1
|
Neyazi N, Mosadeghrad AM, Tajvar M, Safi N. Governance of noncommunicable diseases in Afghanistan. Chronic Dis Transl Med 2024; 10:238-246. [PMID: 39027200 PMCID: PMC11252431 DOI: 10.1002/cdt3.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 07/20/2024] Open
Abstract
Background Noncommunicable diseases (NCDs) are the main reasons of mortality worldwide. One of every two person is dying due to NCDs in Afghanistan. International policy actors, mainly the World Health Organization (WHO), published several reports and declarations on controlling and preventing NCDs. This study aimed to provide a situation for governance of NCDs in Afghanistan and proper solutions for identified challenges. Methods We conducted qualitative research utilizing interpretive phenomenology. A self-developed questionnaire was developed to conduct the semi-structured interviews with 39 experts from Afghanistan. The results were analyzed using a deductive framework analysis. Six building block framework of health system developed by the WHO was used as predefined framework for this study. Results The governance building block of health system consists of five subthemes including policy making, planning, organizing, stewardship, and control. We identified main strengths, weaknesses, opportunities, and challenges for these subthemes. The experts also provided key recommendations to address the challenges. Conclusions Management of NCDs is a neglected part of the health system in Afghanistan. Strengthening evidence-based policy making with technical and indigenous planning, establishing responsive units with adequate financial and human resources within different ministries to address "health in all policies" concept, passing and implementing national laws and regulations to support national strategies for prevention and control of NCDs, and establishing decentralized monitoring systems to control the implementation of these strategies are the main recommendations of this study. Local government and international policy actors should invest and support the development of a multisectoral coordination system at national level for Afghanistan.
Collapse
Affiliation(s)
- Narges Neyazi
- International Campus, School of Public HealthTehran University of Medical SciencesTehranIran
- Department of Health System DevelopmentWorld Health OrganizationAfghanistan
| | - Ali M. Mosadeghrad
- Department of Health Management, Policy and Economics, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Maryam Tajvar
- Department of Health Management, Policy and Economics, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Najibullah Safi
- Department of Health System DevelopmentWorld Health OrganizationAfghanistan
| |
Collapse
|
2
|
Alruwaili BF, Bayyumi DF, Alruwaili OS, Alsadun RS, Alanazi AS, Hadi A, Alruwaili NKS, Thirunavukkarasu A, Aldaghmani NF, Alrayes AA. Prevalence and Determinants of Obesity and Overweight Among Children and Adolescents in the Middle East and North African Countries: An Updated Systematic Review. Diabetes Metab Syndr Obes 2024; 17:2095-2103. [PMID: 38799280 PMCID: PMC11127655 DOI: 10.2147/dmso.s458003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother's occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications.
Collapse
Affiliation(s)
- Bashayer Farhan Alruwaili
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Duaa Fahad Bayyumi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Ohud Saud Alruwaili
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Razan Saud Alsadun
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | | | - Amal Hadi
- Department of Family Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Nada Kareem S Alruwaili
- Department of Primary Healthcare, Ministry of Health, Aljouf Health Cluster, Sakaka, Saudi Arabia
| | | | | | | |
Collapse
|
3
|
Salam RA, Khan MH, Meerza SSA, Das JK, Lewis-Watts L, Bhutta ZA. An evidence gap map of interventions for noncommunicable diseases and risk factors among children and adolescents. Nat Med 2024; 30:290-301. [PMID: 38195753 DOI: 10.1038/s41591-023-02737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
Substance misuse, obesity, mental health conditions, type 1 diabetes, cancers, and cardiovascular and chronic respiratory diseases together account for 41% of disability-adjusted life years linked to noncommunicable diseases (NCDs) among children and adolescents worldwide. However, the evidence on risk factors and interventions for this age group is scarce. Here we searched four databases to generate an evidence gap map of existing interventions and research gaps for these risk factors and NCDs. We mapped 159 reviews with 2,611 primary studies; most (96.2%) were conducted in high-income countries, and only 100 studies (3.8%) were from low- and middle-income countries (LMICs). The efficacy of therapeutic interventions on biomarkers and adverse events for NCDs appears to be well evidenced. Interventions for mental health conditions appear to be moderately evidenced, while interventions for obesity and substance misuse appear to be moderate to very low evidenced. Priority areas for future research include evaluating digital health platforms to support primary NCD prevention and management, and evaluating the impact of policy changes on the prevalence of obesity and substance misuse. Our findings highlight the wide disparity of evidence between high-income countries and LMICs. There is an urgent need for increased, targeted financing to address the research gaps in LMICs.
