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Care for chronic diseases

Care for chronic diseases

Ongoing activities of SWIHPS members on Care for Chronic Diseases

Exchange among network members

Van Olmen et el, 2011

An impression of the NCD summit by a SWIHPS observer_Van PeltIHP Newsletter editorial on the NCD Summitvan Olmen, J., Ku, G., & Slama, S. 2011. Priority actions for the non-communicable disease crisis.Lancet, 378, (9791) 566.Bermejo, R., Prashant, N., & Sharma, S. 2011. Stronger guidance needed on lifelong care for chronic diseases.Lancet, 377, (9764) 463.Grace Marie Ku: Saying it like it is... Rapid Response in BMJ

  • The Global Health Platform Health Systems and Chronic Diseases.For an invitation to join the platform:healthsystems@itg.be

Linking operational experiences to global debates

  • 4 members of the network will be present at the UN High Level of Non Communicable Diseases
  • Alliance with the Geneva Health Forum

Research

  • A research project on Mobile Phone Diabetes Self-Management Support
  • A project to improve access and quality of diabetes care in DR Congo
  • Individual PhD projects on care for Chronic Diseases in: Colombia, Morocco, the Philippines and India.

Growing attention

Chronic Diseases are increasingly being recognised as a neglected global health issue and a particular concern for low and middle income countries (LMICs). The emergence of chronic conditions has serious implications on health systems in those countries. Four out of five CD-related deaths occur in LMIC. People in these countries tend to develop diseases at younger ages, suffer longer – often with preventable complications – and die sooner than those in high income countries.

The United Nations High Level Meeting on Non Communicable Diseases in September 2011 creates a big momentum for an increased effort to address these challenges. A lot of the global attention is (still) skewed towards the primary prevention of risk factors. The growing caseload caused by patients with chronic life-long conditions and how to address the needs of those people and to organize health care in health systems in low resource settings is not well addressed.

  • An impression of the NCD summit by a SWIHPS observer_Van Pelt
  • IHP Newsletter editorial on the NCD Summit
  • van Olmen, J., Ku, G., & Slama, S. 2011. Priority actions for the non-communicable disease crisis.Lancet, 378, (9791) 566.
  • Bermejo, R., Prashant, N., & Sharma, S. 2011. Stronger guidance needed on lifelong care for chronic diseases.Lancet, 377, (9764) 463.
  • Grace Marie Ku: Saying it like it is... Rapid Response in BMJ

Organisation of care

The organisation of care for these conditions is a growing concern for providers, managers and policy makers in health systems, at national and operational level.

  • Van Olmen et el, 2011. The growing caseload of chronic life-long conditions calls for a move towards full self-management in low-income countries
  • Chronic diseases and their challenges to health systems
  • Bermejo, R. 2011. Non-communicable diseases in southeast Asia.Lancet, 377, (9782) 2004

Primary Care Strategies are essential to address the Chronic Disease Burden A packages of interventions for Chronic Diseases should include: 1) Health promotion & primary prevention; 2) Early Secondary prevention (Active inquiry and recording of risk factors and the use of contextualized, non-invasive simple risk assessment tools, focused education and support to targeted “at risk” groups and passive & active screening for chronic conditions); 3) Secondary prevention (care for those already diagnosed and optimal control of their condition, prevention of complications and premature death, target patients and their families); and 4) Tertiary prevention/disability limitation, geared towards patients with co-morbidities / complications (prevention of further complications and mechanisms to “reintroduce” the patient to the community, with an emphasis on care integration, adequate working and living conditions and adequate decision support)

  • Organisation of Health (Care) Systems for Chronic Diseases
  • Grace Marie Ku: A Life-course approach in the control and prevention of chronic diseases

People at the centre

But beyond the establishment of a comprehensive primary care system, we plea to put people living with chronic life-long conditions at the centre of their own disease management. Primary health care providers can contribute to achieving this goal.

  • van Olmen, J., Criel, B., Devadasan, N., Pariyo, G., De Vos, P., Van Damme, W., Van Dormael, M., Marchal, B., & Kegels, G. 2010. Primary Health Care in the 21st century: primary care providers and people's empowerment.Tropical Medicine & International Health,15(4)386-290
  • Role of the community

The wider context

The SWIHPS network explored the meaning of chronic diseases and health systems and the role of diffferent actors in addressing chronic conditions during a workshop on Chronic Diseases and Health Systems in Antwerp in 2009.