (SDI) in the Economic Community of West African States (ECOWAS). Methods: We extracted data from the global burden of disease (GBD) estimates. The GBD was used to estimate variations in epidemiologic data sources, model predictions, and 95% corresponding uncertainty intervals (UIs) for disability-adjusted life years (DALY). COVID-19 data were extracted and collated from web-based repositories as of December 18, 2020. We assessed the strength of association between the number of COVID-19 cases per thousand population, COVID-19 deaths, case-fatality rate, SDI, and DALY due to NCD using Pearson's correlation test. The level of statistical significance wasP< 0.01. Results: Ghana's SDI of 0.56 and DALY% (95% UI) due to NCD of 40.66 (36.05–44.98) was the highest. Ghana had 177 COVID-19 cases/100,000 population while Niger has 11 cases/100,000 population as of December 18, 2020. Niger's SDI of 0.16 and DALY% (95% UI) due to NCD of 21.22 (16.72–25.6) were the minimum. We found a strong positive correlation between COVID-19 cases per thousand population and DALY due to NCD (r = 0.870,P<0.001, n = 15) and a strong positive correlation between SDI and DALY due to NCD (r = 0.647,P= 0.009, n = 15). Conclusion: Countries with higher SDI and DALY due to NCD experienced higher COVID-19 cases. NCD prevention and control should be promoted to reduce COVID-19–related mortality and morbidity in the ECOWAS.

Curbing the Rise of Noncommunicable Diseases in Uganda: Perspectives of Policy Actors.

Uganda faces a complex policy landscape as it simultaneously addresses infectious diseases and noncommunicable diseases (NCDs). The health system has been overwhelmed by the growing burden of NCDs across all socioeconomic strata. In this study, we sought to understand the policy context around NCDs in Uganda, the roles of actors both within and external to the government, and the factors shaping the development and implementation of NCD policies and programs in Uganda. We conducted in-depth interviews with 30 policy actors from the Ugandan Ministry of Health (MOH), nongovernmental organizations, and academia to understand the roles of different actors in the Ugandan NCD space, the programs and policy measures in discussion, and how to bridge any identified gaps. A thematic data analysis was conducted. All national actors viewed funding constraints as a critical barrier to developing and executing an NCD strategic plan and as a barrier to leading and coordinating NCD prevention and control efforts in Uganda. The crowding of nongovernment actors was found to fragment NCD efforts, particularly due to the weak implementation of a framework for action among NCD actors. Relatedly, limited recruitment of technical experts on NCDs within the MOH was viewed to further diminish the government's role in leading policy and program formulation and implementation. Though recent MOH efforts have aimed at addressing these concerns, some skepticism remains about the government's commitment to increase budgetary allocations for NCDs and to address the technical and human resources gaps needed to achieve NCD policy aims in Uganda. This study highlights the immediate need to mobilize more resources, reduce fragmented efforts in the NCD space, and prioritize investment in NCD prevention and management in Uganda.

COVID-19, conflict, and non-communicable diseases among refugees.

Non-communicable diseases (NCDs) are highly prevalent among refugees [1]. This is alarming, considering that many NCDs are key risk factors for severe COVID-19 infection, intersecting with migration-specific factors putting refugees at increased risk of infection and poor outcomes [2]. Prior to, during, and following migration, these populations are exposed to socioeconomic stressors including poor and overcrowded living conditions, limited access to water, sanitation, and hygiene (WASH) services, and linguistic, cultural, and legal barriers to accessing timely and appropriate care, negatively impacting on NCD development and control [2,3].

Bulaşıcı Olmayan Hastalıkların Takibinde Pandemi Etkisi

The first five diseases that make up the disease burden in the first quarter of the 21st century; cardiovascular diseases,cancers, mental illnesses, chronic airway diseases and diabetes. World Healthcare, which emerged in Wuhan city and spread rapidly all over the world, as of March 12, 2020. Covid 19, declared by its organization as a pandemic, is a serious threat to all people physically, spiritually and socially. Noncommunicable diseases (NCD), during the New Coronavirus Disease (COVID-19) It has become a situation that requires much attention. Numerous articles have been written opinions and has been shared on this subject. In this study, measures for the prevention and control of noncommunicable diseases are tried to draw attention to the importance of the period.

