Project

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

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

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

Active participation

Active participation

Self-organised

Communication	Title	Media	Place	Year

Title	Year

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.