Collapse
Affiliation(s)
- Rehana A Salam
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Maryam Hameed Khan
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Saqlain Ali Meerza
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Laura Lewis-Watts
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
| |
Collapse
|
4
|
Afshari M, Teymourlouy AA, Maleki M, Asadi-Lari M. Enhancing global health diplomacy for non-communicable diseases: application of the global health network framework. Global Health 2023; 19:41. [PMID: 37344896 DOI: 10.1186/s12992-023-00944-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 06/03/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND AND AIM Understanding the characteristics of global policy actors and the political context in which they address diplomatic issues in the field of NCDs can play an important role in advancing NCD-related goals. The purpose of this study was to identify and analyze the network of global health actors in the field of NCDs in Iran. METHODS This study was conducted in 2020 using a qualitative methodology and framework analysis. In-depth semi-structured interviews were conducted with subject-matter experts from all levels of diplomacy, including global, regional, and national, who had managerial, administrative, and academic experience. FINDINGS A total of 21 interviews were conducted with individuals who met the inclusion criteria. Following the framework of the World Health Network, the findings were divided into three general areas: the features of the network and the actors; the policy environment; and the characteristics of the issue. CONCLUSION A successful and sustainable program to combat NCDs requires the participation of multiple actors from governments, the private sector, and civil society at international, national, and local levels. The Global Network for Prevention and Control of NCDs should enhance the effectiveness of NCDs policies by highlighting the need to simultaneously improve the internal factors of the network, including relationships among the actors; external factors, including the policy environment; and the complex nature of NCDs.
Collapse
Affiliation(s)
- Mahnaz Afshari
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Boujnah H. Health diplomacy in Africa-opportunities post-COVID-19. Pan Afr Med J 2022; 43:91. [PMID: 36660083 PMCID: PMC9816880 DOI: 10.11604/pamj.2022.43.91.37003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/18/2022] [Indexed: 11/07/2022] Open
Abstract
For the last seventy years, Africa has suffered a disease burden that is steadily growing in scale and complexity. Despite that, health development in the continent has continued to rely on donors´ packages since decolonization. The last decade, however, has marked some health-related achievements on the continent such as the development of the Africa Health Strategy 2016-2030, the establishment of Africa Centres for Disease Control and Prevention (Africa CDC), the launch of The African Continental Free Trade Area (AfCFTA) and most recently the African Medicines Agency (AMA). These developments and the response to the COVID-19 pandemic have highlighted the importance and the opportunities of practicing Global Health Diplomacy on the continent. Home to 27% of the world´s countries, Africa has a tremendous global voting power which makes global health diplomacy an unequivocally effective soft power tool to achieve "The Africa we want". In this paper, we will expand on the importance of Global Health Diplomacy (GHD) practice in Africa as a soft power tool, illustrate the COVID-19 response in the continent championed by the Africa Centres for Disease Control and Prevention (Africa CDC) as a case study, and offer some recommendations to sustain and strengthen GHD´s role in the continent.
Collapse
Affiliation(s)
- Hiba Boujnah
- Africa Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia,Corresponding author: Hiba Boujnah, Africa Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia.
| |
Collapse
|
6
|
Asadi-Lari M, Ahmadi Teymourlouy A, Maleki M, Eslambolchi L, Afshari M. Challenges and opportunities for Iranian global health diplomacy: lessons learned from action for prevention and control of noncommunicable diseases. Health Res Policy Syst 2021; 19:152. [PMID: 34952614 PMCID: PMC8703215 DOI: 10.1186/s12961-021-00800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The 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. METHODS This 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. RESULTS The 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. CONCLUSIONS NCD 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.
Collapse
Affiliation(s)
- Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Eslambolchi
- Health Management and Economics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| |
Collapse
|