Ottawa charter framework as a guide for type 2 diabetes prevention and control in Iran

Abstract

The growth of T2DM in Iran is predicted to be even greater than the global trend. So a new public health movement to effectively prevent and manage T2DM is required more than ever. The solution has lain in the heart of the Ottawa Charter, the first international conference on health promotion more than 30 years ago. The charter contains five useful actions to facilitate the process of diseases prevention and control: 1) building healthy public policy, 2) creating supportive environments, 3) strengthening community action, 4) developing personal skills, and 5) reorienting health care services toward promotion of health. The charter articulates health in all policies and their frameworks. The aim of this review is to examine how the five actions have been implemented in Iran and can serve as a guide to prevent and control diabetes. Several national case studies will be examined to illustrate the challenges facing Iran's health system. It enables the identification and sharing of best practice between countries.

Inequalities in the prevalence, diagnosis awareness, treatment coverage and effective control of diabetes: a small area estimation analysis in Iran

“…However, these multi-fold differences between the maximum and minimum percentages across districts may show disparities in the processes of care and health outcomes relevant to diabetes management [ 33 , 34 ] and also show the need to close gaps in diabetes care. In this regard, diabetes prevention and management must be prioritized as a national agenda by policymakers, with regional progress closely monitored [ 7 ]. Building better healthcare infrastructure, improving standardized treatment services, implementing coordinated multilevel interventions to reduce geographic disparities in care, and using digital technology such as virtual clinics could help to increase awareness, treatment, and control of diabetes [ 7 , 8 , 29 ].…”

“…In this regard, diabetes prevention and management must be prioritized as a national agenda by policymakers, with regional progress closely monitored [ 7 ]. Building better healthcare infrastructure, improving standardized treatment services, implementing coordinated multilevel interventions to reduce geographic disparities in care, and using digital technology such as virtual clinics could help to increase awareness, treatment, and control of diabetes [ 7 , 8 , 29 ]. Moreover, an adopted national clinical practice guideline that considers limited local resources and some problems in accessing Iranian patients’ anti-diabetic drugs, especially modern treatments due to sanctions, should be prepared and regularly updated [ 35 , 36 ].…”

“…The Government of Iran has initiated a response to this growing burden with the National Diabetes Prevention and Control Program, the National Action Plan for Non-communicable diseases Prevention and Control, and the Iranian National Diabetes Framework [6][7][8]. However, besides them, achieving equality has always been one of the crucial goals of national programs; and it has garnered a special place in national health strategic plans in recent decades [9].…”

Long-Term Effects of Integrated Strategies of Community Health Promotion on Diabetes Mellitus Mortality: a Natural Policy Experiment Based on Aggregated Longitudinal Secondary Data

“…To examine retrospectively the effect of ISCHP on health, we classified the initiation of an ISCHP or not as a natural policy experiment as policies were not initiated or allocated by the researchers [13,14]. We chose diabetes mortality as a relevant health outcome because we assumed that health outcomes related to diabetes mellitus are sensitive to ISCHP as healthy diet and promotion of physical activity are common (intermediate) targets of ISCHP [15,16]. Further reasons include that diabetes is highly prevalent in Germany contributing to a substantial burden of disease and the data availability [17,18].…”

Application of the Ottawa Charter Five Priority Areas of Action for Public Health to an Institution-Wide Diabetes Care Promotion

“…In 1986, the Ottawa Charter for Health Promotion issued by the World Health Organization (WHO) defined health promotion as “the process of enabling people to increase control over and improve their health” [ 27 ]. The WHO Ottawa Charter highlights five priority areas for action in public health to facilitate disease prevention and control: building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health care services toward the promotion of health [ 28 , 29 ]. The Charter articulates health in all policies and their frameworks.…”