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Addressing the double burden of disease: improving health systems for Noncommunicable and Neglected Tropical Diseases

English title Addressing the double burden of disease: improving health systems for Noncommunicable and Neglected Tropical Diseases
Applicant Beran David Henri
Number 160366
Funding scheme r4d (Swiss Programme for Research on Global Issues for Development)
Research institution Hôpitaux Universitaires de Genève Division of Tropical and Humanitarian Medicine
Institution of higher education University of Geneva - GE
Main discipline Public Health and Health Services
Start/End 01.02.2016 - 31.01.2022
Approved amount 1'792'764.00
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Keywords (5)

Noncommunicable diseases; Health systems; Neglected Tropical Diseases; Universal Health Coverage; Primary Health Care

Lay Summary (French)

Lead
Les systèmes de santé des pays à faible et moyen revenu ont besoin de s’adapter aux changements du fardeau des maladies auxquels doivent faire face leurs populations. Ces pays sont confrontés à une augmentation de la prévalence des maladies non transmissibles en parallèle au défi des maladies tropicales négligées, qui impactent principalement les populations vulnérables. Des déclarations politiques tentent de rallier les gouvernements à trouver des solutions, mais des défis persistent pour les maladies non transmissibles et les maladies tropicales négligées dans plusieurs contextes.
Lay summary

Contenu et objectifs du travail de recherche

Le projet « COmmunity HEalth System InnovatiON » (COHESION) mené par les Hôpitaux Universitaires de Genève et l’Université de Genève en partenariat avec des collègues au Mozambique, Népal et Pérou ainsi que d’autres institutions suisses vise à aborder ce défi avec une approche scientifique, un engagement des différentes parties prenantes et des interventions au niveau politique, du système de santé et de la communauté.

 

Le projet utilisera différentes approches méthodologiques afin d’évaluer : les politiques au niveau global et national ; les systèmes de santé ; et les facilitateurs ou obstacles aux soins au niveau des communautés. Cette approche permettra le développement d’interventions pilotes tenant compte des questions de culture et de genre.

 

Contexte scientifique et sociétal du projet de recherche

Les pays à faible et moyen revenu sont confrontés à un changement dans les maladies auxquelles ils sont confrontés avec une augmentation des maladies liées aux changements de style de vie. Cela signifie que les systèmes de santé doivent maintenant gérer les maladies non transmissibles en parallèle aux maladies transmissibles avec le fardeau principalement affectant les populations pauvres et vulnérables. Les succès rencontrés avec le traitement du VIH/SIDA n’ont pas été répliqués pour d'autres maladies telles que les maladies tropicales négligées et les maladies non transmissibles. Ce projet vise à répondre à ce double fardeau qui a un impact sur les systèmes de santé et les individus, en renforçant les capacités aux niveaux national, local et communautaire.

 

Direct link to Lay Summary Last update: 07.01.2016

Lay Summary (English)

Lead
Health Systems in low-income countries need to adapt to the changes in the diseases that their populations face. These countries are confronting an increasing prevalence of Noncommunicable diseases, while in parallel are burdened with Neglected Tropical Diseases, which particularly impact the poorest of the poor. Many political statements have tried to rally governments to address these diseases, but the challenges remain in addressing both Noncommunicable and Neglected Tropical diseases in many settings.
Lay summary

Contents and objectives of the research project

The COmmunity HEalth System InnovatiON (COHESION) project being led by the Geneva University Hospitals and the University of Geneva in collaboration with partners in Mozambique, Nepal and Peru as well as other Swiss institutions will address this challenge through research, stakeholder engagement and appropriate interventions at the policy, health system and community level.

 

The project will use multiple research methods to assess: global and national policies; health systems; and community enablers and barriers to care. This will enable a series of pilot interventions to be developed in partnership with local stakeholders taking into account issues of culture and gender.

 

Scientific and Social context of the project

Low and middle income countries are confronting a change in the diseases they face, notably an increase of diseases linked to changes in lifestyle. This means that health systems now need to manage a diverse range of Noncommunicable and infectious diseases with most of the burden of care and prevention needing to focus on poor and vulnerable populations. Many successes with HIV/AIDS care at Primary Health Care level have not been replicated for Neglected Tropical Diseases and Noncommunicable diseases. This project aims to address the double burden of disease now placed on health systems and communities, by building capacity at the national, local and community levels. 

