To tackle the burden of chronic and severe noncommunicable diseases (NCDs) a strategy to address management of severe NCDs at first-level referral health facilities has been unveiled.
The Package of Essential Noncommunicable Disease Interventions-Plus (PEN-Plus) strategy builds on the WHO-PEN for integrated detection, diagnosis, treatment and care of non-communicable diseases at primary health care facilities.
It was presented to delegates attending the WHO Regional Committee for Africa (RC-72).
So far, 21 Member States have adapted and begun implementing the WHO PEN.
However, there is a gap in access to prevention and care for patients with chronic and severe NCDs at the primary health care level. The PEN-Plus strategy will bridge this gap and contribute to reduction in premature deaths from NCDs.
The WHO-PEN has shown promising results in pilot programmes in Liberia, Malawi and Rwanda leading to an increase in the number of patients accessing care for severe NCDs resulting in improved outcomes among people affected by NCDs.
The Director of Communicable and Noncommunicable Diseases cluster, Dr Benido Mpouma stated that globally, NCDs are the main cause of illness and death accounting for 71% of global deaths.
In the African Region, the proportion of deaths due to NCDs ranges from 27% to 88% among member states. Due to weak capacity for early diagnosis, management and care of NCDs, deaths attributed to NCDs have increased from 24.2% in 2000 to 37.1% in 2019 in the African Region.
The strategy proposes priority interventions covering training and mentoring of staff, resource mobilization, multisectoral action, service delivery, data collection, innovation, and research. It also proposes approaches to improve efficiency by providing standardized protocol-based management of severe NCDs.
Over 33 member states provided inputs and comments to the strategy. From the ensuing discussions at the meeting, most countries have made positive strides towards addressing NCDs and have identified best practices and innovative approaches to avail NCD care at PHC level, including involvement of community health workers.
Although countries like Eswatini have trained most health workers at primary and tertiary level in NCD care, most other countries are in the early stages of building this capacity.
Member States observed that investing in NCD programs at PHC level will strengthen the entire health system and contribute to attainment of SDG 3.
Furthermore, they urged WHO secretariat to support resource mobilization including development of NCD investment cases. Additionally, all countries requested for tailored technical support to strengthen NCD programs since they are at different stages of implementing WHO-PEN.
In most parts of Africa, care for noncommunicable diseases is concentrated at tertiary health facilities which are mostly located in large cities.
This exacerbates health inequities, as it puts care beyond the reach of people in most rural, peri-urban and lower-income communities or groups, people who can at best only access district hospitals and local health centres.
In Africa, however, these lower level facilities usually lack the capacity and resources to effectively manage severe noncommunicable diseases.
Africa is experiencing a rising burden of noncommunicable diseases such as diabetes, heart disease and sickle cell disease. In addition, the Region is already battling a high burden of communicable diseases.
This “double burden” of disease has negatively impacted the capacity to respond to and allocate financial resources to NCD management due to competing demands.
Furthermore, and taking lessons from COVID-19 and its impact on health service delivery the Health Ministers at RC 72 underscored the importance of integrating essential NCD services into primary health care. Finally, the Health Ministers unanimously adopted the strategy.