Implementation of Policies and Strategies for Control of Noncommunicable Diseases in Malawi

Lupafya, Phindile Chitsulo; Mwagomba, Beatrice L. Matanje; Hosig, Kathy; Maseko, Lucy M.; Chimbali, Henry

doi:10.1177/1090198115614313

Cited by 38 publications

(44 citation statements)

References 8 publications

(15 reference statements)

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“…Finally, Similar to other experience, we suggest integration of NCDs’ prevention and control in primary health care, enforce appropriate interventions led by provincial committee, technical use of existing infrastructure and human resources, innovative resource mobilization such as funding through nongovernmental resource, provide progress monitoring system and ensure accountability from the involved sectors, and actions to accelerate progress [20, 36, 45]. …”

Section: Resultssupporting

confidence: 63%

National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic

Peykari

Hashemi

Dinarvand

et al. 2017

J Diabetes Metab Disord

155

151

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Emerging Non-communicable diseases burden move United Nation to call for 25% reduction by 2025 in premature mortality from non-communicable diseases (NCDs). The World Health Organization (WHO) developed global action plan for prevention and control NCDs, but the countries’ contexts, priorities, and health care system might be different. Therefore, WHO expects from countries to meet national commitments to achieve the 25 by 25 goal through adapted targets and action plan.In this regards, sustainable high-level political statement plays a key role in rules and regulation support, and multi-sectoral collaborations to NCDs’ prevention and control by considering the sustainable development goals and universal health coverage factors.Therefore, Iran established the national authority’s structure as Iranian Non Communicable Diseases Committee (INCDC) and developed NCDs’ national action plan through multi-sectoral approach and collaboration researchers and policy makers. Translation Iran’s expertise could be benefit to mobilizing leadership in other countries for practical action to save the millions of peoples.

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Section: Resultssupporting

confidence: 63%

National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic

Peykari

Hashemi

Dinarvand

et al. 2017

J Diabetes Metab Disord

155

151

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“…Studies predominantly focus on particular aspects of the health system. These include, for example, gaps in staff training to manage NCDs [21]; incomplete NCD burden data [3], low knowledge and awareness of NCD burdens, drivers and impact, and non-availability of relatively inexpensive NCD medications in public sector facilities [22]; patients' knowledge gaps regarding the preventable aspects of hypertension and diabetes and mistrust in the health care system [23]; limited progress on guidelines for management of NCD and drug therapy and counselling [24]; lack of multisectoral collaboration [25]; poor financial protection for NCD patients [26]; poor accessibility, equity and responsiveness of primary healthcare services for CVD [27]. However, few studies have conducted a comprehensive and systematic health systems assessment of NCD management and services in LMIC and fragile settings.…”

Section: Introductionmentioning

confidence: 99%

Opportunities and challenges for delivering non-communicable disease management and services in fragile and post-conflict settings: perceptions of policy-makers and health providers in Sierra Leone

et al. 2020

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Background: The growing burden of non-communicable diseases in low-and middle-income countries presents substantive challenges for health systems. This is also the case in fragile, post-conflict and post-Ebola Sierra Leone, where NCDs represent an increasingly significant disease burden (around 30% of adult men and women have raised blood pressure). To date, documentation of health system challenges and opportunities for NCD prevention and control is limited in such settings. This paper aims to identify opportunities and challenges in provision of NCD prevention and care and highlight lessons for Sierra Leone and other fragile states in the battle against the growing NCD epidemic. Methods: This paper focuses on the case of Sierra Leone and uses a combination of participatory group model building at national and district level, in rural and urban districts, interviews with 28 key informants and review of secondary data and documents. Data is analysed using the WHO's health system assessment guide for NCDs. Results: We highlight multiple challenges typical to those encountered in other fragile settings to the delivery of preventive and curative NCD services. There is limited government and donor commitment to financing and implementation of the national NCD policy and strategy, limited and poorly distributed health workforce and pharmaceuticals, high financial barriers for users, and lack of access to quality-assured medicines with consequent high recourse to private and informal care seeking. We identify how to strengthen the system within existing (low) resources, including through improved clinical guides and tools, more effective engagement with communities, and regulatory and fiscal measures. Conclusion: Our study suggests that NCD prevention and control is of low but increasing priority in Sierra Leone; challenges to addressing this burden relate to huge numbers with NCDs (especially hypertension) requiring care, overall resource constraints and wider systemic issues, including poorly supported primary care services and access barriers. In addition to securing and strengthening political will and commitment and directing more resources and attention towards this area, there is a need for in-depth exploratory and implementation research to shape and test NCD interventions in fragile and post-conflict settings.

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“…This was also evident in the challenges of monitoring local policy interventions against set international targets. This problem of data generation is not unique to Kenya and has been mirrored in other African countries [49][50][51][52] and to a greater extent LMICs. Investment in implementation research to generate relevant local data and improve progress monitoring is warranted for evidence-informed decision-making.…”

Section: Discussionmentioning

confidence: 99%

Challenges in policy reforms for non-communicable diseases: the case of diabetes in Kenya

Shiroya

Neuhann

Müller

et al. 2019

Global Health Action

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Background: The 2011 UN declaration on non-communicable diseases (NCDs) recognized their importance as a global health issue, particularly for low-and middle-income countries. The extent to which these countries address policy implementation gaps in the face of resource limitations and competing priorities remains largely unexplored. Objective: This qualitative study presents Kenya's experience of translating the UN declaration to national policies for diabetes prevention and control. Methods: Policy documents published between 2006 and 2016 were analyzed. Thirty-two documents were included in the analysis. Interviews with six purposively selected policy stakeholders at multiple levels of decision-making were conducted. Emerging themes were deconstructed into a policy analysis triangle. Results: Diabetes-specific policies already existed in Kenya before 2011, suggesting successful advocacy work by diabetes interest groups. The 2011 UN declaration subsequently coincided with a period of political transition in Kenya, opening policy windows that the diabetes community leveraged to trigger political drive against prevailing challenges. The postdeclaration period reflected a transition from diabetes-specific policies to a wider NCD agenda. Most of the documents and national strategies aligned strongly with international documents, however, were based on scant local evidence. The implementation process was largely health-sector driven. The non-health sector remained largely uninvolved, contrary to global recommendations. This, in addition to fragmented health governance and weak monitoring systems, continues to undermine existing gains and efforts to fight diabetes and NCDs on a wider scale. Conclusions: In Kenya, a major gap remains between how diabetes is addressed within the NCD policy agenda and tackling diabetes in reality, with respect to local implementation processes. More emphasis on population-wide prevention and inclusion of the non-health sector could help to cascade national efforts to the grassroots level. A concerted effort from the highest political level is needed to address overarching NCD drivers while maintaining health system improvement strategies.

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Implementation of Policies and Strategies for Control of Noncommunicable Diseases in Malawi

Cited by 38 publications

References 8 publications

National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic

National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic

Opportunities and challenges for delivering non-communicable disease management and services in fragile and post-conflict settings: perceptions of policy-makers and health providers in Sierra Leone

Challenges in policy reforms for non-communicable diseases: the case of diabetes in Kenya

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