Package of Essen al NCD (PEN) interven ons for primary
health care in low-resource se ngs.
Dr. Sevil Huseynova
World Health Organiza on
Country Liaison Officer for Northern Micronesia
(Republic of Palau, Federated States of Micronesia, Republic of the Marshall Islands)
50% of
eligible
people (high
risk)
Links to mental
health
NCD progression and implica ons for
preven on and control
Healthy
Risk factors
High risk
NCD
Complications
Health
and
economic
burden
Rehabilitation
Progression of NCD
Pop
ulatio
n to b
e co
vere
d
Health
promo on
Risk
reduc on
Psycho-social
support
Treatment
NCD ROADMAP REPORT
• Strengthened tobacco control
• Policies on reducing consump on of food and drink
products
•
Improved efficiency and impact from
the exis ng health dollar by realloca ng
resources to targeted primary and
secondary preven on of NCDs including
scaling up of PEN and be er drug prices;
•
Strengthening the evidence base
Objec ves of WHO PEN
• Assist low resource se ngs to
address NCDs in the context of health
system strengthening in an affordable
and sustainable manner
• Assist low resource se ngs to
address NCDs through a PHC
approach
• Support countries in a aining NCD
targets (1, 8 and 9)
Health services- limita ons
Many risk factors coexist in the same individual
High BP
High Blood
Sugar
Dyslipidaemia
High
Uric acid
Ischaameic
heart disease
Fa y
liver
Smoker
Be er yield… (get most of the red
balls)
10 $ for one scoop
30-40 years
40-50 years
50-60 years
Be er management of those at
high absolute risk and prevent
complica ons
Medica on,
counseling, foot care,
periodic check up for
urine protein,
compliance…
Less heart a acks,
strokes, renal
failure and
amputa ons
• Diagnosis
– CHAT Scan and not CAT Scan
• Honesty in communica on
• ‘Low tech’ and ‘high touch’
therapy
• Involvement of family
• Realis c goals
Approach to NCDs
Con nuing Care in the Community
(Volunteers linked to health system)
• Emo onal support
• Basic nursing
• Diabe c foot care
• Follow up
• Linking up with the professional team
• Social support to the affected family by
way of
– Helping with transport to hospital
– Linking with other support groups
– Helping to get benefits from various sources
– Rehabilita on
The cycle of health systems for NCD
Risk identification
and reduction
in the community
Risk and disease
Management in
the health centre
Referral care and
Specialized
management
Rehabilitation
Care in the
community
Overall risk reduction
and health promotion through
population based policies
and programmes
ADAPTING WHO PEN IN THE PACIFIC
•
15 PICs have started the adaptation.
•
Demonstration phase indicates the need for
–
service delivery model, screening thresholds,
drugs, equipment and skill building of personnel.
•
Skill building is feasible
•
STEPS surveys
–
are providing an indication of the number of
people at high risk for CVD
•
Support for costing of PEN has begun with
studies in 5 PICs
–
and development of tool for costing
Factors affec ng PEN implementa on