A MULTI-SECTOR APPROACH TO PREVENT AND CONTROL NCDS
Considerable in-country capacity development work is being carried out by MANA alliance partners. Sustaining, strengthening and extending investments in these on-going initiatives is crucial for creating the step change needed in NCD monitoring, particularly in the areas of:
- Full civil registration and vital statistics, accurate death certification and coding;
- Regular surveys of risk factors, NCD prevalence and health sector responses;
- Monitoring of key Pacific NCD policy and health service interventions; and
- National HIS strengthening and epidemiological skills support.
Additional areas for development in some countries might include:
- Mapping and integrating NCD monitoring data (population and economic surveys etc) within HIS;
- Developing in-country survey repositories, and skills in data management and analysis and use of evidence for planning and policy;
- Stimulating policy dialogues and promoting greater translation of evidence into policies;
- Monitoring for other national priorities (e.g. food environment, child BMI);
Regional Public Goods
The promotion of ‘regional public goods’ is based on the rationale that the countries of Pacific share both challenges and opportunities for development that can be addressed more effectively and efficiently at a regional level through collective action and cooperation. Such access to regional goods is especially important for smaller, lower capacity PICTs.
It is crucial that current resources are sustained and expanded with secure, longer-term financial support. A more coordinated approach to the operation of existing facilities from different sources is needed for improved efficiency and greater cost effectiveness.
Considerable regional resources have already been built up but, in general, these are far from sufficient to meet the growing needs. Available expertise (people and systems) that support PICTs and regional initiatives in NCD monitoring include:
- Regional training courses in epidemiology through PPHSN (with a new FNU accredited Masters-level programme under development);
- The Pacific Regional Information Management System (PRISM) (with easy access to national statistics office websites and regional statistics tables) is maintained by SPC;
- A regional data repository is being developed by WHO WPRO. Support will be available to assist countries to develop national microdata repositories;
- A variety of NCD related indicators and databases are maintained by SPC and WHO;
- Regional specialists including epidemiologists, a public health nutritionist, statisticians, and demographers are supported by SPC and WHO WPRO;
- Pacific Open Learning Health Network (POLHN) provides free online health courses and is supported by WHO and FNU;
- New post-graduate NCD program (Certificate) to be piloted by FNU;
- Regional initiatives, such as Tobacco Free Pacific 2025 (TFP 2025).
Innovation and Accountability mechanisms
It is proposed that the Pacific MANA collaborative alliance agrees to form a platform to:
- Stimulate innovation in NCD monitoring in response to Pacific needs. Current priorities include: strengthened monitoring of policies and environments for tobacco, food, physical activity and alcohol; and monitoring in children, especially for childhood obesity.
- Promote the translation of the monitoring evidence into policy and practice and disseminate exemplars of good practice from the Pacific and the world.
- Support the Pacific NCD Crisis Roadmap, national, other regional and global commitments by undertaking regular (e.g. biennial) independent assessments of progress towards stipulated targets and recommendations. Experts from partner universities will contribute to this review process. This regional mutual accountability system will assist PICTs, networks and agencies to respond more effectively to the NCD crisis and demonstrate areas of achievement and success.
These include (but not limited to): the WHO STEPwise survey approach (STEPs) and the CDC Behaviour Risk Factor Surveillance System (BRFSS) to assess adult risk factors; the Global School-based Student Health Survey (GSHS) and Youth Risk Behaviour Survey (YRBS) to measure and assess behavioural risk factors among young people; and PEN, the WHO Package of essential NCD interventions for primary health care for cancer, diabetes, heart disease and stroke, and chronic respiratory disease.