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1.
Health Res Policy Syst ; 19(1): 7, 2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461592

RESUMO

BACKGROUND: The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) is a research consortium concerned with the prevention, diagnosis and treatment of non-communicable diseases. CEBHA+ seeks to engage policymakers and practitioners throughout the research process in order to build lasting relationships, enhance evidence uptake, and create long-term capacity among partner institutions in Ethiopia, Malawi, Rwanda, South Africa and Uganda in collaboration with two German universities. This integrated knowledge translation (IKT) approach includes the formal development, implementation and evaluation of country specific IKT strategies. METHODS: We have conceptualised the CEBHA+ IKT approach as a complex intervention in a complex system. We will employ a comparative case study (CCS) design and mixed methods to facilitate an in-depth evaluation. We will use quantitative surveys, qualitative interviews, quarterly updates, and a policy document analysis to capture the process and outcomes of IKT across the African CEBHA+ partner sites. We will conduct an early stage (early 2020) and a late-stage evaluation (early 2022), triangulate the data collected with various methods at each site and subsequently compare our findings across the five sites. DISCUSSION: Evaluating a complex intervention such as the CEBHA+ IKT approach is complicated, even more so when undertaken across five diverse countries. Despite conceptual, methodological and practical challenges, our comparative case study addresses important evidence gaps: While involving decision-makers in the research process is gaining traction worldwide, we still know very little regarding (i) whether this approach really makes a difference to evidence uptake, (ii) the mechanisms that make IKT successful, and (iii) relevant differences across socio-cultural contexts. The evaluation described here is intended to provide relevant insights on all of these aspects, notably in countries in Sub-Saharan Africa, and is expected to contribute to the science of IKT overall.


Assuntos
Doenças não Transmissíveis/prevenção & controle , Projetos de Pesquisa , Pesquisa Médica Translacional , África , Assistência à Saúde , Alemanha , Pesquisa sobre Serviços de Saúde , Humanos , Estudos Multicêntricos como Assunto , Saúde Pública
5.
Rev. enferm. UERJ ; 28: e49931, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1128455

RESUMO

Objetivo: analisar o perfil de internações por Doenças Crônicas não Transmissíveis (DCNT) e sua relação com a cobertura da Estratégia Saúde da Família (ESF). Método: estudo descritivo, exploratório e de abordagem quantitativa, realizado em São Carlos-SP, no período de 2016 a 2018. As informações foram coletadas no sistema e-SUS e nas fichas de Autorizações de Internação Hospitalar. Os dados foram analisados por meio da estatística descritiva. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal de São Carlos. Resultados: destaca-se que as taxas de internação por angina, insuficiência cardíaca, diabetes e hipertensão diminuíram, sobretudo entre 2017 e 2018, quando houve ampliação da cobertura de ESF. Conclusão: a expansão da ESF foi determinante para reduzir as internações por DCNT; contudo, faz-se necessário ampliar os serviços prestados aos usuários, e reavaliar as estratégias de cuidado, especialmente aquelas direcionadas aos idosos e indivíduos acometidos por doenças cerebrovasculares e pulmonares.


Objective: to analyze the profile of hospitalizations for Chronic non-Communicable Diseases (NCDs) and their relationship with coverage by the Family Health Strategy (FHS). Method: this exploratory, quantitative, descriptive study was conducted from 2016 to 2018 at 21 FHS units in São Carlos, São Paulo State, Brazil. Information was collected from the e-SUS system and Hospitalization Authorization forms and data were analyzed using descriptive statistics. The study was approved by the research ethics committee of São Carlos Federal University. Results: hospitalization rates for angina, heart failure, diabetes, and hypertension were found to have decreased between 2017 and 2018, when FHS coverage expanded. Conclusion: expansion of the FHS was crucial to reduce NCD admissions. However, the services provided to users need to be expanded, and care strategies, especially those directed to the elderly and individuals suffering from cerebrovascular and pulmonary diseases, need to be reassessed and intensified.


