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2.
Nutrients ; 12(12)2020 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-33266028

RESUMO

Non-communicable diseases (NCDs) are responsible for almost two-thirds of the deaths in the 22 countries and territories of the WHO Eastern Mediterranean Region and unhealthy diets are a major contributor. Prevalence of overweight and obesity has increased among adults, adolescents and older children in recent decades. Among countries with the highest prevalence there are signs that the increase is slowing down or even that prevalence is declining. There has been no increase in the prevalence rate in younger children, although the absolute number of children under five years affected by overweight has increased. This review summarizes prevalence data and examines current implementation of regulatory, fiscal and voluntary measures to promote healthy diet across the Region. The last decade has seen a step up in such action. Ten of the Region's countries have policies relating to trans-fatty acids and they are increasingly implementing specific regulatory measures. Thirteen countries had fully or partially implemented national salt reduction policies by 2019. Only four countries had adopted policies relating to aspects of marketing food to children by 2019, and concrete action in this area is still lacking. Eight countries have introduced taxes-sometimes at a rate of 50%-on carbonated or sugar-sweetened beverages. In order to meet the agreed global and regional goals relating to nutrition and diet-related NCDs, countries will need to build on this progress and scale up action across the Region while intensifying efforts in areas where concrete action is lacking.

3.
East Mediterr Health J ; 26(12): 1436-1439, 2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33355380

RESUMO

The Universal Health Coverage (UHC) Day has been commemorated on 12 December every year since 2017. In 2019, the theme of the day was "Keep the Promise", referring to the Political Declaration on UHC endorsed by Heads of States at the United Nations General Assembly High-Level Meeting on 23 September 2019. In 2020, the theme is "Protect Everyone", emphasizing global and individual health security in the context of the COVID-19 pandemic, attributed to SARS-CoV 2 - a virus that infected more than 4 million people in the Eastern Mediterranean Region (EMR) and left over 100 000 dead in less than 12 months (6.6% and 7.1% of the global toll, respectively). Keeping the promise of UHC, while ensuring health security, is becoming a priority agenda of policy-makers and practitioners in the EMR in order to save lives, advance health and protect livelihoods.


Assuntos
/epidemiologia , Pandemias , Cobertura Universal do Seguro de Saúde , Saúde Global , Política de Saúde , Prioridades em Saúde , Programas Gente Saudável , Humanos , Região do Mediterrâneo/epidemiologia , Nações Unidas
4.
East Mediterr Health J ; 26(11): 1318-1319, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33226097

RESUMO

This year, World Diabetes Day on 14 November coincides with the International Year of the Nurse and the Midwife, and therefore focuses on highlighting the role of nurses in the prevention and management of diabetes.Diabetes is recognized as an important cause of premature death and disability globally and in the Eastern Mediterranean Region, where its prevalence has been steadily increasing since 1990. Although the annual decline of the risk of dying from a major noncommunicable disease between the ages of 30 and 70 years is slowing globally, diabetes is showing a 5% increase in attributed premature mortality. In 2016, diabetes was the direct cause of 1.6 million deaths globally and 43% of all deaths before the age of 70 years occur due to high blood glucose. Overweight and obesity are the strongest risk factors for type 2 diabetes. In addition, diabetes increases the risk of heart disease and stroke and is a leading cause of blindness, lower limb amputation and kidney failure. A study conducted in 35 countries indicated that people living with diabetes are more likely to experience catastrophic health expenditures with an estimated increase of 4% between diabetic and non-diabetic individuals, regardless of their insurance status.

