package of essential ncd (pen) interventions for primary health care in low-resource settings. dr....
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Package of Essential NCD (PEN) interventions for primary health care in low-resource settings.
Dr. Sevil HuseynovaWorld Health Organization
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 implications for prevention and control
Healthy
Risk factors
High risk NCD
Complications
Health and economic burden
Rehabilitation
Progression of NCD
Population to be
covered
Health promotion
Risk reduction
Psycho-social support
Treatment
NCD ROADMAP REPORT
• Strengthened tobacco control• Policies on reducing consumption of food and drink
products
• Improved efficiency and impact from the existing health dollar by reallocating resources to targeted primary and secondary prevention of NCDs including scaling up of PEN and better drug prices;
• Strengthening the evidence base
Objectives of WHO PEN
• Assist low resource settings to address NCDs in the context of health system strengthening in an affordable and sustainable manner
• Assist low resource settings to address NCDs through a PHC approach
• Support countries in attaining NCD targets (1, 8 and 9)
Health services- limitations
Many risk factors coexist in the same individual
High BP
High Blood Sugar
Dyslipidaemia
High Uric acid
Ischaameic heart disease
Fatty liver
Smoker
Better yield… (get most of the red balls)
10 $ for one scoop
30-40 years 40-50 years 50-60 years
Better management of those at high absolute risk and prevent
complications
Medication, counseling, foot care, periodic check up for
urine protein, compliance…
Less heart attacks, strokes, renal
failure and amputations
Less heart attacks, strokes, renal
failure and amputations
• Diagnosis– CHAT Scan and not CAT Scan
• Honesty in communication• ‘Low tech’ and ‘high touch’
therapy• Involvement of family • Realistic goals
Approach to NCDs
Continuing Care in the Community (Volunteers linked to health system)
• Emotional support• Basic nursing• Diabetic 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– Rehabilitation
The cycle of health systems for NCD
Risk identification and reduction in the community
Risk and disease Management in the health centre
Referral care andSpecialized management
RehabilitationCare 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 affecting PEN implementation