by Danielle Doughman, Policy Outreach Manager, APHRC Non-communicable diseases, or NCDs, are illnesses or conditions including cancer, high blood pressure, diabetes, and obesity that progress slowly over time, and are increasingly...
The Center has been at the forefront of research on the emerging epidemics of non-communicable disease (NCD) and injuries across Africa even in the face of a continuing high burden of infectious diseases. We have generated
evidence that has led to stronger and more responsive health systems, able to address the specific needs of vulnerable populations. The Center has developed and tested models of service delivery to reduce leakages
across the NCD risk reduction continuum, and to improve quality and access to private sector-provided primary health care among slum residents. Gaps in evidence remain, however, related to mainstreaming chronic disease management, attracting and retaining NCD patients in care, and strengthening skills among low-cost private providers. There is yet to be an increase in research on the epidemiology of, or mitigating strategies for, the rising burden of injury.
The need for evidence on what works to improve awareness of NCD risk factors, linkages to and retention in NCD care programs, and how to integrate NCD care into existing platforms for chronic infectious disease management is acute”. So is the need to understand the systems that generate and sustain health at the community, health system and societal levels, and to test models for strengthening systems to make them responsive to current epidemiological trends.
Generating evidence to drive stronger and more resilient systems for improved health is the overarching goal of this Unit in three programmatic areas:
The signature issue for this Unit will be chronic disease management. We will aim to understand the magnitude, burden and impacts of non-communicable diseases and other chronic conditions (mental health problems and injuries), and the interactions and intersections between infectious and NCDs in order to inform integrated and efficient health system responses to major public health problems. The program will also identify and assess the impact of patient-centered and technology based approaches to improve integrated management of chronic
The Unit will also continue its current initiatives in NCD epidemiology research, expanding the scope to children, adolescents and older people. Interventions to mitigate risk of common NCDs will be developed and tested. A new area of work will develop and test approaches to enhance and/or maintain intrinsic physical and cognitive capacity at older age.
The third program of work will aim to understand and characterize health system needs to end the big epidemics and respond to new global health threats. It will contribute to improved knowledge by understanding the differentiated health needs of vulnerable populations. We will aim to understand the needs of long-term users of antiretroviral treatment and how care for people with HIV/AIDS is integrated into service delivery, including SRHR for young people and NCDs for older adults. The program will also conduct research on health system approaches for integrated care of infectious diseases and NCDs.
Non-communicable diseases (NCDs) and their risk factors are increasing in sub-Saharan Africa (SSA). Out of the many NCDs, four–cardiovascular diseases, diabetes, cancers and chronic respiratory illnesses–have been identified globally as being responsible for the greatest burden. These four disease groups also share a set of four risk factors namely tobacco use, unhealthy diets, alcohol misuse and physical inactivity. In the last few years, WHO/UN member states have made global commitments to take action on NCDs with national governments being urged to develop, fund and implement strong NCD policies.
As part of its global Action Plan on NCDS, WHO identified Multi-Sectoral Action (MSA) as a cornerstone for NCD prevention at population level. MSA for health refers to actions undertaken by sectors outside the health sector, possibly, but not necessarily, in collaboration with the health sector, on health or health-related outcomes or the determinants of health or health equity. WHO also identified several “Best Buys” for NCD prevention including measures to reduce common risk factors such as tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol that would deliver the greatest benefit in reducing population level risk in a cost-effective manner. Best Buys require MSA in most cases.
There is limited research on the application and success of MSA in implementing the Best Buys in sub-Saharan Africa. To help fill evidence gaps, APHRC is implementing a multi-country study to promote multi-sectoral policy-making and action for NCD prevention by providing evidence on the effectiveness of these approaches. The evidence from six countries across SSA will be used to catalyze a process of policy engagement by the established network of researchers to support efforts to adopt MSA into policy making and programming.