 

Direct link to Lay Summary Last update: 07.01.2016

Responsible applicant and co-applicants

Employees

Publications

Publication
The process of prioritization of non-communicable diseases in the global health policy arena
Heller Olivia, Somerville Claire, Suggs L Suzanne, Lachat Sarah, Piper Julianne, Aya Pastrana Nathaly, Correia Jorge C, Miranda J Jaime, Beran David (2019), The process of prioritization of non-communicable diseases in the global health policy arena, in Health Policy and Planning, X.
Forty years since Alma-Ata: do we need a new model for noncommunicable diseases?
Beran David, Perel Pablo, Miranda J Jaime (2019), Forty years since Alma-Ata: do we need a new model for noncommunicable diseases?, in Journal of Global Health, 9(1), 010316.
High-quality health systems: time for a revolution in research and research funding
Beran David, Chappuis François, Damasceno Albertino, Jha Nilambar, Pesantes Maria Amalia, Singh Suman Bahadur, Somerville Claire, Suggs L Suzanne, Miranda J Jaime (2019), High-quality health systems: time for a revolution in research and research funding, in The Lancet Global Health, 7(3), e303-e304.
“If you will counsel properly with love, they will listen”: A qualitative analysis of leprosy affected patients’ educational needs and caregiver perceptions in Nepal
Correia Jorge César, Golay Alain, Lachat Sarah, Singh Suman Bahadur, Manandhar Varsha, Jha Nilambar, Chappuis François, Beran David (2019), “If you will counsel properly with love, they will listen”: A qualitative analysis of leprosy affected patients’ educational needs and caregiver perceptions in Nepal, in PLOS ONE, 14(2), e0210955-e0210955.
Moving from research to interventions: insights from a community health system project in Mozambique, Nepal and Peru.
Beran et al.David (2018), Moving from research to interventions: insights from a community health system project in Mozambique, Nepal and Peru., in BMJ Global Health, 3:e001183, 1-8.
Food Perceptions and Dietary Changes for Chronic Condition Management in Rural Peru: Insights for Health Promotion
Perez-Leon Silvana (2018), Food Perceptions and Dietary Changes for Chronic Condition Management in Rural Peru: Insights for Health Promotion, in Nutrients , 1-13.
Social marketing interventions for neglected tropical diseases (NTDs): A systematic review protocol
Aya Pastrana Nathaly (2017), Social marketing interventions for neglected tropical diseases (NTDs): A systematic review protocol, in PeerJ Preprints , 5:e3350v1, 1-16.
The need to focus on primary health care for chronic diseases
Beran et al. (2016), The need to focus on primary health care for chronic diseases, in The Lancet Diabetes & Endocrinology, Vol 4 (4), 731-732.
Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru
Miranda J et al. (2016), Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru, in Globalization and Health, 12: 29(12: 29), 1-24.
Partnerships in global health and collaborative governance: lessons learnt from the Division of Tropical and Humanitarian Medicine at the Geneva University Hospitals
Beran et al. (2016), Partnerships in global health and collaborative governance: lessons learnt from the Division of Tropical and Humanitarian Medicine at the Geneva University Hospitals, in Globalization and Health , 12:14(12:14), 1-13.

