Wednesday, 26 August 2015

SPHPM researcher examines non-communicable disease policies in Mongolia

SPHPM’s Ms Oyun Chimeddamba has co-authored an article with Adjunct Associate Professor Anna Peeters, Associate Professor Catherine Joyce and Helen Walls evaluating the alignment of the Mongolian non-communicable disease (NCD) policies with the World Health Organization’s (WHO) 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs.

The emergence and spread of NCD has led it to become the leading cause of death across the globe. NCDs, also known as chronic or lifestyle-related disease, accounted for 63 per cent of the 57 million global deaths in 2008 alone. The burden that NCD’s place on developing regions is rapidly rising.

Figures from 2008 demonstrate that 80 per cent of NCD related deaths happened in low to middle income countries. This is a spike from 40 per cent in 1990. Projected figures estimate that NCDs may overtake communicable, perinatal, maternal and nutritional disease as the leading cause of death by 2030. They are also expected to be the leading cause of mortality overall without the implementation of adequate responses.

Mongolia has witnessed fast epidemiological and demographic transitions since the 1990’s, however cardiovascular disease is the current leading cause of mortality within the country. In 2011, cardiovascular disease represented 36.7 per cent of all deaths and cancer represented 20.7 per cent. In light of the rapid growth and proliferation of NCDs, the Mongolian Government has been redeveloping existing policies to better handle the prevention of NCDs. Ms Chimeddamba et al paper sought to evaluate the degree to which the NCD prevention health policies of the Mongolian Government are aligned with the objectives of the WHO Action Plan.

Cardiovascular disease, diabetes, chronic respiratory disease and cancer represent around 80 per cent of total NCD associated deaths and all share the same four modifiable risk factors. These include alcohol consumption, sedentary lifestyle, poor diet and smoking. The impact of these NCDs places a substantial burden on not only the individual, but families, the health system and governments. This creates a series of consequences in terms of economic and social growth. To adequately address these associated risk factors, there is a significant need for strategies and policies to minimise the detrimental impact of NCDs on a global scale.

In acknowledgement of this pressing need for policy and change, the WHO developed the 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs (Action Plan), aimed to assist immediate action against NCDs, particularly in low to middle income countries. While the Action Plan has successfully raised awareness in regards to the need for further NCD policies and strategies, it is unknown as to its role on successfully improving the development and implementation of policy, specifically in developing regions; analysis and research into policy efficacy and development has been limited in developing regions. The authors of the paper report that there is a lack of theoretical and conceptual approaches in analysing of current health policies within low to middle income countries.

The authors undertook a review of the various policy documents implemented by the Mongolian Government from 2000 to 2013. Documents were identified and selected via the use of a literature review, expert consultation and internet-based search. Matrixes were utilised to extract data, with each document being mapped against the six objectives from the WHO Action Plan. Forty five NCD-associated policies were identified. 

The results indicated that both control and prevention of common NCDs, as well as associated risk factors which were originally discussed by the WHO, were thoroughly addressed and the Mongolian Government’s policies were clearly aligned with the objectives from the Action Plan. Several documents also discussed exhaustive implementation and monitoring of the frameworks. The authors state that each objective was closely addressed and discussed. However, they also noted that areas which were not as well addressed included physical activity guidelines, dietary requirements and chronic respiratory illness.

The authors concluded that the Mongolian Government’s response to the growth of NCDs is not only a population-based public health approach. They also indicate that itincludes the use of a national multisectoral framework, as well as the amalgamation of NCD control and prevention policies into existing national health policies. They do suggest that the gaps regarding physical activity, food policy and chronic respiratory disease should be addressed, as ignoring these areas could result in difficulties in tackling the NCD issue in Mongolia.

“There is also a need for further research into the efficacy of national NCD policies and their reach in being implemented in the practical environment, said Ms Chimeddamba.

You can read the paper here.

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