The Cuban Healthcare System: An Insight

All the countries in the world are struggling to improve their healthcare systems regardless of being rich or poor. Talking about Cuba, it represents an example of well-developed healthcare system and policies which is comparable to developed countries of the world. The success of Cuban healthcare system largely depends upon its strong primary health care system, proper immunization, robust public health policies, treating all the population classes equally providing them with free healthcare services. The control of infection spread and non-communicable diseases also contributes to the success of Cuban Healthcare system. We have discussed the Cuban health care system from start till the current situation and also, we performed SWOT analysis to bring the clearer depiction of the Cuban Healthcare System as it highlights the key internal and external issues which are further discussed in detail.

How do international bureaucrats affect policy outputs? Studying administrative influence strategies in international organizations

The article investigates how international public administrations, as corporate actors, influence policymaking within international organizations. Starting from a conception of international organizations as political-administrative systems, we theorize the strategies international bureaucrats may use to affect international organizations’ policies and the conditions under which these strategies vary. Building on a most-likely case design, we use process tracing to study two cases of bureaucratic influence: the influence of the secretariat of the World Health Organization on the “Global action plan for the prevention and control of noncommunicable diseases”; and the influence of the International Labour Office on the “Resolution concerning decent work in global supply chains”. We use interview material gathered from international public administration staff and stakeholders to illustrate varying influence strategies and the conditions under which these strategies are used. The study shows how and when international public administrations exert policy influence, and offers new opportunities to extend the generalizability of public administration theories. Points for practitioners International bureaucrats influence the outcomes of multilateral negotiations by means of their technical expertise and strategic involvement in the decision-making process. Their influence is primarily geared toward achieving organizational goals. However, the perception of too much influence can threaten the implementation of a decision. Political leadership needs to find the right balance between encouraging entrepreneurial behavior and providing sufficient political steering. Civil servants themselves need a well-functioning political radar to sense how far they can push with their ambitions.

Health Seeking Behavior Among Adults and Elderly With Chronic Health Condition(s) in Albania.

Aim: Assess the use of different health care service providers by adults (aged 18–59) and elderly (aged > =60) who suffer from non-communicable disease (NCD) and explore relationships between sociodemographic variables and care-seeking behaviors.Methods: A cross-sectional survey was conducted in the districts of Diber and Fier in December 2018, using random cluster sampling. Descriptive statistics were used to compare the care-seeking behaviors of adults and elderly people. We employed binary and multinomial logistic regression to assess factors associated with the type of health service provider used. Analyses were adjusted for clustering within districts of residence.Results: Out of 3,799 respondents, 1,116 (29.4%) suffered from an NCD. Of these, 95% sought to obtain care for their chronic condition through public healthcare providers. The elderly were more likely to use primary healthcare services (PHC) to initiate care when facing health problems (56%), compared to those aged 18–59 years (49%, p < 0,001). Over the last 8 weeks, 82% (914/1,116) of participants sought care. Binary and multinomial logistic regression analyses, adjusted for socio-demographic variables, showed that the elderly were more likely to choose PHC services (OR 1.56; 95% CI: 1.04; 2.35). Moreover, individuals who suffered from hypertension used PHC services more frequently than hospitals (OR 1.94; 95% CI: 1.32; 2.85). A positive association was found between living in an urban area and seeking care for NCDs at polyclinics (OR 10.1; 95% CI: 2.1; 50.1). There was no significant gender difference observed with regard to the type of provider consulted.Conclusion: Public facilities were reported as the main providers for initiating care and the main providers used in the 8 weeks prior to the interview. While a majority of elderly people visited a PHC to initiate treatment (and follow up) on their chronic conditions, a substantial proportion of adults (aged 18–59) initiated and sought regular NCD care at a hospital. Educating patients and caregivers on active participation in NCD prevention, management, and control through the PHC level should be a long-term effort, along with the establishment of well-structured referral mechanisms and integrated care systems.

Health Promoting Schools in Germany. Mapping the Implementation of Holistic Strategies to Tackle NCDs and Promote Health.