Collaboration

Group / person Country
Types of collaboration
B P Koirala Institute of Health Sciences Nepal (Asia)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Graduate Institute Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
University of Geneva - Faculty of Sociology Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Exchange of personnel
University of Leicester Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
KFPE Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Boston University United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Industry/business/other use-inspired collaboration
Eduardo Mondlane University Mozambique (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Università della Svizzera italiana Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
Universidad Peruana Cayetano Heredia Peru (South America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
COHRED Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
University of Cape Town South Africa (Africa)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
EPICAH - Encuentro Por la Investigacion Cayetano Heredia 2018, Silvana Perez Leon Talk given at a conference COHESION project 14.08.2018 Lima, Peru Miranda Jaime;
International Social Marketing Conference Talk given at a conference Greater Social Good for Whom? Advancing Gender in Social Marketing; Special Session "Critical Issues in Social Change in the Asia- Pacific 15.07.2018 Singapoure, Singapore Aya Pastrana Nathaly;
28th European Meeting on Hypertension and Cardiovascular Protection Talk given at a conference Evolução dos Factores de Risco para DNT em Moçambique. Desafios para o Futuro: Data and Examples from COHESION Project 07.06.2018 Barcelona, Spain Damasceno Albertino;
28th European Meeting on Hypertension and Cardiovascular Protection Talk given at a conference What is being done in Africa to face the burden of Hypertension: Data and Examples from COHESION Project 07.06.2018 Barcelona, Spain Damasceno Albertino;
7th edition of the Geneva Health Forum Talk given at a conference Innovating by integrating care for NCDs and Communicable Diseases 10.04.2018 Genève, Switzerland Beran David Henri;
7th edition of the Geneva Health Forum Talk given at a conference "Partnerships for global health", in collaboration with KFPE and COHRED 10.04.2018 Geneva, Switzerland Beran David Henri;
78th Meeting of the Society for Applied Anthropology Talk given at a conference "Health and Health Access: Living with chronic conditions in rural areas of Peru", Maria Amalia Pesantes 07.04.2018 Philadelphia, United States of America Miranda Jaime;
1st India Public Policy Network Conference Talk given at a conference Addressing the double burden of disease: improving health systems for Noncommunicable and Neglected Tropical Diseases 28.02.2018 Bhubaneswar, India Jha Nilambar;
II Congreso de Investigación de Ciencia y Humanidades de la Universidad de Ciencias y Humanidades Talk given at a conference "Social responsibility in research, a need to create awareness and contribute to society", Dr Maria Lazo Porras 21.11.2017 Lima, Peru Miranda Jaime;
World NCD Congress Talk given at a conference Addressing the double burden of disease: Improving health systems for NCDs and NTDs 04.11.2017 Chandigar, India Jha Nilambar;
South East Asia Diabetes Foundation Conference (SEADFCON), Sailendra Thapa Talk given at a conference Study on health care seeking behaviour among people living with type 2 diabetes in rural area of Eastern Nepal 04.11.2017 Dharan, Nepal Jha Nilambar;
South East Asia Diabetes Foundation Conference (SEADFCON), Dr Sangita Shah Talk given at a conference Study of health-related quality of life and health care utilization among T2 diabetic population in an urban area of eastern Nepal 04.11.2017 Dharan, Nepal Jha Nilambar;
Medicus Mundi Symposium 2017 on NCDs Talk given at a conference How to leverage the political construction of NCDs at the global level 02.11.2017 Basel, Switzerland Beran David Henri;
EPICAH congress (Encuentro por la Investigación de Cayetano Heredia) Talk given at a conference COHESION Project: Health system assessment for diabetes, hypertension and neurocysticercosis at Primary Health Care level 08.09.2017 Lima, Peru Miranda Jaime;
Global Alliance for Chronic Diseases (GACD) Implementation Science Workshop Talk given at a conference PhD proposal: NCD management in Mozambique, data from the COHESION Project 06.09.2017 Cape Town, South Africa Damasceno Albertino;
4th edition of the International Conference on Research for Development (ICRD) Talk given at a conference "Partnerships between health services and communities", Silvana Perez Leon 04.09.2017 Bern, Switzerland Miranda Jaime;
National Conference of Nepalese Society of Community Medicine (CONCOM), Dr Suman Bdr. Singh Talk given at a conference COHESION Project: transformative research findings and co-creation process 26.08.2017 Kathmandu, Nepal Jha Nilambar;
Congress of Medical Students, Maria Cardenas Talk given at a conference Presentation of the methodology of HSA of COHESION 01.08.2017 Ica, Peru Miranda Jaime;
World Social Marketing Conference Talk given at a conference "Gender Responsiveness of Social Marketing Interventions"; "Social Marketing Interventions for NTDs: A systematic review"; "Beyond Salsa, Samba and Tango: Social Marketing in Latin America". 16.05.2017 Washington, United States of America Aya Pastrana Nathaly;
International Conference for Research and Development (ICRD 2017) Talk given at a conference Increasing equality in partnerships: views from the field, policy makers and funders 15.05.2017 Bern, Switzerland Beran David Henri;