5.
East Mediterr Health J ; 26(10): 1148-1150, 2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33103740

RESUMO

The global COVID-19 pandemic has demonstrated the impact of a major public health emergency on mental health, and the ways that individuals, communities, professionals and systems can react positively to such a crisis. The Eastern Mediterranean Region (EMR) has substantial experience in mental health and psychosocial support (MHPSS) in crises, and COVID-19 has driven further innovation to support mental health and well-being.Global and regional guidance has been developed quickly, applying lessons learnt from previous disease outbreaks to respond to the pandemic at a systems level, for different population groups, and for countries of different income levels. Preliminary results from a global rapid assessment survey to assess the impact of COVID-19 on MHPSS services, indicate that 20 of the 22 EMR Member States have MHPSS as integral components of national COVID-19 response plans; one-third have allocated additional funding. However, MHPSS services have been severely impacted by the pandemic, including psychotherapy, psychosocial interventions, community services, and services for children/adolescents. Innovative solutions such as crisis hotlines, tele-consultations, digital self-help platforms, novel approaches to ensure supply of psychotropic medicines, and task sharing/shifting for basic psychosocial support, are being used in many countries to overcome service disruptions and maintain care for those with mental conditions.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Serviços de Saúde Mental/organização & administração , Saúde Mental , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , África do Norte/epidemiologia , Betacoronavirus , Desastres , Saúde Global , Comportamentos Relacionados com a Saúde , Promoção da Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Humanos , Oriente Médio/epidemiologia , Pandemias , Resiliência Psicológica , Determinantes Sociais da Saúde , Fatores Socioeconômicos
7.
Int J Cancer ; 2020 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-32683692

RESUMO

Data from population-based cancer registries (PBCR) are critical for planning, monitoring and evaluation of cancer control programs, but are frequently underutilized by key stakeholders. As part of the ongoing partnership of the International Agency for Research on Cancer (IARC) and the WHO Eastern Mediterranean Regional Office (EMRO) in cancer surveillance, we designed a cancer registry survey to assess the level of involvement of PBCR in national cancer control planning across the region. A questionnaire on registry characteristics, their contribution to cancer control and perceived barriers, was sent to 14 countries with operational PBCR. We obtained replies from Bahrain, Egypt, Iraq, Iran, Jordan, Kuwait, Lebanon, Morocco, Oman, Qatar, Saudi Arabia, Tunisia and the United Arab Emirates. We found a high participation of PBCR in cancer control planning (all registries involved, 46% routinely) and the evaluation of screening (92% registries involved, 46% routinely), but a much lower level of participation in palliative care and rehabilitation activities. Specified barriers included poor governance, a lack of awareness by policy makers, insufficient resources and a limited availability of data electronically, including mortality data. Appropriate planning to ensure the sustainability of PBCR (including the employment of permanent staff), increasing training, building research capacity and ensuring an efficient provision of high-quality data to policymakers, were among the proposed solutions. The results of our study reinforce the need for further tailoring of activities in support of cancer registration and enhanced networking among stakeholders, toward improving quality and use of cancer registry data for cancer control in the EMR.

8.
East Mediterr Health J ; 26(1): 4-5, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32043539

RESUMO

Although the World Health Organization Framework Convention on Tobacco Control (FCTC) came into force in 2005, the tobacco control challenge continues to escalate. Despite the fact that tobacco use is finally projected to decrease in the Eastern Mediterranean Region (EMR), as indicated in the WHO Global Report on Trends in the Prevalence of Tobacco Use, the tobacco epidemic is still far from over.The challenges facing the Region do not have a single source; the tobacco epidemic started as a multi-faceted problem and remains so today. The emergency situation in several EMR countries is pushing tobacco control down the list of priorities for decision-makers, whether directly or indirectly affected by regional conflict. The existence of unregulated and novel tobacco products, such as e-cigarettes, in many EMR countries complicates the situation further. Such products allow affordable access to tobacco products for young people, which consequently increases nicotine dependence and thus worsens the tobacco epidemic.


Assuntos
Cooperação Internacional , Uso de Tabaco/epidemiologia , Uso de Tabaco/prevenção & controle , Organização Mundial da Saúde/organização & administração , África do Norte/epidemiologia , Humanos , Oriente Médio/epidemiologia , Uso de Tabaco/legislação & jurisprudência
9.
Nutrients ; 12(2)2020 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-31991939

RESUMO

The provision of simplified nutrition information, in a prominent place on the front of food packages, is recommended as an important element of comprehensive strategies to tackle the burden of death and disease caused by unhealthy diets. There is growing evidence that front-of-pack nutrition labels are preferred by consumers, are more likely to be looked at or noticed than nutrition labelling on the back or side of packages and can help consumers to better identify healthier and less healthy products. This review summarizes current implementation of front-of-pack nutrition labelling policies in the countries of the WHO Eastern Mediterranean Region. Implementation of front-of-pack nutrition labelling in the Eastern Mediterranean Region remains limited, but three types of scheme were identified as having been implemented or at an advanced stage of development by governments in six countries. Through a review of reviews of existing research and evidence from country implementation, the authors suggest some pointers for implementation for other countries in the Region deciding to implement front-of-pack nutrition labelling policies.


Assuntos
Comportamento do Consumidor , Dieta Saudável , Rotulagem de Alimentos , Valor Nutritivo , Comportamento de Escolha , Humanos , Região do Mediterrâneo
10.
Glob Health Action ; 11(1): 1532632, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30422084

RESUMO

BACKGROUND: In October 2012, the WHO Eastern Mediterranean Region (EMR) developed a Regional Framework for Action to implement multisectoral action plans (MAPs) for the prevention and control of noncommunicable diseases (NCDs). OBJECTIVES: The aim of this project was to draw on the experiences of four EMR countries that had made good progress in developing these MAPs, to identify best practice and barriers in the development of them. METHODS: Structured interviews were held with key stakeholders in the development of the MAPs from the four focal EMR countries: Lebanon, Morocco, Sudan, and Yemen. These interviews comprised two stages: first we conducted face-to-face interviews in September 2014; we then carried out follow-up teleconference interviews during October 2014. Thematic analysis of transcripts was used to identify several themes, including examples of best practices and challenges that were common to all four focal countries and are likely to be also relevant to many other countries in the development of MAPs. RESULTS: Best practice in the development of MAPs includes methods to identify and recruit key sectors, ways to foster collaboration between sectors in the development and implementation of the action plan and means through which to encourage public support. Challenges identified included measuring outcomes in evaluating MAP success, current pressures and competing priorities for sectors and the perception of health issues as the responsibility of the health sector. Cultural and bureaucratic challenges were also discussed along with multisectoral fatigue, through the promotion of multisectoral approaches for a number of national issues. CONCLUSIONS: Although the development of multisectoral action plans to tackle NCDs is recommended, the process is a challenging one. Reflections from those countries which have experience in developing such action plans is important in identifying common challenges as well as recommending best practice, such that other countries may learn from their experiences.


Assuntos
Reforma dos Serviços de Saúde/organização & administração , Política de Saúde , Doenças não Transmissíveis/prevenção & controle , Doenças não Transmissíveis/terapia , Humanos , Líbano , Marrocos , Formulação de Políticas , Sudão , Iêmen
11.
East Mediterr Health J ; 24(1): 3-4, 2018 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30370915

RESUMO

Noncommunicable diseases (NCDs) are the leading causes of death worldwide. They are responsible for approximately 68% of global mortality each year, with cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases being the four main NCD killers. It is estimated that annually, 16 million people die prematurely (before the age of 70) as a result of NCD. The majority of NCD deaths (74%) occur in low- and middle-income countries, where this public health crisis is especially challenging due to severe social and economic conditions already faced.

12.
East Mediterr Health J ; 24(1): 5-6, 2018 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30370916

RESUMO

Noncommunicable diseases (NCDs) are a great burden in the Eastern Mediterranean Region (EMR) and, if no strategic intervention is taken, the burden is forecast to become even heavier, particularly with the additional impact of ageing populations. Currently, 62% of deaths in the EMR are due to NCDs. However, by 2030 this proportion is projected to increase to nearly 70%. The EMR is disproportionately affected by NCDs as a result of the Region's rapid urbanization and the globalization of unhealthy behaviours. Moreover, many of the EMR countries have health systems whose structures are not designed for the prevention, early detection and management of NCDs.


Assuntos
Saúde Global , Doenças não Transmissíveis/prevenção & controle , Atenção Primária à Saúde/organização & administração , África do Norte/epidemiologia , Análise Custo-Benefício , Humanos , Oriente Médio/epidemiologia , Doenças não Transmissíveis/economia , Assistência Centrada no Paciente/organização & administração , Atenção Primária à Saúde/economia , Qualidade da Assistência à Saúde/organização & administração , Fatores de Risco , Organização Mundial da Saúde/organização & administração
13.
East Mediterr Health J ; 24(4): 323-324, 2018 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-30370917

RESUMO

23 May 2018 will be remembered as an important day in the history of the World Health Organization (WHO) and global health. It was the day when the 194 Member States that constitute the World Health Assembly (WHA) - the highest decision-making body of WHO, making it effectively the global parliament for health - unanimously adopted the thirteenth general programme of work (GPW 13) for the Organization, covering the next five years (2019-2003). In its 70 years of existence, WHO has already seen 12 GPWs, but GPW 13 marks a new departure in many ways, heralding the Organization's entry into a new era of work with new ways of tackling the task of improving people's health and well-being across the globe.

14.
East Mediterr Health J ; 24(5): 409-410, 2018 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-30370919

RESUMO

The movement to reduce tobacco use has been gathering pace in the Eastern Mediterranean Region (EMR), as governments aim at implementing legislation to encourage populations to turn away from tobacco consumption and avoid the associated health risks. Indeed, within the Region it was in 2007 that Egyptian cardiologist Prof. Hamdi El Sayed, former member of parliament and former head of the Medical Syndicate, successfully proposed legislation for the implementation of graphic health warnings on tobacco packets covering 50% of visible packaging. In 2011, cardiologist Dr George Saade, former focal point of tobacco control in the Lebanese Ministry of Health, proposed banning tobacco use in all public places in Lebanon - a country coined a "paradise for smokers" in local media - and witnessed the implementation of this ground-breaking legislation. Meanwhile, in 2013, cardiologist Dr Sania Nishtar, Pakistan, stood strongly in support of the tobacco control movement with regard to the adoption of legislation comprehensively banning tobacco advertising in Pakistan.


Assuntos
Cardiologistas , Saúde Global , Produtos do Tabaco/legislação & jurisprudência , Tabagismo/prevenção & controle , Publicidade/legislação & jurisprudência , Política de Saúde , Humanos , Região do Mediterrâneo/epidemiologia , Tabagismo/epidemiologia
16.
Glob Cardiol Sci Pract ; 2018(1): 1, 2018 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-29644228

RESUMO

In recent years, a number of global commitments have been made in the area of noncommunicable diseases (NCD). These include the UN NCD Political Declaration in 2011, and the UN Comprehensive Review on NCDs and Outcome Document in 2014. Nine global targets have been agreed in the area of NCDs, and NCDs have been addressed in the Sustainable Development Goals (SDG). Another UN high-level meeting will take place in September 2018 to assess country progress across the globe. At the regional level, a number of initiates have taken place to deliver on these global commitments. One of the guiding documents is the Regional Framework for Action on Noncommunicable Diseases. This framework was endorsed at the WHO EM Regional Committee in 2012, and includes 17 strategic interventions and 10 monitoring indicators, covering the areas of NCD governance, prevention, surveillance and healthcare. Progress is being monitored on an annual basis through the development of country progress factsheets and biennial WHO Country Capacity Survey on NCDs. To date however, progress has been insufficient and uneven. Moreover, is has been slowest in the areas of planning and surveillance, and tobacco control. No uniform approach or model exists for all EMR countries, but a number of countries have advanced their national NCD agenda through original and innovative initiatives. Perceived challenges include the uneven progress and needs across the WHO EM region, humanitarian emergencies and political instability, vertical approaches, a lack of human and financial resources and other health systems weaknesses. Opportunities however exist through the global SDG and universal health coverage (UHC) agendas offering an opportunity to revisit essential health services package until 2030. Overall, there has been political commitment to NCD governance, as evidenced by the EM Regional Committee's endorsement of the regional framework for action. However, despite the clear roadmap, progress has been slow and scattered, differing vastly by country and by topic. We recommend that countries urgently scale up their efforts in all four areas of the EM Regional Framework of Action to be able to achieve their national and international targets.