Noncommunicable diseases (NCDs) and their underlying risk factors are seen as major public health problems that threaten health and welfare systems worldwide. The holistic and resource oriented Health Promoting School (HPS) approach can serve as an appropriate framework for the prevention and control of NCDs. The paper aimed to map the implementation of HPS activities in German schools and to examine associations with potential influencing factors. A series of cross-sectional online studies including five federal states and 5006 school principals (40.2% males, 50.8% females) from primary and secondary public schools was conducted from 2013 to 2018. Principal component analysis (PCA) resulted in two factors of HPS implementation (F1: concrete HPS action, F2: capacity building for HPS). Comparing both factors, a lower implementation level could be identified for HPS capacity building with lowest mean values found for regular teacher training and intersectoral collaboration. Multiple binary regression analyses revealed significant associations between low HPS implementation and male gender (OR: 1.36 to 1.42), younger age (OR: 1.47 to 1.90), secondary school (OR: 1.78 to 3.13) and federal state (Lower Saxony = OR: 1.27 to 1.45; Schleswig-Holstein = OR: 1.95 to 2.46). Moreover, low access to resources, decision-latitude and perceived educational benefits were independently associated with both factors of HPS implementation. Based on the results of this study, there is a need to support schools in their capacity building for health (e.g., regular teacher training, cooperation with local health services). Moreover, considering the core mission of schools, more evidence of the educational impact of health promotion and its translation into the language of education is needed for secondary schools in particular.

Prevalence of non-communicable disease risk factors among nurses and para-health professionals working at primary healthcare level of Bangladesh: a cross-sectional study

ObjectiveTo determine the prevalence of non-communicable disease (NCD) risk factors among nurses and para-health professionals (PHPs) working at primary healthcare centres in Bangladesh. In addition to this, we also investigated...

Exploring health literacy needs in Chronic obstructive pulmonary disease (COPD): Associations between demographic, clinical variables, psychological well-being and health literacy

BackgroundThe World Health Organization (WHO) points to health literacy as an important factor in prevention and control of non-communicable diseases (NCDs), including COPD. ObjectiveTo investigate associations between selected demographic and clinical variables, psychological well-being and health literacy. MethodsHealth literacy was measured using the nine domain Health Literacy Questionnaire (HLQ) and one domain from the eHealth Literacy Questionnaire (eHLQ). Using data from a cross-sectional sample of 158 people with COPD, recruited from a hospital-based patient list period (2014-2016), multiple regression analyses were performed. ResultsThe strongest associated variables with health literacy were psychological well-being, measured by the WHO-5 well-being index and education, indicating that higher psychological well-being and educational level are associated with higher levels of health literacy. ConclusionThe present study highlights the importance of specifically looking to psychological factors in determining potentially health literacy needs among people with COPD.

Rate of achievement of therapeutic outcomes and factors associated with control of non-communicable diseases in rural east Malaysia: implications for policy and practice

Non-communicable diseases (NCDs) are an increasing problem worldwide, including in Malaysia. National surveys have been performed by the government but had poor coverage in east Malaysia, particularly in rural regions. This study aimed to describe the achievement of target therapeutic outcomes in the control of diabetes mellitus (DM), hypertension (HPT), and dyslipidemia (DLP) among diabetic patients in rural east Malaysia. A cross-sectional study was conducted among DM patients who visited the NCDs clinic in Lundu Hospital, Sarawak, Malaysia, from Jan to March 2016. In total, 214 patients (male, 37.9%; female, 62.1%) were recruited using a systemic sampling method. Multiple logistic regression models were applied to estimate the adjusted odds ratio (AOR) and confidence interval (CI) for the target therapeutic achievement in the control of DM, HPT, and DLP. Compared to the national average, therapeutic target achievement in Lundu was higher for DM (43.0% vs. 23.8%), equal for DLP (35.8% vs. 37.8%) but lower for HPT (30.9% vs. 47.9%). DM patients who had at least yearly HbA1c monitoring (AOR 2.30, 95% CI 1.04–5.06, P = 0.039), and those 58.7 years or older (AOR 2.50, 95% CI 1.32–4.74, P = 0.005) were more likely to achieve the therapeutic target for DM. Health promotion and public education regarding HPT needs to be emphasized in rural Malaysia. HbA1c monitoring at least once a year was one of the important factors associated with achieving DM control in rural east Malaysia. Accessibility to HbA1c tests and monitoring should be ensured for diabetic patients.

Climate effects on health in Small Islands Developing States

Climate effects on health in Small Islands Developing States

Leveraging role of non-physician health workers in prevention and control of non-communicable diseases in India: Enablers and challenges.