Knowledge transfer events



Self-organised

Title Date Place
COHESION 3rd Mozambican Advisory Board Meeting 29.05.2018 maputo, Mozambique
2nd Co-creation meeting with officials from the District Public Health Office, Inaruwa, on RESPONSIVENESS (meso-level) 06.05.2018 Sunsari, Nepal
2nd Co-creation meeting with officials from the District Public Health Office, Bhadrapur on RESPONSIVENESS (meso-level) 04.05.2018 Jhapa, Nepal
2nd Co-creation meeting with District Health Directorate and Moamba PHC staff on RESPONSIVENESS (meso-level) 26.04.2018 Moamba, Mozambique
2nd Co-creation meeting with community in Moamba on RESPONSIVENESS (micro-level) 26.04.2018 Moamba, Mozambique
COHESION 4th Peruvian Advisory Board Meeting 18.04.2018 Lima, Peru
3rd Co-creation meeting with Officials of the Sub- region of Health on RESPONSIVENESS (meso-level) 17.04.2018 Piura, Peru
3rd Co-creation meetings with communities of Sicacate and Pingola on RESPONSIVENESS (micro-level) 15.04.2018 Piura, Peru
2nd Co-creation meetings with community in Xipamanine on RESPONSIVENESS (micro-level) 14.04.2018 Maputo , Mozambique
2nd Co-creation meeting with District Health Directorate and Xipamanine PHC staff on RESPONSIVENESS (meso-level) 12.04.2018 Maputo, Mozambique
COHESION 4th Nepalese Advisory Board Meeting 08.04.2018 Kathmandu, Nepal
3rd round of Co-creation meetings with Officals from MoH on RESPONSIVENESS (macro-level) 08.04.2018 Kathmandu, Nepal
3rd Co-creation meetings with communities of Itahari and Baniyani on RESPONSIVENESS (micro-level) 05.04.2018 Jhapa, Nepal
COHESION 2nd Global Advisory Board Meeting 2017 20.11.2017 Geneva, Switzerland
2nd round of Co-creation interviews with national stakeholders (macro-level) 01.11.2017 Lima, Peru
2nd Co-creation meeting with Officials of the Sub- region of Health (meso-level) 30.10.2017 Piura, Peru
2nd Co-creation meetings with communities of Sicacate and Pingola (micro-level) 28.10.2017 Piura, Peru
COHESION 3rd Nepalese Advisory Board Meeting 14.10.2017 Kathmandu, Nepal
2nd round of Co-creation meetings for prioritization (macro-level) 09.10.2017 Kathmandu, Nepal
2nd Co-creation meeting with community of Baniyani and Itahari (micro-level) 06.10.2017 Jhapa and Sunsari, Nepal
COHESION 3rd Peruvian Advisory Board Meeting 27.09.2017 Lima, Peru
2nd Co-creation meeting at National Health Research Council- NHRC(macro-level) 01.09.2017 Kathmandu, Nepal
1st Co-creation meeting during the National Conference of Nepalese Society of Community Medicine - CONCOM (macro-level) 26.08.2017 Kathmandu, Nepal
1st round of Co-creation meetings with MoH and NCD & NTD departments (macro-level) 17.08.2017 Maputo, Mozambique
1st Co-creation meeting with Maputo municipality and Doctors from 3 urban districts incl. Xipamanine (meso-level) 16.08.2017 Maputo, Mozambique
1st Co-creation meeting with officials from the District Public Health Office, Inaruwa (meso-level) 14.08.2017 Sunsari, Nepal
1st co-creation meeting with Moamba District Health Directorate and Moamba PHC staff (meso-level) 11.08.2017 Moamba, Mozambique
1st Co-creation meetings with communities in Sábie and Moamba (micro-level) 10.08.2017 Moamba, Mozambique
1st Co-creation meetings with communities of Sicacate and Pingola (micro-level) 21.07.2017 Piura, Peru
1st Co-creation meeting with Officials of the Sub- region of Health (meso-level) 17.07.2017 Piura, Peru
COHESION 2nd Nepalese Advisory Board Meeting 10.07.2017 Kathmandu, Nepal
COHESION 2nd Peruvian Advisory Board Meeting 15.06.2017 Lima, Peru
1st round of Co-creation interviews with national stakeholders, within HSA (macro-level) 01.06.2017 Lima, Peru
1st Co-creation meeting with officials from the District Public Health Office, Bhadrapur (meso-level) 25.05.2017 Jhapa, Nepal
1st national stakeholders engagement meeting (macro-level) 03.05.2017 Lima, Peru
1st Co-creation meetings with communities of Itahari and Baniyani (micro-level) 22.04.2017 Jhapa and Sunsari, Nepal
"Una Mirada al Mundo del mercado Social: Conceptos Introductorios" 06.04.2017 Universidad Peruana Cayetano Heredia, Lima, Peru
COHESION 2nd Mozambican Advisory Board Meeting 14.02.2017 Maputo, Mozambique
COHESION 1st Peruvian Advisory Board Meeting 26.01.2017 Lima, Peru
COHESION 1st Mozambican Advisory Board Meeting 12.12.2016 Maputo, Mozambique
COHESION 1st Global Advisory Board Meeting 2016 21.11.2016 Geneva, Switzerland
COHESION 1st Nepalese Advisory Board Meeting 26.08.2016 Dharan, Nepal

