Non‐communicable diseases in low‐and middle‐income countries: context, determinants and health policy (original) (raw)
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Systemic Solutions for Addressing Non-Communicable Diseases in Low- and Middle-Income Countries
Journal of Multidisciplinary Healthcare, 2020
Non-communicable diseases (NCDs) have been on the rise in low-and middleincome countries (LMICs) over the last few decades and represent a significant healthcare concern. Over 85% of "premature" deaths worldwide due to NCDs occur in the LMICs. NCDs are an economic burden on these countries, increasing their healthcare expenditure. However, targeting NCDs in LMICs is challenging due to evolving health systems and an emphasis on acute illness. The major issues include limitations with universal health coverage, regulations, funding, distribution and availability of the healthcare workforce, and availability of health data. Experts from across the health sector in LMICs formed a Think Tank to understand and examine the issues, and to offer potential opportunities that may address the rising burden of NCDs in these countries. This review presents the evidence and posits pragmatic solutions to combat NCDs.
Preventing Non-Communicable Diseases in Low- and Middle-Income Countries: A Literature Review
The Malaysian Journal of Nursing, 2021
Background: Both the older adult population and the number of patients with non-communicable diseases (NCDs) have rapidly increased in low-and middle-income countries in recent years. This has added to the burden of health issues, such as communicable diseases and conditions related to maternal and child health. Results: Approximately 90% of premature deaths in low-and middle-income countries are due to NCDs. Individuals with NCDs are also more susceptible to severe illness or death from infection with the severe acute respiratory syndrome coronavirus 2, which causes the coronavirus disease (COVID-19), and older adults with NCDs have a particularly increased susceptibility to COVID-19. Insufficient nutrition and maternal metabolic status during pregnancy are causes of metabolic disorders and cardiovascular disease during adulthood. Conclusion: A holistic approach with integrated multi-specialized systems-such as early intervention to develop healthy behavior among children, improvements in women's educational opportunities, and training that enables health care workers to handle multiple health issues in the community-is needed to address health issues at various stages of human development. In this manner, the vicious circle of hindering sustainable development will be broken not only in low-and middle-income countries but also worldwide, allowing humans to coexist with other living beings.
Non‐Communicable Diseases (NCDs) in developing countries: a symposium report
In recent years, non-communicable diseases (NCDs) have globally shown increasing impact on health status in populations with disproportionately higher rates in developing countries. NCDs are the leading cause of mortality worldwide and a serious public health threat to developing countries. Recognizing the importance and urgency of the issue, a one-day symposium was organized on NCDs in Developing Countries by the CIHLMU Center for International Health, Ludwig-Maximilians-Universität, Munich on 22nd March 2014. The objective of the symposium was to understand the current situation of different NCDs public health programs and the current trends in NCDs research and policy, promote exchange of ideas, encourage scientific debate and foster networking, partnerships and opportunities among experts from different clinical, research, and policy fields. The symposium was attended by more than seventy participants representing scientists, physicians, academics and students from several institutes in Germany and abroad. Seven key note presentations were made at the symposium by experts from Germany, UK, France, Bangladesh and Vietnam. This paper highlights the presentations and discussions during the symposium on different aspects of NCDs in developing countries. The symposium elucidated the dynamics of NCDs in developing countries and invited the participants to learn about evidence-based practices and policies for prevention and management of major NCDs and to debate the way forward.
Chronic Diseases in Developing Countries
Annals of the New York Academy of Sciences, 2008
Chronic diseases are increasing in global prevalence and seriously threaten developing nations' ability to improve the health of their populations. Although often associated with developed nations, the presence of chronic disease has become the dominant health burden in many developing countries. Chronic diseases were responsible for 50% of the disease burden in 23 high-burden developing countries in 2005 and will cost those countries $84 billion by 2015 if nothing is done to slow their growth. The rise of lifestyle-related chronic disease in poor countries is the result of a complex constellation of social, economic, and behavioral factors. Variability in the prevalence of chronic disease is found both at the country level and within countries as differences in risk factors are observed. This upward trend is forecast to continue as epidemiologic profiles and age structures of developing countries further shift. More research is needed to identify a full range of prevention-focused, cost-effective interventions against chronic diseases in the developing world.