Objetivo: analizar el perfil de las hospitalizaciones por Enfermedades Crónicas no Transmisibles (ENT) y su relación con la cobertura de la Estrategia de Salud de la Familia (ESF). Método: este estudio exploratorio, cuantitativo y descriptivo se realizó de 2016 a 2018 en 21 unidades de la ESF en São Carlos, Estado de São Paulo, Brazil. Se recopiló información del sistema e-SUS y de los formularios de Autorización de Hospitalización y se analizaron los datos mediante estadística descriptiva. El estudio fue aprobado por el comité de ética en investigación de la Universidad Federal de São Carlos. Resultados: se encontró que las tasas de hospitalización por angina, insuficiencia cardíaca, diabetes e hipertensión disminuyeron entre 2017 y 2018, cuando se expandió la cobertura de la ESF. Conclusión: la expansión de la ESF fue crucial para reducir los ingresos por ENT. Sin embargo, es necesario ampliar los servicios que se brindan a los usuarios y reevaluar e intensificar las estrategias de atención, especialmente las dirigidas a las personas mayores y a las personas que padecen enfermedades cerebrovasculares y pulmonares.


Assuntos
Humanos , Atenção Primária à Saúde , Estratégia Saúde da Família , Doenças não Transmissíveis/prevenção & controle , Hospitalização/estatística & dados numéricos , Serviços Preventivos de Saúde , Brasil , Epidemiologia Descritiva
7.
Nutrients ; 12(11)2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33167515

RESUMO

Past public health crises (e.g., tobacco, alcohol, opioids, cholera, human immunodeficiency virus (HIV), lead, pollution, venereal disease, even coronavirus (COVID-19) have been met with interventions targeted both at the individual and all of society. While the healthcare community is very aware that the global pandemic of non-communicable diseases (NCDs) has its origins in our Western ultraprocessed food diet, society has been slow to initiate any interventions other than public education, which has been ineffective, in part due to food industry interference. This article provides the rationale for such public health interventions, by compiling the evidence that added sugar, and by proxy the ultraprocessed food category, meets the four criteria set by the public health community as necessary and sufficient for regulation-abuse, toxicity, ubiquity, and externalities (How does your consumption affect me?). To their credit, some countries have recently heeded this science and have instituted sugar taxation policies to help ameliorate NCDs within their borders. This article also supplies scientific counters to food industry talking points, and sample intervention strategies, in order to guide both scientists and policy makers in instituting further appropriate public health measures to quell this pandemic.


Assuntos
Comportamento Aditivo/prevenção & controle , Dieta , Açúcares da Dieta/efeitos adversos , Fast Foods/efeitos adversos , Indústria Alimentícia/legislação & jurisprudência , Doenças não Transmissíveis/prevenção & controle , Saúde Pública , Comportamento Aditivo/etiologia , Infecções por Coronavirus , Comportamento Alimentar , Manipulação de Alimentos/legislação & jurisprudência , Humanos , Obesidade/etiologia , Obesidade/prevenção & controle , Pandemias , Pneumonia Viral , Política Pública , Controle Social Formal , Impostos
8.
Int J Gynaecol Obstet ; 151 Suppl 1: 6-15, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32894587

RESUMO

With the increase in obesity prevalence among women of reproductive age globally, the risks of type 2 diabetes, gestational diabetes, pre-eclampsia, and other conditions are rising, with detrimental effects on maternal and newborn health. The period before pregnancy is increasingly recognized as crucial for addressing weight management and reducing malnutrition (both under- and overnutrition) in both parents to reduce the risk of noncommunicable diseases (NCDs) in the mother as well as the passage of risk to her offspring. Healthcare practitioners, including obstetricians, gynecologists, midwives, and general practitioners, have an important role to play in supporting women in planning a pregnancy and achieving healthy nutrition and weight before pregnancy. In this position paper, the FIGO Pregnancy Obesity and Nutrition Initiative provides an overview of the evidence for preconception clinical guidelines to reduce the risk of NCDs in mothers and their offspring. It encourages healthcare practitioners to initiate a dialogue on women's health, nutrition, and weight management before conception. While acknowledging the fundamental importance of the wider social and environmental determinants of health, this paper focuses on a simple set of recommendations for clinical practice that can be used even in short consultations. The recommendations can be contextualized based on local cultural and dietary practices as part of a system-wide public health approach to influence the wider determinants as well as individual factors influencing preconception health.


