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PHC Reforms proposed (WHR 2008)

Integration of Noncommunicable Diseases into PHC in low-resource settings Lessons learned Dr Shanthi Mendis Chronic Disease Prevention and Management World Health Organization. Universal coverage Service delivery Leadership reforms Public policy reforms. PHC Reforms proposed (WHR 2008).

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PHC Reforms proposed (WHR 2008)

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  1. Integration of Noncommunicable Diseases into PHC in low-resource settingsLessons learned Dr Shanthi Mendis Chronic Disease Prevention and Management World Health Organization

  2. Universal coverage • Service delivery • Leadership reforms • Public policy reforms PHC Reforms proposed (WHR 2008)

  3. Bhutan • Eritrea • Sri Lanka • Sudan • Syria WHO provides Technical support for National Health Development process (Driven by country needs)

  4. Challenges • Opportunities • Capacity • Sustainability • Affordability • Balance • Evaluation Lessons

  5. Per capita expenditure on health Expenditure Number of countries 33 25 72 24 19 18 Less than 50 $ 50 – 99 100-499 500-999 1000-1999 >2000

  6. Contribution to morbidity and mortality (Cardiovascular diseases , diabetes, Cancer, CRD) • Availability of cost effective interventions • Feasibility of implementing in primary care Setting priorities

  7. Next level Service delivery Back referral Referral >40% 20-<30% 30-<40% 10-<20% Low Medium High Very high Very low risk Manage in PC PC (NPHW)

  8. WHO/ISH charts To screen for risk of heart attacks and strokes Using simple variables Age Smoking Sex Blood pressure Blood cholesterol Blood sugar

  9. Define functions of all levels of the health system based on PHC: skills, requirements, equipment, medicines, interactions between levels and sectors • Financing models for different social and economic contexts and health systems • Service delivery models that promote continuity of care across different NCDs, levels and sectors of care • Type of training, support and supervision needed for delivery of interventions by physician/ non-physician PHC based Health System

  10. Per capita health expenditure in many LMIC countries is inadequate to provide universal coverage • Range of cost effective NCD interventions can be integrated into PHC, even in low resource settings. •  If sustainable approaches are used they  can reduce morbidity and premature mortality due to NCDs . • PHC has the potential to reduce suffering from preventable NCDs and reduce health-care costs. Integration of NCD into PHC

  11. ` THANK YOU

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