Due to upsurge of non-communicable disease (NCD) burden, there is accentuated emphasis on task sharing and shifting NCDs-related health care delivery to non-physician healthcare workers especially nursing personnel and grass root level health professionals. This narrative review summates role of non-physician health workers, highlights various enablers and challenges while engaging them in delivery of NCD services so as to prevent and control various NCDs in India. Pubmed, Google scholar databases were searched using various keywords and Mesh terminologies. In addition, reference lists of selected articles were also screened. It is concluded that with regular update of knowledge, training, and supervision, these workers can efficiently deliver promotive, preventive, curative, and rehabilitative NCD-related healthcare services to needy. While engagement of this workforce in NCDs mitigation is a transforming concept, it also has its own challenges and issues which need to be explored and addressed in order to utilize this human resource to their maximum potential.

Profile of risk factors for Non-Communicable Diseases (NCDs) in a highly urbanized district of India: Findings from Puducherry district-wide STEPS Survey, 2019-20.

Rapid urbanization and industrialization drives the rising burden of Non-Communicable Diseases (NCDs) worldwide that are characterized by uptake of unhealthy lifestyle such as tobacco and alcohol use, physical inactivity and unhealthy diet. In India, the prevalence of various NCDs and its risk factors shows wide variations across geographic regions necessitating region-specific evidence for population-based prevention and control of NCDs. To estimate the prevalence of behavioral and biological risk factors of NCDs among adult population (18-69 years) in the Puducherry district located in Southern part of India. We surveyed adults using the World Health Organization (WHO) prescribed STEPwise approach to NCD surveillance (STEPS) during February 2019 to February 2020. A total of 2560 individuals were selected from urban and rural areas (50 clusters in each) through multi-stage cluster random sampling method. STEPS instrument was used to assess behavioral and physical measurements. Fasting blood sample was collected to estimate biochemical risk factors (Diabetes, Hypercholesterolemia) of NCDs. Among men, alcohol use 40.4% (95% CI: 37.4-43.4) was almost twice higher compared to tobacco use 24.4% (95% CI: 21.7-26.9). Nearly half of the population was physically inactive 45.8% (95% CI: 43.8-47.8) and obese 46.1% (95% CI: 44-48.1). Hypertension and diabetes mellitus were present among one-third 33.6% (95% CI: 31.6-35.5) and one-fourth 26.7% (95% CI: 24.1-29.1) of the population which were significantly higher among men (37.1% vs 30.8% and 31.6% vs 23.2% respectively). Physical inactivity and overweight/obesity increased with increasing education levels. Tobacco and alcohol use was more common among men, whereas physical inactivity with obesity and hypercholesterolemia was higher among women. We found high prevalence of various NCDs and its risk factors among the adult population of Puducherry district.

Dynamics of non-communicable disease prevention, diagnosis and control in Lebanon, a fragile setting

BackgroundNon-communicable diseases (NCD) present an increasing global health challenge, particularly for settings affected by fragility where access to care may be disrupted, and where high-quality continuous care delivery is difficult to achieve. This study documents the complex dynamics of NCD prevention and management in the fragile setting of rural Beqaa, Lebanon.MethodsParticipatory system dynamics methods were used, including 30 semi-structured interviews and three Group Model Building (GMB) workshops. Participants included health care providers offering NCD care, and Lebanese host- and Syrian refugees community members affected by NCDs.ResultsParticipants across all groups articulated a shared complex understanding of both the structural and direct determinants behind NCD onset. Lebanese and Syrian community members further identified several barriers to health seeking, including restrictions in health coverage, limited availability of services in the Beqaa and perceptions of poor-quality care. Health providers and community members described a health system overtly focused on disease control and overwhelmed by delivery of care to people living with NCD across both communities.ConclusionParticipants across all groups agreed on the need for health promotion and primary prevention activities and identified priority interventions in these areas.

Noncommunicable disease control: Clinicians and health policy makers.

Noncommunicable disease control: Clinicians and health policy makers.

Community health workers\u2019 involvement in the prevention and control of non-communicable diseases in Wakiso District, Uganda

