Non-communicable diseases and health systems reform in low and middle-income countries

Public health Diseases Policy

Non-communicable diseases (NCDs) are becoming an increasing major health and socio-economic concern in low-and-middle-income  countries (LMICs). The World Health Organization estimates that NCDs accounted  for 63 per cent of global mortality in 2008, 80 per cent of which was in LMICs.

Experiences of high-income countries in controlling NCDs demonstrates the need for responses to be comprehensive and multi-sectoral, integrating health promotion, prevention and treatment  strategies, as well as the community and the health sector. Such multi-sectoral approaches require robust and effective health systems.

The majority of health systems in LMICs, however, are fragile and will need to adapt to address NCDs while continuing to tackle communicable diseases. This paper outlines reform in four areas for this adaptation:

  • Building political commitment and addressing health system constraints
  • Developing public policies in health promotion and disease prevention
  • Creating new service delivery models
  • Ensuring equity in access and payments
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