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Saad RK, Alsouri R, Kruse MH, Kufoof L, Lobanov-Rostovsky S, Richter P, Khader Y. Addressing emerging public health threats: the Noncommunicable Disease Capacity Assessment and Planning (N-CAP) Process. Front Public Health 2024; 12:1384957. [PMID: 38903573 PMCID: PMC11188389 DOI: 10.3389/fpubh.2024.1384957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024] Open
Abstract
Background The global epidemic of noncommunicable diseases (NCDs) is increasing. Current assessments that monitor capacity to address NCDs are often externally led and do not facilitate country planning. The Noncommunicable Disease Capacity Assessment and Planning (N-CAP) Process assists ministries of health and other governmental and non-governmental stakeholders to assess, prioritize, and plan how to address NCDs and other public health threats. This paper describes the development of this tool. Materials and methods Driven by ministries of health, the N-CAP Process engages new and existing stakeholders in three activities: Stakeholder Mapping; Strengths, Weaknesses, Opportunities, and Threats Workshop; and N-CAP Workshop that uses Discussion Guides to lead in-depth assessment and planning. Standard Operating Procedures, a library of Discussion Guides based on common NCD themes, and an open-access e-learning course are available. Results The N-CAP Process outcome is a prioritized plan of how to improve the country's public health functions. Adaptations to the tool were made after piloting in Jordan and Iraq. Conclusion The N-CAP Process helps countries engage various stakeholders to identify gaps and create collaborative, country-specific strategies to effectively respond to NCDs, a leading public health threat. The pilots sparked interest from other countries and underscored its potential for broader implementation to combat the rising global burden of NCDs.
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Affiliation(s)
- Randa K. Saad
- Research and Policy, Center of Excellence for Applied Epidemiology, Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Ruba Alsouri
- Workforce Capacity, Center of Excellence for Applied Epidemiology, Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Meredith H. Kruse
- Global Public Health Systems, Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
- Alexton Inc., Springfield, VA, United States
| | - Lara Kufoof
- Project Management Office, Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Sophie Lobanov-Rostovsky
- Global Public Health Systems, Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Patricia Richter
- Global Public Health Systems, Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Yousef Khader
- Department of Community Medicine, Public Health, and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
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Johnson R, Carnalla M, Basto-Abreu A, Haw D, Morgenstern C, Doohan P, Forchini G, Hauck KD, Barrientos-Gutiérrez T. Promoting healthy populations as a pandemic preparedness strategy: a simulation study from Mexico. LANCET REGIONAL HEALTH. AMERICAS 2024; 30:100682. [PMID: 38332937 PMCID: PMC10850772 DOI: 10.1016/j.lana.2024.100682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 02/10/2024]
Abstract
Background The underlying health status of populations was a major determinant of the impact of the COVID-19 pandemic, particularly obesity prevalence. Mexico was one of the most severely affected countries during the COVID-19 pandemic and its obesity prevalence is among the highest in the world. It is unknown by how much the COVID-19 burden could have been reduced if systemic actions had been implemented to reduce excess weight in Mexico before the onset of the pandemic. Methods Using a dynamic epidemic model based on nationwide data, we compare actual deaths with those under hypothetical scenarios assuming a lower body mass index in the Mexican population, as observed historically. We also model the number of deaths that would have been averted due to earlier implementation of front-of-pack warning labels or due to increases in taxes on sugar-sweetened beverages and non-essential high-energy foods in Mexico. Findings We estimate that 52.5% (95% prediction interval (PI) 43.2, 61.6%) of COVID-19 deaths were attributable to obesity for adults aged 20-64 and 23.8% (95% PI 18.7, 29.1%) for those aged 65 and over. Had the population BMI distribution remained as it was in 2000, 2006, or 2012, COVID-19 deaths would have been reduced by an expected 20.6% (95% PI 16.9, 24.6%), 9.9% (95% PI 7.3, 12.9%), or 6.9% (95% PI 4.5, 9.5%), respectively. If the food-labelling intervention introduced in 2020 had been introduced in 2018, an expected 6.2% (95% PI 5.2, 7.3%) of COVID-19 deaths would have been averted. If taxes on sugar-sweetened beverages and high-energy foods had been doubled, trebled, or quadrupled in 2018, COVID-19 deaths would have been reduced by an expected 4.1% (95% PI 2.5, 5.7%), 7.9% (95% PI 4.9, 11.0%), or 11.6% (95% PI 7.3, 15.8%), respectively. Interpretation Public health interventions targeting underlying population health, including non-communicable chronic diseases, is a promising line of action for pandemic preparedness that should be included in all pandemic plans. Funding This study received funding from Bloomberg Philanthropies, awarded to Juan A. Rivera from the National Institute of Public Health; Community Jameel, the UK Medical Research Council (MRC), Kenneth C Griffin, and the World Health Organization.
