Donors, non-communicable diseases and universal health coverage to high-quality healthcare: an opportunity for action on global functions for health.

The world is increasingly globalized, and has seen major economic and demographic changes. These factors have dramatically changed the global burden of disease, shifting from mostly rural pediatric infections in low income countries to mostly urban adult comorbidity from noncommunicable diseases (NCDs) in middle income countries. As countries become less reliant on development assistance for health to support their individual needs, the globalization of disease will need a new type of global health engagement. Global functions- those functions that transcend national sovereignty and provide dispersible benefits to all- will take increasing importance as countries grapple with providing universal coverage to high quality care for NCDs

A rapid mixed-methods assessment of Libya’s primary care system

Background: Libya has experienced decades of violent conflict that have severely disrupted health service delivery. The Government of National Unity is committed to rebuilding a resilient health system built on a platform of strong primary care. Aim: Commissioned by the government, we set out to perform a rapid assessment of the system as it stands and identify areas for improvement. Design and setting: We used a rapid applied policy explanatory-sequential mixed-methods design, working with Libyan data and Libyan policymakers, with supporting interview data from other primary care policymakers working across the Middle East and North Africa region. Method: We used the Primary Health Care Performance Initiative framework to structure our assessment. Review of policy documents and secondary analysis of WHO and World Bank survey data informed a series of targeted policymaker interviews. We used deductive framework analysis to synthesise our findings. Results: We identified 11 key documents and six key policymakers to interview. Libya has strong policy commitments to providing good quality primary care, and a high number of health staff and facilities. Access to services and trust in providers is high. However, a third of facilities are non-operational; there is a marked skew towards axillary and administrative staff; and structural challenges with financing, logistics, and standards has led to highly variable provision of care. Conclusion: In reforming the primary care system, the government should consolidate leadership, clarify governance structures and systems, and focus on setting national standards for human resources for health, facilities, stocks, and clinical care

Global susceptibility and response to noncommunicable diseases.

Globalization and human interdependence have created immeasurable value for humanity. These forces, however, also provide channels for health risks to spread throughout the world. Global functions for health, such as international partnerships or research and development, are a rational response to global health risks like pandemics or globalized supply chains. Self-interest compels governments – or donors – to provide global functions even though their benefits are widely shared the world over

Conflict as a macrodeterminant of non-communicable diseases: the experience of Libya.

From Europe PMC via Jisc Publications RouterHistory: ppub 2022-10-01Publication status: PublishedFunder: World Bank Grou

Engaging with the Private Sector for Noncommunicable Disease Prevention and Control: Is it Possible to Create "Shared Value?"

Noncommunicable diseases (NCDs) are the leading cause of premature mortality worldwide. Corporate interests are sometimes well-aligned with public health, but profiteering from the consumption of products that are known to be the major contributors to the noncommunicable disease burden undermines public health. This paper describes the key industry actors shaping the NCD landscape; highlights the unhealthy commodities' impact on health and the growing burden of NCDs; and outlines challenges and opportunities to reduce exposure to those risk factors. Corporations deploy a wide array of strategies to maximize profits at the expense of health, including sophisticated marketing techniques, interference in the policy-making process, opposition and distortion of research and evidence, and whitewashing of health-harming activities through corporate social responsibility initiatives. There can be no shared value for industries that sell goods that harm health irrespective of consumption patterns (such as tobacco and likely alcohol), so government actions such as regulation and legislation are the only viable policy instruments. Where shared value is possible (for example, with the food industry), industry engagement can potentially realign corporate interests with the public health interest for mutual benefit. Deliberate, careful, and nuanced approaches to engagement are required

Conflict as a macrodeterminant of non-communicable diseases: the experience of Libya.

It has been argued that peace and its reciprocal—conflict—are macrodeterminants of health. Nowhere has experienced greater conflict than the Middle East in recent decades. The experience of Libya offers potent lessons on the bidirectional relationship between peace and health that extend beyond the immediate violence-related health impacts of civil war

Non-communicable disease policy implementation in Libya: A mixed methods assessment

From PLOS via Jisc Publications RouterHistory: collection 2022, received 2022-02-03, accepted 2022-10-09, epub 2022-11-10Acknowledgements: Disclaimer: The findings, interpretations, and conclusions expressed in this work are those of the authors and do not necessarily reflect the views of the Libyan Ministry of Health or the World Bank, their Boards of Directors, or the governments they represent.Publication status: PublishedFunder: World BankGiulia Loffreda - ORCID: 0000-0003-4895-1051 https://orcid.org/0000-0003-4895-1051The Libyan Ministry of Health is keen to understand how it can introduce policies to protect its population from non-communicable diseases (NCDs). We aimed to perform an implementation research assessment of the current situation, including challenges and opportunities. We used an explanatory sequential mixed methods design. We started with a quantitative assessment of NCD policy performance based on review of the WHO NCD Progress Monitor Reports. Once we had identified Libya’s NCD policy gaps we performed a systematic review to identify international lessons around barriers and successful strategies for the policies Libya has not yet implemented. Finally, we performed a series of key stakeholder interviews with senior policymakers to explore their perspectives around promising policy actions. We used a realist paradigm, methods triangulation, and a joint display to synthesise the interpretation of our findings and develop recommendations. Libya has not fully implemented any of the recommended policies for diet, physical activity, primary care guidelines & therapeutics, or data collection, targets & surveillance. It does not have robust tobacco policies in place. Evidence from the international literature and policymaker interviews emphasised the centrality of according strong political leadership, governance structures, multisectoral engagement, and adequate financing to policy development activities. Libya’s complex political and security situation are major barriers for policy implementation. Whilst some policies will be very challenging to develop and deploy, there are a number of simple policy actions that could be implemented with minimum effort; from inviting WHO to conduct a second STEPS survey, to signing the international code on breast-milk substitutes. Like many other fragile and conflict-affected states, Libya has not accorded NCDs the policy attention they demand. Whilst strong high-level leadership is the ultimate key to providing adequate protections, there are a range of simple measures that can be implemented with relative ease.pubpu

Assessing the characteristics of 110 low- and middle-income countries' noncommunicable disease national action plans

Noncommunicable diseases (NCDs) are a leading contributor to preventable mortality and impoverishment in low- and middle-income countries (LMICs). To support countries in developing holistic and integrated NCD plans, the World Health Organization (WHO) has produced get rid of this a NCD Multisectoral Action Plan (MSAP) guidance. To date, over 160 countries have produced MSAPs and uploaded them to the WHO's NCD document repository. We examined the content and comprehensiveness of the MSAPs uploaded by all 110 LMICs, with reference to the WHO guidance. Overall, the MSAPs included 71% of the elements recommended by the WHO, however, there was a tendency to present situational analyses and recommended actions without providing costings or an overall funding plan. We found no correlation between MSAP comprehensiveness (alignment with the WHO guidance) and policy implementation. There were no significant differences in MSAP alignment by region or income group. Countries with higher universal health coverage indices had lower MSAP alignment score. We concluded that the existence of a comprehensive MSAP is not enough to guarantee policy implementation, and that the WHO should focus its support on helping countries to translate plans and policies into concrete actions to address NCDs