Assuntos
Doenças não Transmissíveis/prevenção & controle , Cuidado Pré-Concepcional/métodos , Saúde da Mulher , Peso Corporal , Feminino , Humanos , Saúde do Lactente/normas , Recém-Nascido , Serviços de Saúde Materno-Infantil/organização & administração , Guias de Prática Clínica como Assunto , Cuidado Pré-Concepcional/normas , Gravidez
12.
BMC Int Health Hum Rights ; 20(1): 22, 2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32859194

RESUMO

Notwithstanding COVID-19, non-communicable diseases (NCDs) will be the leading cause of death in every region in the world by 2030. This contribution, which forms an introduction to our collection of articles in this journal, identifies elements for a transdisciplinary research agenda between law, public health, health economics and international relations aimed at designing concrete interventions to curb the NCD pandemic, both globally and domestically.


Assuntos
Pesquisa Interdisciplinar/organização & administração , Doenças não Transmissíveis/prevenção & controle , Pandemias/prevenção & controle , Causas de Morte/tendências , Saúde Global/estatística & dados numéricos , Humanos , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/mortalidade
13.
Artigo em Inglês | MEDLINE | ID: mdl-32824798

RESUMO

Non-communicable diseases (NCDs) are a major cause of disability and mortality worldwide. Physical inactivity is an important contributor to the development of NCDs. Increasing physical activity through supervised exercise therapy (SET) is proven to be effective, and is a key component in both the prevention and treatment of most NCDs. However, only a minority of patients with NCDs receive this treatment, mainly due to an insufficient number and poor accessibility of specialized physical therapists. The aim of this article is to describe a solution that, if indicated, enables all patients with NCDs in the Netherlands to receive SET by a specialized physical therapist: Chronic CareNet. Chronic CareNet is a nationwide network of specialized physical therapists, providing high quality SET and lifestyle counselling to patients with NCDs, initially focusing on peripheral arterial disease, chronic obstructive pulmonary disease and coronary heart disease. The network evolved from ClaudicatioNet. In order to monitor quality of care, therapists enroll in a continuous educational program, and process and outcome indicators are collected by all therapists, which can be compared with a nationwide benchmark (quality system). A robust infrastructure of information and communication technology provides an online care finder and referral system to locate and refer to nearby therapists. All elements of Chronic CareNet are essential, to ensure that all patients in the Netherlands have access to a nearby specialized therapist.


Assuntos
Doenças não Transmissíveis/prevenção & controle , Aconselhamento , Terapia por Exercício , Humanos , Estilo de Vida , Países Baixos
14.
PLoS One ; 15(8): e0236699, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760079

RESUMO

INTRODUCTION: Unhealthy food environments drive the increase of diet-related non-communicable diseases (NCDs). OBJECTIVE: We aimed to examine healthy food environment policies in Kenya and identify priorities for future action. METHODS: Using the Healthy Food Environment Policy Index (Food-EPI) we collected evidence on the extent of government action to create healthy food environments across 13 policy and infrastructure support domains and 43 related good practice indicators between 2017 and 2018. A panel of 15 national experts rated the extent of government action on each indicator compared to the policy development cycle and international best practice respectively. Based on gaps found, actions to improve food environments in Kenya were identified and prioritized. RESULTS: In the policy development cycle, 16/43 (37%) of good practice policy indicators were judged to be in 'implementation' phase, including: food composition targets, packaged foods' ingredient lists/nutrient declarations; systems regulating health claims; restrictions on marketing breast milk substitutes; and school nutrition policies. Infrastructure support actions in 'implementation' phase included: food-based dietary guidelines; strong political support to reduce NCDs; comprehensive NCD action plan; transparency in developing food policies; and surveys monitoring nutritional status. Half (22/43) of the indicators were judged to be 'in development'. Compared to international best practice, the Kenyan Government was judged to be performing relatively well ('medium' implementation) in one policy (restrictions on marketing breast milk substitutes) and three infrastructure support areas (political leadership; comprehensive implementation plan; and ensuring all food policies are sensitive to nutrition). Implementation for 36 (83.7%) indicators were rated as 'low' or 'very little'. Taking into account importance and feasibility, seven actions within the areas of leadership, food composition, labelling, promotion, prices and health-in-all-policies were prioritized. CONCLUSION: This baseline assessment is important in creating awareness to address gaps in food environment policy. Regular monitoring using Food-EPI may contribute to addressing the burden of diet-related NCDs in Kenya.