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Affiliation(s)
- Rob Johnson
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
| | - Martha Carnalla
- Centro de Salud en Investigación Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Ana Basto-Abreu
- Centro de Salud en Investigación Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - David Haw
- Department of Mathematical Sciences and Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, UK
| | - Christian Morgenstern
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
| | - Patrick Doohan
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
| | - Giovanni Forchini
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
- USBE, Umeå Universitet, Umeå, Sweden
| | - Katharina D. Hauck
- MRC Centre for Global Infectious Disease Analysis & WHO Collaborating Centre for Infectious Disease Modelling, Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
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Kehlenbrink S, Jobanputra K, Reddy A, Boulle P, Gomber A, Nugent R, Varma V, Nakayama AT, Ellman T. Diabetes Care in Humanitarian Settings. Endocrinol Metab Clin North Am 2023; 52:603-615. [PMID: 37865476 DOI: 10.1016/j.ecl.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Despite the increasing prevalence of diabetes in populations experiencing humanitarian crisis, along with evidence that people living with diabetes are at higher risk for poor outcomes in a crisis, diabetes care is not routinely included in humanitarian health interventions. We here describe 4 factors that have contributed to the inequities and lack of diabetes inclusion in humanitarian programmes: (1) evolving paradigms in humanitarian health care, (2) complexities of diabetes service provision in humanitarian settings, (3) social and cultural challenges, and (4) lack of financing. We also outline opportunities and possible interventions to address these challenges and improve diabetes care among crisis-affected populations.
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Affiliation(s)
- Sylvia Kehlenbrink
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, 221 Longwood Avenue RFB-2, Boston, MA 02115, USA.
| | - Kiran Jobanputra
- Médecins Sans Frontières, Chancery Exchange, Lower Ground Floor, 10 Furnival Street, London EC4A 1AB, UK
| | - Amulya Reddy
- Médecins Sans Frontières, Chancery Exchange, Lower Ground Floor, 10 Furnival Street, London EC4A 1AB, UK
| | - Philippa Boulle
- Médecins Sans Frontières, Route de Ferney 140, Geneva 1202, Switzerland
| | - Apoorva Gomber
- Division of Global Health Equity, Brigham and Women's Hospital, Center for Integration Science, 75 Francis Street, Boston MA 02115, USA
| | - Rachel Nugent
- Department of Global Health, University of Washington, 3980 15th Avenue Northeast, Seattle, WA 98195, USA
| | - Vinod Varma
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin du Pommier 40, 1218 Grand-Saconnex, Geneva, Switzerland
| | - Anna T Nakayama
- International Alliance for Diabetes Action, 101 South Hanley Road, Suite 800, Saint Louis, MO 63105, USA
| | - Tom Ellman
- Médecins Sans Frontières, 9th Floor, Zurich House, 70 Fox Street, Marshalltown, Johannesburg 2001, South Africa
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Nguyen TNT, Nguyen TTT, Tran BQ, Pham CT, Perry KE, Haregu T, Oldenburg B, Kowal P. Putting non-communicable disease data to work in Vietnam: an investigation of community health surveillance capacity. BMC Public Health 2023; 23:321. [PMID: 36788519 PMCID: PMC9926709 DOI: 10.1186/s12889-023-14986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/04/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Despite the public health system's critical role in non-communicable disease (NCD) surveillance in Vietnam, limited evidence exists on the implementation of NCD surveillance activities within these systems and the need for capacity building across different system levels to meet expected NCD surveillance goals. This study aimed to evaluate the status of and describe factors affecting the implementation of NCD surveillance activities and to identify the NCD surveillance capacity building needs of the public health system in Vietnam. METHODS We used a mixed-methods approach in four provinces, conducting self-completed surveys of staff from six Preventive Medicine Institutes (PHI), 53 Centres for Disease Control (CDC) and 148 commune health stations (CHS), as well as 14 in-depth interviews and 22 focus group discussions at four PHI, four CDC, and eight district health centres and CHS. RESULTS Study findings highlighted that although Vietnam has a well-functioning NCD surveillance system, a number of quality issues related to NCD surveillance data were salient. Multifactorial reasons were identified for incomplete, unconfirmed, and inaccurate mortality data and current disease surveillance data. Data on NCD management and treatment were reported to be of better quality than data for screening, targeted treatment, and counselling communication. Main factors affected the effective implementation of NCD surveillance, namely lack of complete and specific guidelines for NCD surveillance, limitations in human resource capacity within NCD departments, and shortage of funding for NCD surveillance activities. CONCLUSION Study findings provide practical strategies for strengthening health system capacity for NCD surveillance through developing policies, guidelines, and standardised tools to guide NCD surveillance and a road map for integrated NCD surveillance, developing training packages and manuals for all levels of the health system, and conducting utilisation-focused surveillance training programs.
