|Year : 2018 | Volume
| Issue : 2 | Page : 43-44
World NCD Federation guidelines for prevention, surveillance, and management of noncommunicable diseases at primary and secondary health-care settings
JS Thakur1, Sanjay Bhadada2
1 Department of Community Medicine School of Public Health, PGIMER, Chandigarh, India
2 Department of Endocrinology, PGIMER, Chandigarh, India
|Date of Web Publication||26-Jun-2018|
J S Thakur
School of Public Health, PGIMER, Chandigarh - 160 012
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Thakur J S, Bhadada S. World NCD Federation guidelines for prevention, surveillance, and management of noncommunicable diseases at primary and secondary health-care settings. Int J Non-Commun Dis 2018;3:43-4
|How to cite this URL:|
Thakur J S, Bhadada S. World NCD Federation guidelines for prevention, surveillance, and management of noncommunicable diseases at primary and secondary health-care settings. Int J Non-Commun Dis [serial online] 2018 [cited 2018 Sep 22];3:43-4. Available from: http://www.ijncd.org/text.asp?2018/3/2/43/235210
Noncommunicable diseases (NCDs) have emerged as a major public health problem globally due to demographic, epidemiological, and socioeconomic transition. As 70% of deaths are contributed by NCDs globally, there is an urgency to combat these NCDs and need to focus on global health agenda of sustainable development goals. However, there is no comprehensive guidelines available on the prevention, surveillance, and management of NCDs applicable to primary and secondary health-care facilities of low-resource settings except for few conditions. These comprehensive guidelines will equally cover the prevention, surveillance, and management aspects of common NCDs at primary and secondary health-care settings targeting primarily health-care professionals, program managers, policymakers, and implementers at these health-care settings. The methodology used for the development of these guidelines is that there will be three major guideline development groups, namely, prevention, surveillance, and management, with seven subgroups in the management group for each selected NCD, namely, cardiovascular diseases, type 2 diabetes mellitus, chronic respiratory diseases, cancers, mental health, cerebrovascular diseases, chronic kidney diseases, and chronic liver diseases (alcoholic liver disease and nonalcoholic fatty liver disease).
Experts from different parts of India and world participated for the development of these comprehensive guidelines. The process started from January 2018 with identification of key experts and formation of expert group with chair, coordinator, and convenors for each group. Each expert group worked on initial draft. The expert group meeting was organized by World NCD Federation in Chandigarh (India) on March 6–7, 2018. Each group presented and extensive discussions were made on prevention, surveillance, and management of specific NCD. On the 1st day of meeting, the existing guidelines and the lacunae that need to be dealt in the health-care systems, which are responsive to the problem of NCDs, presentation on evidence synthesis for guidelines, protocol process, overview of available health facilities and services at primary and secondary health-care level, and system readiness and requirements were discussed. A panel discussion on participation of professional associations and implementation of guidelines was also organized. Health system issues of implementing the guidelines were raised by experts and discussed upon to make the guidelines suitable for uptake by the national/subnational health workforce experts. The role of accrediated social health activists (ASHAs), auxillary nurse midwives (ANMs), and other staff available at primary and secondary health-care level was also discussed keeping in view of task-shifting approach so that, within appropriate time frame and finances, guidelines could be implemented. It was emphasized that proper skill building, refresher trainings, and dissemination of information need to be ensured to all the human resources working at primary and secondary health-care settings in order to take timely action in the direction of mitigating the losses incurred to world economy due to NCDs. On the 2nd day, the discussion was held on the feasibility within the health system infrastructure of country, challenges and operational issues for the implementation, key stakeholders' perspective, need to shift to translational research, and usage of guidelines by workforce at all levels of health care was discussed. Suggestions were given for increasing focus on the implementation of guidelines and improving access to health-care facilities, and the answer lies in universal health coverage through strategies such as health insurance and through. Recommendations were made on promoting prevention, screening, and early detection strategies in cases of diseases such as cancer that are largely preventable. Moreover, appropriate implementation of these guidelines at subcenter level (ASHAs and ANMs) will help in combating the NCDs and their complications. It will also reduce the patient burden at secondary and tertiary level of health-care system. Eventually, the inputs were given to all the groups and were asked to resubmit the draft documents after discussion within the expert group and for finalization.
These guidelines will help to provide the evidence-based solutions to overcome the challenges posed to the health-care systems in combating NCDs, improving the usage of best practices and quality of care, and reducing premature mortality due to NCDs in low-resource settings. They will be helpful to take further steps in capacity building for surveillance, monitoring, implementation of NCD prevention and control policies and programs and evaluation at national, regional, and international level.
| References|| |
GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1151-210.
World Health Organization. Prevention and Control of Noncommunicable Diseases: Guidelines for Primary Health Care in Low Resource Settings. Geneva: WHO; 2012.