RT Journal Article
SR Electronic
T1 Prioritizing Health-Sector Interventions for Noncommunicable Diseases and Injuries in Low- and Lower-Middle Income Countries: National NCDI Poverty Commissions
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP 626
OP 639
DO 10.9745/GHSP-D-21-00035
VO 9
IS 3
A1 Gupta, Neil
A1 Mocumbi, Ana
A1 Arwal, Said H.
A1 Jain, Yogesh
A1 Haileamlak, Abraham M.
A1 Memirie, Solomon T.
A1 Larco, Nancy C.
A1 Kwan, Gene F.
A1 Amuyunzu-Nyamongo, Mary
A1 Gathecha, Gladwell
A1 Amegashie, Fred
A1 Rakotoarison, Vincent
A1 Masiye, Jones
A1 Wroe, Emily
A1 Koirala, Bhagawan
A1 Karmacharya, Biraj
A1 Condo, Jeanine
A1 Nyemazi, Jean Pierre
A1 Sesay, Santigie
A1 Maogenzi, Sarah
A1 Mayige, Mary
A1 Mutungi, Gerald
A1 Ssinabulya, Isaac
A1 Akiteng, Ann R.
A1 Mudavanhu, Justice
A1 Kapambwe, Sharon
A1 Watkins, David
A1 Norheim, Ole
A1 Makani, Julie
A1 Bukhman, Gene
A1 NCDI Poverty National Commissions Authorship Group; NCDI Poverty Network Secretariat
YR 2021
UL http://www.ghspjournal.org/content/9/3/626.abstract
AB Key FindingsNational Noncommunicable Disease and Injury (NCDI) Poverty Commissions were established in 16 low- and lower-middle-income countries (LLMICs) to define local NCDI epidemiology, determine an expanded set of priority NCDI conditions, and recommend cost-effective, equitable health-sector interventions.Commissions prioritized an average of 35 health-sector interventions estimated to cost an additional US$4.70–US$13.70 per capita or approximately 9.7%–35.6% of current total health expenditure (0.6%–4.0% of current gross domestic product).Commissions demonstrated positive outcomes in understanding NCDIs of poverty, informing national planning and implementation of NCDI health-sector interventions, and improving governance and coordination for NCDIs.Key ImplicationsPolicy makers should use findings from the National NCDI Poverty Commissions to provide evidence-based, locally driven determination of priorities to guide health-sector policies, programs, and investments for NCDIs.External financing will be required to bridge the gap in financing for NCDIs to achieve universal health coverage in LLMICs.Health sector priorities and interventions to prevent and manage noncommunicable diseases and injuries (NCDIs) in low- and lower-middle-income countries (LLMICs) have primarily adopted elements of the World Health Organization Global Action Plan for NCDs 2013–2020. However, there have been limited efforts in LLMICs to prioritize among conditions and health-sector interventions for NCDIs based on local epidemiology and contextually relevant risk factors or that incorporate the equitable distribution of health outcomes. The Lancet Commission on Reframing Noncommunicable Diseases and Injuries for the Poorest Billion supported national NCDI Poverty Commissions to define local NCDI epidemiology, determine an expanded set of priority NCDI conditions, and recommend cost-effective, equitable health-sector interventions. Fifteen national commissions and 1 state-level commission were established from 2016–2019. Six commissions completed the prioritization exercise and selected an average of 25 NCDI conditions; 15 conditions were selected by all commissions, including asthma, breast cancer, cervical cancer, diabetes mellitus type 1 and 2, epilepsy, hypertensive heart disease, intracerebral hemorrhage, ischemic heart disease, ischemic stroke, major depressive disorder, motor vehicle road injuries, rheumatic heart disease, sickle cell disorders, and subarachnoid hemorrhage. The commissions prioritized an average of 35 health-sector interventions based on cost-effectiveness, financial risk protection, and equity-enhancing rankings. The prioritized interventions were estimated to cost an additional US$4.70–US$13.70 per capita or approximately 9.7%–35.6% of current total health expenditure (0.6%–4.0% of current gross domestic product). Semistructured surveys and qualitative interviews of commission representatives demonstrated positive outcomes in several thematic areas, including understanding NCDIs of poverty, informing national planning and implementation of NCDI health-sector interventions, and improving governance and coordination for NCDIs. Overall, national NCDI Poverty Commissions provided a platform for evidence-based, locally driven determination of priorities within NCDIs.