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Affiliation(s)
- Thu Nam T. Nguyen
- FHI 360 Vietnam Office, 17Th Floor, Capital Tower, 109 Tran Hung Dao Street, Hanoi, Vietnam
| | - Thi Tho T. Nguyen
- grid.419597.70000 0000 8955 7323Noncommunicable Disease Prevention and Control Department, National Institute of Hygiene and Epidemiology, 1 Yec Xanh Street, Hanoi, Vietnam
| | - Bao Quoc Tran
- grid.67122.30Noncommunicable Disease Prevention and Control Department, General Department of Preventive Medicine, Ministry of Health, 138 Giang Vo Street, Hanoi, Vietnam
| | - Cong Tuan Pham
- FHI 360 Vietnam Office, 17Th Floor, Capital Tower, 109 Tran Hung Dao Street, Hanoi, Vietnam
| | - Kelly E. Perry
- FHI 360, Asia Pacific Regional Office, 19Th Floor, Tower 3 Sindhorn Building 130-132 Wireless Road Kwaeng Lumpini, Khet Phatumwan, Bangkok, Thailand
| | - Tilahun Haregu
- grid.1051.50000 0000 9760 5620Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, Melbourne, Australia
| | - Brian Oldenburg
- grid.1051.50000 0000 9760 5620Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, Melbourne, Australia
| | - Paul Kowal
- International Health Transitions, Canberra, Australia ,grid.7132.70000 0000 9039 7662Research Institute for Health Sciences, Chiang Mai University, 239 Huay Kaew RdMueang Chiang Mai District, Chiang Mai, Tambon Su Thep, Thailand
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NCD Countdown 2030: efficient pathways and strategic investments to accelerate progress towards the Sustainable Development Goal target 3.4 in low-income and middle-income countries. Lancet 2022; 399:1266-1278. [PMID: 35339227 PMCID: PMC8947779 DOI: 10.1016/s0140-6736(21)02347-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/03/2021] [Accepted: 10/19/2021] [Indexed: 12/11/2022]
Abstract
Most countries have made little progress in achieving the Sustainable Development Goal (SDG) target 3.4, which calls for a reduction in premature mortality from non-communicable diseases (NCDs) by a third from 2015 to 2030. In this Health Policy paper, we synthesise the evidence related to interventions that can reduce premature mortality from the major NCDs over the next decade and that are feasible to implement in countries at all levels of income. Our recommendations are intended as generic guidance to help 123 low-income and middle-income countries meet SDG target 3.4; country-level applications require additional analyses and consideration of the local implementation and utilisation context. Protecting current investments and scaling up these interventions is especially crucial in the context of COVID-19-related health system disruptions. We show how cost-effectiveness data and other information can be used to define locally tailored packages of interventions to accelerate rates of decline in NCD mortality. Under realistic implementation constraints, most countries could achieve (or almost achieve) the NCD target using a combination of these interventions; the greatest gains would be for cardiovascular disease mortality. Implementing the most efficient package of interventions in each world region would require, on average, an additional US$18 billion annually over 2023-30; this investment could avert 39 million deaths and generate an average net economic benefit of $2·7 trillion, or $390 per capita. Although specific clinical intervention pathways would vary across countries and regions, policies to reduce behavioural risks, such as tobacco smoking, harmful use of alcohol, and excess sodium intake, would be relevant in nearly every country, accounting for nearly two-thirds of the health gains of any locally tailored NCD package. By 2030, ministries of health would need to contribute about 20% of their budgets to high-priority NCD interventions. Our report concludes with a discussion of financing and health system implementation considerations and reflections on the NCD agenda beyond the SDG target 3.4 and beyond the SDG period.
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Kostova DA, Moolenaar RL, Van Vliet G, Lasu A, Mahar M, Richter P. Strengthening Pandemic Preparedness Through Noncommunicable Disease Strategies. Prev Chronic Dis 2021; 18:E93. [PMID: 34672923 PMCID: PMC8588872 DOI: 10.5888/pcd18.210237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Deliana A Kostova
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30322.
| | - Ronald L Moolenaar
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
| | | | - Ally Lasu
- RTI International, Research Triangle Park, North Carolina
| | - Michael Mahar
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
| | - Patricia Richter
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
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