BackgroundCommunity health workers (CHWs) are an important cadre of the global health workforce as they are involved in providing health services at the community level. However, evidence on the role of CHWs in delivering interventions for non-communicable diseases (NCDs) in Uganda is limited. This study, therefore, assessed the involvement of CHWs in the prevention and control of NCDs in Wakiso District, Uganda with a focus on their knowledge, attitudes and practices, as well as community perceptions.MethodsA cross-sectional study using mixed methods was conducted which involved a structured questionnaire among 485 CHWs, and 6 focus group discussions (FGDs) among community members. The study assessed knowledge, perceptions including the importance of the various risk factors, and the current involvement of CHWs in NCDs, including the challenges they faced. Quantitative data were analysed in STATA version 13.0 while thematic analysis was used for the qualitative data.ResultsThe majority of CHWs (75.3%) correctly defined what NCDs are. Among CHWs who knew examples of NCDs (87.4%), the majority mentioned high blood pressure (77.1%), diabetes (73.4%) and cancer (63.0%). Many CHWs said that healthy diet (86.2%), physical activity (77.7%), avoiding smoking/tobacco use (70.9%), and limiting alcohol consumption (63.7%) were very important to prevent NCDs. Although more than half of the CHWs (63.1%) reported being involved in NCDs activities, only 20.9 and 20.6% had participated in community mobilisation and referral of patients respectively. The majority of CHWs (80.1%) who were involved in NCDs prevention and control reported challenges including inadequate knowledge (58.4%), lack of training (37.6%), and negative community perception towards NCDs (35.1%). From the FGDs, community members were concerned that CHWs did not have enough training on NCDs hence lacked enough information. Therefore, the community did not have much confidence in them regarding NCDs, hence rarely consulted them concerning these diseases.ConclusionsDespite CHWs having some knowledge on NCDs and their risk factors, their involvement in the prevention and control of the diseases was low. Through enhanced training and community engagement, CHWs can contribute to the prevention and control of NCDs, including health education and community mobilisation.

Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study

BackgroundThe increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh.MethodsWe used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders’ consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n = 4); key informant interviews with central level health policymakers/ managers (n = 15) and focus group discussions with CHWs (4 FGDs; total n = 29). Participants in a stakeholder consultative meeting included members from the government (n = 4), non-government organisations (n = 2), private sector (n = 1) and universities (n = 2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses.ResultsThe CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation.ConclusionEngaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.

Efficiency and productivity of health systems in prevention and control of non-communicable diseases in China, 2008-2015.

This article examines the health system performance impact of China's new round of healthcare reform adopted in 2009. Specifically, we evaluated productivity and efficiency of health production pre- and post-reform period, compared the effects across all the 31 provinces of mainland China and identified potential determinants. As a major source of disability and premature mortality in China, non-communicable diseases (NCDs) had been the focus of our analysis, and the period during 2008-2015 was considered to allow enough time for the policy to have meaningful impact on the country's health system. Productivity and efficiency performance were analyzed using a bootstrapping data envelopment analysis (DEA) and the Malmquist productivity index (MPI) techniques, while a Tobit regression technique was used to identify determinants of inefficiency. We find that after the reform efficiency and productivity had declined across large number of provinces. Mean overall technical efficiency (OTE) post 2009 was about 30% lower than the potential maximum capacity, while productivity also fell at a rate of 7.57% per annum. Trends in productivity and efficiency performance were largely linked to patterns of scale of technological change observed during the study period. The findings suggest that efficiency and productivity can be improved through enhancing financial security, optimizing health resource allocation, particularly between human resources for health and hospital beds, and expanding cost-effective technology within the health sector. Better urban planning practices and investment in education were also found to contribute to improved efficiency of NCDs services.

An analysis of Sri Lankan government policies for prevention and control of non-communicable diseases and its risk factors

Non-communicable diseases (NCDs) are the leading causes of mortality, morbidity, and disability in Sri Lanka. The Government of Sri Lanka is committed to address the NCD burden of the country. This report presents an analysis of the Sri Lankan government policies of health sector as well as all other related sectors in relation to prevention and control of NCD and its risk factors in the country. Collection of policies and selection, the relevant policies to be included in the analysis were based on a systematic approach and the analysis was based on a framework which included aspects of prevention and control of NCD/NCD risk factors that are supported by the policy; and the main policy directives/strategies proposed. The selected policies were also mapped against the four strategic areas of the multisectoral action plan for the prevention and control of NCD of Sri Lanka. The analysis showed that a great majority of health and non-health policies have explicitly specified its support to the relevant areas of NCD or NCD risk factor prevention or control. The main aspects that were not explicitly specified by the health sector policies were prevention and control of psychological stress, obtaining the support of media in inculcating healthy lifestyles and targeted interventions to the marginalized or vulnerable population groups and people with special needs. Almost all the policy documents analyzed were well aligned with the four strategic action areas of the National Multisectoral Action Plan for the prevention and control of NCD 2016–2020. The Government of Sri Lanka has adequate health and non-health policy support to prevent and control NCD and NCD risk factors.