Communication with the public

Communication Title Media Place Year
Video/Film video Peru International Italian-speaking Switzerland German-speaking Switzerland Western Switzerland Rhaeto-Romanic Switzerland 2018
Other activities COHESION Newslewtter International Western Switzerland German-speaking Switzerland Italian-speaking Switzerland 2017
New media (web, blogs, podcasts, news feeds etc.) @COHESIONproject Italian-speaking Switzerland Rhaeto-Romanic Switzerland Western Switzerland International German-speaking Switzerland 2016
New media (web, blogs, podcasts, news feeds etc.) COHESION blogs Italian-speaking Switzerland Western Switzerland Rhaeto-Romanic Switzerland International German-speaking Switzerland 2016
Media relations: print media, online media COHESION Press Releases Western Switzerland International Italian-speaking Switzerland German-speaking Switzerland 2016
New media (web, blogs, podcasts, news feeds etc.) COHESION site web web Western Switzerland German-speaking Switzerland International Rhaeto-Romanic Switzerland Italian-speaking Switzerland 2016
Video/Film COHESION The double burden German-speaking Switzerland Italian-speaking Switzerland Western Switzerland Rhaeto-Romanic Switzerland International 2016
Print (books, brochures, leaflets) Flyer COHESION International 2016

Awards

Title Year
COHESION doctoral student, Ms. Nathaly Aya Pastrana, won the BEST STUDENT PAPER AWARD at the World Social Marketing Conference 2017 (6-8- May, Washington DC), for her paper on “Social Marketing Interventions for Neglected Tropical Diseases: A Systematic Review”. 2017

Abstract

Low and Middle Income Countries are facing an epidemiological transition, with increases in the prevalence of and mortality related to Noncommunicable diseases. This burden of Noncommunicable diseases coexists in settings where important burdens of Communicable diseases still exist, leading to a double burden of disease. Health systems play a key role in the control and management for both Noncommunicable diseases and Neglected Tropical Diseases, which disproportionately affect poor and vulnerable populations, including women and children and their roles as carers. In Low and Middle Income Countries health systems are weak and these diseases have not received the funding and policy responses commensurate with their burden. Although political declarations exist addressing Noncommunicable diseases and Neglected Tropical Diseases and these highlight the importance of Primary Health Care and Universal Health Coverage in addressing these challenges, very little has been done to explore or develop action in this area. Research is therefore needed to develop context specific interventions to transform existing health systems to manage these conditions. The COmmunity HEalth System InnovatiON (COHESION) project being led by the Geneva University Hospitals and the University of Geneva in collaboration with partners in Mozambique, Nepal and Peru as well as other Swiss institutions will address this challenge through effective research, stakeholder engagement and appropriate interventions at the policy, health system and community level in order to sustainably improve the health of vulnerable populations. The research phases will combine multiple qualitative and quantitative research methods to assess: global and national policies; the health system at national level and in an urban/peri-urban and rural area with a focus on Primary Health Care; and in these same areas community barriers and enablers to Noncommunicable diseases and Neglected Tropical Diseases management. Results from this research will be communicated to different stakeholders using contextualised communication strategies adapted to each country. To develop the interventions for the COHESION project, we follow a co-creation process of designing the interventions with engagement from the target audience. The outcome of this will be a toolbox of interventions for policy, health system and communities targeted at Primary Health Care. One intervention from the overall toolbox will be tested in each country at the policy, health system and community levels. The intervention at the health system and community level may vary between the two settings in each country depending on the local circumstances and needs. Another aspect of the COHESION project will be the overall learning process in comparing these countries and settings throughout the research, intervention development and intervention implementation phases. These lessons and interventions will then be evaluated to propose both a conceptual model for addressing Noncommunicable diseases and Neglected Tropical Diseases as well as tailored plans for scale-up in each context.
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