Assuntos
Benchmarking , Promoção da Saúde , Doenças não Transmissíveis/prevenção & controle , Política Nutricional , Dieta Saudável , Governo , Humanos , Quênia , Formulação de Políticas , Saúde Pública
15.
J Stroke Cerebrovasc Dis ; 29(9): 105089, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807484

RESUMO

BACKGROUND: The interaction between coronavirus disease 2019 (COVID-19) and non-communicable diseases may increase the global burden of disease. We assessed the association of COVID-19 with ageing and non-communicable diseases. METHODS: We extracted data regarding non-communicable disease, particularly cardiovascular disease, deaths, disability-adjusted life years (DALYs), and healthy life expectancy (HALE) from the Global Burden of Disease Study (GBD) 2017. We obtained data of confirmed COVID-19 cases, deaths, and tests from the Our World in Data database as of May 28, 2020. Potential confounders of pandemic outcomes analyzed include institutional lockdown delay, hemispheric geographical location, and number of tourists. We compared all countries according to GBD classification and World Bank income level. We assessed the correlation between independent variables associated with COVID-19 caseload and mortality using Spearman's rank correlation and adjusted mixed model analysis. FINDINGS: High-income had the highest, and the Southeast Asia, East Asia, and Oceania region had the least cases per million population (3050.60 vs. 63.86). Sub-saharan region has reported the lowest number of COVID-19 mortality (1.9). Median delay to lockdown initiation varied from one day following the first case in Latin America and Caribbean region, to 34 days in Southeast Asia, East Asia, and Oceania. Globally, non-communicable disease DALYs were correlated with COVID-19 cases (r = 0.32, p<0.001) and deaths (r = 0.37, p<0.001). HALE correlated with COVID-19 cases (r = 0.63, p<0.001) and deaths (r = 0.61, p<0.001). HALE was independently associated with COVID-19 case rate and the number of tourists was associated with COVID-19 mortality in the adjusted model. INTERPRETATION: Preventive measures against COVID-19 should protect the public from the dual burden of communicable and non-communicable diseases, particularly in the elderly. In addition to active COVID-19 surveillance, policymakers should utilize this evidence as a guide for prevention and coordination of health services. This model is timely, as many countries have begun to reduce social isolation.


Assuntos
Infecções por Coronavirus/epidemiologia , Saúde Global , Doenças não Transmissíveis/epidemiologia , Pneumonia Viral/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/patogenicidade , Causas de Morte , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Efeitos Psicossociais da Doença , Bases de Dados Factuais , Feminino , Necessidades e Demandas de Serviços de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Interações Hospedeiro-Patógeno , Humanos , Incidência , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Doenças não Transmissíveis/mortalidade , Doenças não Transmissíveis/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Prognóstico , Fatores de Risco , Fatores de Tempo
16.
Rev. habanera cienc. méd ; 19(4): e2906, tab
Artigo em Espanhol | LILACS | ID: biblio-1139181

RESUMO

RESUMEN Introducción: Diversos estudios a través del tiempo han demostrado los potenciales beneficios de la práctica de la Actividad Física (AF); sin embargo, también se han identificado algunos de sus moduladores conocidos como determinantes que modifican su práctica. Objetivo: Recopilar y resumir la información disponible sobre la importancia de la actividad física, su definición, determinantes y métodos de evaluación en adultos, así como establecer el desarrollo de las recomendaciones a lo largo del tiempo. Material y Métodos: Se realizó una búsqueda en bases de datos entre el período comprendido entre 1996 y 2019, con términos de búsqueda en inglés y español de actividad física, recomendaciones, determinantes. Se incluyeron artículos relacionados con adultos y se excluyeron aquellos sobre niños y adolescentes. Desarrollo: Las recomendaciones han evolucionado desde 1978 del Colegio Americano de Medicina Deportiva (ACSM) con unas especificaciones muy generales como prácticas AF de 3 a 5 días por semana con una intensidad de 60 por ciento al 90 por ciento de la Frecuencia Cardíaca de Reserva (FCR) hasta las más recientes recomendaciones de 2018 realizadas por el Centro para el Control y la Prevención de Enfermedades (CDC). Dentro de los métodos de evaluación se encuentra criterio, objetivos y subjetivos. Conclusiones: La práctica regular de AF es una estrategia eficiente para disminuir los factores de riesgo asociados con Enfermedades No Transmisibles (ENT). Asimismo, se identifican métodos criterio, objetivos y subjetivos para su evaluación; las recomendaciones han evolucionado desde 1978 hasta 2018, y establecen que los adultos deberán practicar entre 150 a 300 minutos/semana de AF(AU)