Epidemiologic Transition of Diseases and Health-Related Events in Developing Countries: A Review
Background: Over the past centuries, mortality and morbidity patterns have been changing all over the world albeit with variations in timing and pace. These changes have been referred to as the epidemiologic transition. The main features of the transition include a decline in mortality, an increase in life expectancy, and a shift in the leading causes of morbidity and mortality from infectious and parasitic diseases to non-communicable, chronic, degenerative diseases. The transition is linked to improvements and advances in nutrition, hygiene and sanitation, and medical knowledge and technology. As such, the epidemiologic transition is related to the demographic transition and the nutritional transition, and is part of a more broadly defined health transition. Objectives: This paper was aimed at studying these shifts in pattern of mortality, life expectancy, and causes of death. Methods: Relevant literature was reviewed from medical journals, library research, Pub Med search, Google search and search using other internet search engines. The key words for the search were "Epidemiologic transition", "Developing countries", "Diseases" and "health related events". Result: Several studies have given perspectives on epidemiologic transition, the factors that are responsible for the transition, the effects on the health of man, the scenarios in developed world and in the developing countries. Also highlighted are the challenges posed to humanity and possible measures to arrest the situation. Conclusion: It is obvious that epidemiologic transition is a reality that is present with humanity. In the developing world we have more problems on our hand as we have not succeeded in controlling the communicable diseases and the non-communicable diseases mostly nutrition-related are becoming predominant. This calls for action to prevent the dire consequences of double burden of disease arising from inaction.
Double Burden of Disease in the Developing World: An Epidemiologic Perspective
Journal of the Obafemi Awolowo University Medical Students’ Association, 2023
Developing countries continue to struggle with the morbidity and mortality of infectious diseases in combination with an increasing prevalence of noncommunicable diseases in their population. This article examines the concept of the double burden of disease in the developing world. The effects of infectious diseases on a population are ravaged by the effects of chronic non-communicable diseases. The epidemiology; prevalence, patterns, and factors that contribute to it. This article also examines infectious and noncommunicable diseases through the lens of developing countries, the prevalence of its major entity, associated risk factors, management, and challenges. The high prevalence of infectious diseases does not reduce morbidity and mortality of non-communicable diseases. Additionally, this article explores the challenges developing countries face with healthcare systems in managing the burden of the double burden of disease and the strategies to address them in management, prevention, and control. Understanding this concept, its prevalence, and its effect on the health system in developing countries opens pathways to controlling it.
Risk Management and Health Policy , 2020
Abstract: The prevalence of long-term (chronic) non-communicable diseases (NCDs) is increasing globally due to an ageing global population, urbanization, changes in lifestyles, and inequitable access to healthcare. Although previously more common in high- and uppermiddle-income countries, lower-middle-income countries (LMICs) are more affected, with NCDs in LMICs currently accounting for 85–90% of premature deaths among 30–69 years old. NCDs have both high morbidity and mortality and high treatment costs, not only for the diseases themselves but also for their complications. Primary health care (PHC) services are a vital component in the prevention and control of long-term NCDs, particularly in LMICs, where the health infrastructure and hospital services may be under strain. Drawing from published studies, this review analyses how PHC services can be utilized and strengthened to help prevent and control long-term NCDs in LMICs. The review finds that a PHC service approach, which deals with health in a comprehensive way, including the promotion, prevention, and control of diseases, can be useful in both high and low resource settings. Further, a PHC based approach also provides opportunities for communities to better access appropriate healthcare, which ensures more significant equity, efficiency, effectiveness, safety, and timeliness, empowers service users, and helps healthcare providers to achieve better health outcomes at lower costs
Lancet
National health systems need strengthening if they are to meet the growing challenge of chronic diseases in lowincome and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health fi nancing, governance, health workforce, health information, medical products and technologies, and health-service delivery. These constraints have become more evident as development partners have accelerated eff orts to respond to HIV, tuberculosis, malaria, and vaccine-preventable diseases. A new global agenda for health-systems strengthening is arising from the urgent need to scale up and sustain these priority interventions. Most chronic diseases are neglected in this dialogue about health systems, despite the fact that noncommunicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low-income and middle-income countries. At the same time, advocates for action against chronic diseases are not paying enough attention to health systems as part of an eff ective response. Eff orts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because eff ective chronic disease programmes are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening.