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LETTER TO EDITOR
Year : 2017  |  Volume : 44  |  Issue : 3  |  Page : 165-166

Implementing the world health organization's package of essential noncommunicable disease interventions in primary care settings


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Date of Web Publication14-Feb-2018

Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thiruporur - Guduvanchery Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.JSS_30_17

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Implementing the world health organization's package of essential noncommunicable disease interventions in primary care settings. J Sci Soc 2017;44:165-6

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Implementing the world health organization's package of essential noncommunicable disease interventions in primary care settings. J Sci Soc [serial online] 2017 [cited 2018 May 23];44:165-6. Available from: http://www.jscisociety.com/text.asp?2017/44/3/165/225503

Sir,

Globally, noncommunicable diseases (NCDs) account for 7 out of 10 reported deaths each year.[1] The alarming rise in the incidence of NCDs and associated deaths has been observed in most of the low- and middle-income nations, especially after they have been successful in reducing the incidence of infectious diseases and malnutrition.[1],[2] In fact, the available estimates clearly indicate that a further rise in the incidence of NCDs is expected to occur in the coming years across the world.[1]

Acknowledging the magnitude of the problem, a wide range of cost-effective, population-based, and high-risk interventions have been implemented to ensure early detection through cheap methods, alterations in the potential risk factors through varied approaches, and supply of inexpensive medicines for both the prevention and treatment of each of the NCDs.[1],[2],[3] In fact, it has been presumed that, upon effective delivery of these measures, significant gains can be derived in the future (viz., decrease in the direct and indirect medical expenses, improvement in the quality of life, and better productivity).[1],[2],[3]

Nevertheless, due to the prevailing weaknesses in the health systems, poor socioeconomic status, and inaccessibility, substantial lacunae have been identified in the implementation or even in ensuring that people can avail the benefit of these interventions.[3] This calls for an urgent transformation in the functioning of the health system of a nation, in such a way that the delivered care is proactive, people centered, community based, and sustainable.[3] The World Health Organization has developed a package of essential intervention for NCDs (WHO PEN), which can be implemented in the delivery of primary care in low-resource settings.[4] Moreover, the rationale behind these services is to ensure the integration of NCD with primary health care, and should be considered as the minimal standards to be maintained for the strengthening of the national capacity and a better quality of response.[4]

The WHO PEN comprises a range of cost-effective measures (such as essential technologies and tools such as risk prediction standardized charts, list of medicines, and protocol for implementation of NCD-related interventions), to enable the delivery of satisfactory care, even in low-resource settings.[4] In Iran, a 3-fold rise in urban population has been observed, and with that, a proportional rise in the exposure to various potential risk factors (tobacco, unhealthy diet, and physical inactivity) has also been observed.[4] To improve the scenario, the national Health Ministry under the guidance of the WHO has implemented a customized version of PEN in their settings.[4] Furthermore, health workers are assisting patients by counseling them about their condition, healthy lifestyle, and ways to prevent aggravation of the disease.[3],[4]

The customized PEN initiative has been implemented in four districts of the nation, and significant gains in terms of reduction in the price of essential drugs for the management of NCDs, better collaboration between concerned sectors, and even encouragement of healthy lifestyles in school settings have been observed.[3],[4] Since its implementation, a periodic rise in the financial allocation has been observed so that NCDs can be better contained.[4] In addition, the department of Food and Drug Administration has called for manufacturers to modify their products to extend their support toward creation of a health-enabling environment by ensuring the availability of healthier foods.[4] Moreover, interventions in the form of “traffic light” food labeling scheme and regulations on intake of salt, sugar, and fat have been established, owing to which a significant decline in their consumption has been observed.[4] All these evidences indicate that responding to the NCD epidemic is quite feasible, provided all the concerned partners are committed toward improving the quality of life of people.[1],[2],[4]

To conclude, considering the impact of NCDs on the multiple domains of an individual's life, it is high time that essential interventions should be implemented right at the level of primary care to combat the situation effectively.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Noncommunicable Diseases - Fact Sheet No. 355; 2017. Available from: http://www.who.int/mediacentre/factsheets/fs355/en/. [Last accessed on 2017 Jul 27].  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Rising trends of risk factors for non-communicable diseases in African Region. MAMC J Med Sci 2017;3:52-3.  Back to cited text no. 2
  [Full text]  
3.
World Health Organization. Package of Essential NCD Interventions for Primary Health Care: Cancer, Diabetes, Heart Disease and Stroke, Chronic Respiratory Disease. Geneva: WHO Press; 2010. p. 1-24.  Back to cited text no. 3
    
4.
World Health Organization. Islamic Republic of Iran on a Fast-Track to Beating Noncommunicable Diseases; 2017. Available from: http://www.who.int/features/2017/iran-noncommunicable-diseases/en/. [Last accessed on 2017 Jul 27].  Back to cited text no. 4
    




 

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