ABSTRACT Introduction: Several studies have shown the potential benefits of the practice of Physical Activity (PA) over the years; however, some modulators known as determinants that modify its practice have also been identified. Objective: To gather and summarize available information on the importance of physical activity, its definition, determinants and evaluation methods in adults, as well as to establish the development of recommendations over time. Material and Methods: A search was made in different databases using search terms of physical activity, recommendations, and determinants in both English and Spanish during the period between 1996 and 2019. Articles related to adults were included and those about children and adolescents were excluded. Development: The recommendations have evolved from 1978 when the American College of Sports Medicine (ACSM) established very general specifications such as PA practices from 3 to 5 days per week at an intensity between 60 percent and 90 percent Heart Rate Reserve (HRR) until the most recent recommendations made by the Center for Disease Control and Prevention (CDC) in 2018. Objective and subjective criteria are among the evaluation methods. Conclusions: Regular PA practice is an efficient strategy to reduce the risk factors associated with Non-Communicable Diseases (NCDs). Likewise, subjective and objective criteria are identified for its evaluation. The recommendations have evolved from 1978 to 2018 establishing that adults should be involved in PA from 150 to 300 minutes per week(AU)


Assuntos
Humanos , Adulto , Exercício Físico , Doenças não Transmissíveis/prevenção & controle , Estilo de Vida , Atividade Motora
17.
Washington; Organización Panamericana de la Salud; ago 25, 2020. 11 p. ilus.
Não convencional em Espanhol | LILACS | ID: biblio-1117907

RESUMO

El Programa Subregional para América del Sur (SAM) representa la visión estratégica de la OPS/OMS a mediano plazo para la subregión sudamericana. El Programa apoya las prioridades subregionales en materia de salud y busca armonizar el trabajo de OPS/OMS con los mecanismos de integración, particularmente con el Mercado Común del Sur (MERCOSUR), el Organismo Andino de Salud - Convenio Hipólito Unanue (ORAS-CONHU), la Organización del Tratado de Cooperación Amazónica (OTCA), PROSUR, Alianza del Pacífico y otros socios.


Assuntos
Humanos , Administração de Recursos Humanos , Sistemas de Saúde/organização & administração , Controle de Doenças Transmissíveis , Saúde de Populações Indígenas , Pandemias/prevenção & controle , Doenças não Transmissíveis/prevenção & controle , Organização Pan-Americana da Saúde , Pneumonia Viral/epidemiologia , Áreas de Fronteira , Mudança Climática , Infecções por Coronavirus/epidemiologia , Mercosul , Betacoronavirus , América Latina
18.
Arch. argent. pediatr ; 118(4): s118-s129, agosto 2020.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1118605

RESUMO

En las últimas décadas, las enfermedades crónicas no transmisibles (ENT) se han convertido en la principal causa de mortalidad global y han aumentado en América Latina. La contribución de recursos de la ciencia del desarrollo, la epigenética, las neurociencias, las ciencias ambientales, la epidemiología y la investigación ha generado evidencia del origen de las ENT desde la programación fetal. Los resultados de salud y enfermedad devienen de una trayectoria dinámica en la que se agregan factores protectores para una vida saludable o factores de riesgo para enfermedades del individuo y las comunidades.El concepto de Developmental Origins of Health and Disease redimensiona el papel del equipo de salud materno-infantil y debe guiar las políticas públicas para priorizar los primeros mil días de vida para un desarrollo saludable y la prevención de ENT. Se presenta una actualización sobre las principales condiciones ambientales adversas que pueden alterar la programación del desarrollo y predisponer a ENT en el curso de la vida.