19.
East Mediterr Health J ; 24(1): 52-62, 2018 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-29658621

RESUMO

Surveillance is an essential component in the campaign to prevent and control noncommunicable diseases (NCDs), both globally and in the Eastern Mediterranean Region (EMR). In order to address the increasing burden from these diseases, countries must first evaluate their own systems and see what steps need to be taken to improve preparedness. Therefore, the WHO Regional Office for the Eastern Mediterranean in Cairo, Egypt, conducts country capacity surveys on a regular basis to compare each Member State's NCD provision to the Framework for Action to implement the UN Political Declaration (2011). Ten progress indicators cover governance and planning, reducing risk factors and healthcare provision. Each one is scored for whether a country is fully, partially or not achieving this goal. This review focuses on comparing the Progress Monitor reports for the 22 EMR countries in 2015 and 2017. While the criteria used to assess some of the indicators have been updated over this period, many categories still show strong improvements. However, others still require extensive work if countries are to meet the sustainable development goal of reducing by 25% the number of premature deaths from NCDs by the year 2025.


Assuntos
Fortalecimento Institucional/organização & administração , Saúde Global , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/prevenção & controle , África do Norte/epidemiologia , Humanos , Oriente Médio/epidemiologia , Vigilância em Saúde Pública/métodos , Fatores de Risco , Organização Mundial da Saúde/organização & administração
20.
PLoS One ; 10(6): e0128907, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26075615

RESUMO

BACKGROUND: TB is one of the main health priorities in Uzbekistan and relatively high rates of unfavorable treatment outcomes have recently been reported. This requires closer analysis to explain the reasons and recommend interventions to improve the situation. Thus, by using countrywide data this study sought to determine trends in unfavorable outcomes (lost-to-follow-ups, deaths and treatment failures) and describe their associations with socio-demographic and clinical factors. METHOD: A countrywide retrospective cohort study of all new and previously treated TB patients registered in the National Tuberculosis programme between January 2006 and December 2010. RESULTS: Among 107,380 registered patients, 67% were adults, with smaller proportions of children (10%), adolescents (4%) and elderly patients (19%). Sixty per cent were male, 66% lived in rural areas, 1% were HIV-infected and 1% had a history of imprisonment. Pulmonary TB (PTB) was present in 77%, of which 43% were smear-positive and 53% were smear-negative. Overall, 83% of patients were successfully treated, 6% died, 6% were lost-to-follow-up, 3% failed treatment and 2% transferred out. Factors associated with death included being above 55 years of age, HIV-positive, sputum smear positive, previously treated, jobless and living in certain provinces. Factors associated with lost-to-follow-up were being male, previously treated, jobless, living in an urban area, and living in certain provinces. Having smear-positive PTB, being an adolescent, being urban population, being HIV-negative, previously treated, jobless and residing in particular provinces were associated with treatment failure. CONCLUSION: Overall, 83% treatment success rate was achieved. However, our study findings highlight the need to improve TB services for certain vulnerable groups and in specific areas of the country. They also emphasize the need to develop unified monitoring and evaluation tools for drug-susceptible and drug-resistant TB, and call for better TB surveillance and coordination between provinces and neighbouring countries.


Assuntos
Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Antituberculosos/uso terapêutico , Estudos de Coortes , Coinfecção , Feminino , Infecções por HIV , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Vigilância da População , Sistema de Registros , Fatores de Risco , Falha de Tratamento , Resultado do Tratamento , Tuberculose/terapia , Uzbequistão/epidemiologia , Adulto Jovem
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