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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

  • 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.