In recent decades, chronic non-communicable diseases (NCDs) have become the leading cause of global mortality and increased in Latin America. The contribution of the resources from development science, epigenetics, neurosciences, environmental sciences, epidemiology and research has generated evidence of the origin of NCDs since fetal programming. The healt and disease outcomes result from a dynamic trajectory where protective factors are added for a healthy life or risk factors for diseases of the individual and the communities. Developmental Origins of Health and Disease concept resizes the role of the maternal and child health team and should guide public policies by prioritizing the first 1000 days of life for healthy development and NCDs prevention. We present an update on principal adverse environmental conditions that may alter development programming and predispose NCDs in life course


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Meio Ambiente , Doenças não Transmissíveis/epidemiologia , Desenvolvimento Infantil , Saúde Pública , Saúde Materno-Infantil , Exposição Ambiental , Epigenômica , Doenças não Transmissíveis/prevenção & controle
19.
Washington; Organización Panamericana de la Salud; ago. 11, 2020.
Não convencional em Inglês, Espanhol, Português | LILACS | ID: biblio-1117108

RESUMO

As doenças não transmissíveis (DNTs) são a principal causa de morte e incapacidade em todo o mundo. O controle eficaz dessas doenças crônicas depende em grande parte de serviços continuados, responsivos, acessíveis e de qualidade, além de engajamento e autocontrole satisfatórios por parte dos pacientes. A saúde digital, em especial as teleconsultas médicas, os prontuários eletrônicos e as prescrições eletrônicas, já demonstrou ser vantajosa para assegurar a continuidade da assistência, principalmente quando os serviços são interrompidos, além do monitoramento e da avaliação de intervenções em DNTs.


Las enfermedades no transmisibles (ENT) son la primera causa de muerte y discapacidad en el mundo. El tratamiento eficaz de estos trastornos crónicos depende en gran medida de la continuidad de unos servicios receptivos, accesibles y de calidad, así como de la participación de los pacientes y su autocuidado. Está comprobado que la salud digital ­en particular la telemedicina y las historias clínicas y recetas electrónicas­ es ventajosa para resguardar la continuidad de la atención, especialmente cuando hay alteraciones de los servicios, además de facilitar el seguimiento y evaluación de las intervenciones contra las ENT.


Noncommunicable diseases (NCDs) are the main cause of death and disability worldwide. Effective management of these chronic conditions depends largely on continuous, responsive, accessible, and quality services and successful patient engagement and self-management. Digital health, and in particular telemedicine visits, electronic records, and electronic prescriptions, have already demonstrated having advantages in successfully ensuring continuity of care, especially when services are disrupted, as well as monitoring and evaluating interventions for NCDs.


Assuntos
Telemedicina/métodos , Telemedicina/organização & administração , Pandemias/prevenção & controle , Gestão da Informação em Saúde/organização & administração , Doenças não Transmissíveis/prevenção & controle , Fatores de Risco , Controle de Infecções/organização & administração
20.
S Afr Med J ; 110(3): 188-191, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32657694

RESUMO

Health promotion - keeping people healthy - is critical to ensuring that South Africa (SA)'s National Health Insurance (NHI) services and funding will not be overwhelmed by having to service and pay for large numbers of people with avoidable disease. Although the 2019 NHI Bill mentions health promotion, its lack of emphasis and the narrow approach proposed in the Bill make it unlikely that health promotion will have significant impact on population health or reducing healthcare need. Health promotion experts submit that there is in fact huge potential for carefully planned and researched health promotion to impact on population health. The establishment of a multisectoral National Health Commission or an independent Health Promotion and Development Foundation linked directly to the NHI Fund that includes several relevant government departments and civil society and researchers is proposed. Of the NHI Fund, 2% should be dedicated specifically to promoting health and preventing illness, which must support comprehensive, multisectoral health promotion interventions that go beyond awareness raising and health education. SA's specific realities and needs, including poverty and its related behavioural impacts and health consequences, must be taken into account.


Assuntos
Promoção da Saúde , Programas Nacionais de Saúde/economia , Administração Financeira , Governo , Educação em Saúde , Humanos , Doenças não Transmissíveis/mortalidade , Doenças não Transmissíveis/prevenção & controle , África do Sul
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