All posts by mari

NCD initiatives

In 2011 WHO organized the First global ministerial conference on healthy lifestyles and NCDs control. Based on The Global strategy for the prevention and control of NCDs and its action plan, the conference aimed at supporting Member States to develop and strengthen policies and programmes on healthy lifestyles and NCD prevention. 

The forum report describes the objectives, content and the meeting  outcomes  that would help to move NCD prevention and control forward ( p.19) Here are some key outcomes:

−There was broad agreement that NCD prevention and control is critical to national development (health, social and economic) and effective development cannot occur without addressing NCDs.

– Better epidemiological surveillance of NCDs is critical to demonstrate the extent of the problem and empower government action based on evidence and to monitor progress.

Health systems strengthening, including adequate and well-trained supply of health worker, should focus on integration across disease areas and particularly on community-based primary health care.

Implementing the agreed ‘best buys’, e.g. raising taxes on tobacco and alcohol are key opportunities to reduce risk factors and, potentially, generate revenue that can be used to tackle NCDs


The tremendous gap in death rates due to NCD

Non communicable diseases (NCD), such as diabetes, cardiovascular diseases, cancer, and chronic respiratory diseases represent a new epidemic worldwide.

NCD kill more than 36 million people each year. Nine million of all deaths attributed to NCD occur before the age of 60; 90% of these “premature” deaths occurred in low- and middle-income countries. (WHO fact sheet)

The difference in death rates due to NCD between countries shows once again the major inequities existing around the world  in term of access to prevention and treatment services for the population, for the same diseases.

WHO’s interactive map shows the NCD death rates around the world. access map here

Switzerland :292/100.000 population   USA:  413/100.000

Swaziland: 702/100.000   Haiti: 725/100.000   Laos 680.000/100.000

Looking at the impact of SORT-IT for health programmes

In order to evaluate the impact of the SORT-IT initiative, Zachariah and colleagues assessed  the changes in health policies and practice following the publications of the module participants.
74% of the studies assessed  (65 out of 88 ) brought an effect on policy and  practice  in one of the following domains: changes in program implementation, adaptation of monitoring tools or changes of existing guidelines. 

Rony Zachariah et al. Research to policy and practice change: is capacity building in operational research delivering the goods? Tropical Medicine & International Health. Volume 19, Issue 9, pages 1068–1075, September 2014

SORT-IT initiative outcomes

The Union reported on three publications about the results of the SORT-IT initiative

  • After the courses, 62% of participants completed a new research project; 50% published another paper; and 43% facilitated at other operational research courses.  A significant proportion of participants continue to engage in operational research after completing a course, providing evidence of the long-term value of this capacity building model.
  • 74% of the studies produced a reported effect that included changes to programme implementation, adaptation of monitoring tools and changes to existing guidelines.

access the Union page

SORT-IT: public health professionals are asking for it!

When I started writing in this blog I posted a couple of notes related to the development of operational research. A few month later, here I am with a success story!

SORT-IT  (Structured Operational Research and Training Initiative) is a training model designed by The Union and MSF, who joined with the Special Programme for Research and Training in Tropical Diseases(TDR) at the World Health Organization (WHO) to work toward spreading  operational research skills, in order to encourage public health professionals all over the world (and especially in developing countries) to design, implement and publish research outcomes capable to feed national health programs and thus improve health services for people all over the world.

go to article

Ramsay, Harries, Zachariah et al.,The Structured Operational Research and Training Initiative for public health programmes,  Health Action, vol. 4 no. 2, published 21 June 2014

Increasing the use of VCT for HIV through a better education of the general population

Researchers looked at the perception of Kenyan women about voluntary counseling and testing for HIV. Fear of stigma, especially targeting women, is the main reason for not submitting to VCT.

In order to generalize the use of VCT and thus to provide treatment to the ones in need, there should be more emphasis put on education for the general population about HIV.

go to article

compétences transculturelles parmi les soignants: nous pouvons faire mieux!

Dans le cadre du programme national “Migrant Friendly Hospitals” voici les résultats d’une étude faite auprès des soignants (médecins et infirmiers/ères) du CHUV concernant leurs compétences à soigner des patients de cultures différentes (compétences transculturelles). Sur la base de questionnaires auto-administrés, 244 infirmières et 124 médecins ont auto-évalué leur savoir-faire lorsqu’il s’agit de soigner un patient migrant. Les questions étaient basées sur le “Cross-Cultural Care Survey”, un outil déjà validé.

Parmi les infirmières :

(seulement) 6 sur 10  se percevait comme compétente ou très compétente pour évaluer la compréhension du patient concernant la cause de sa propre maladie ou pour identifier à quel point le patient  peut lire ou écrire en français.

Seulement une infirmière sur 2  se sent compétente ou très compétente pour travailler de façon efficace avec un interprète communautaire.

Seulement 4 infirmières sur 10 s’évaluent compétentes pour identifier les habitudes culturelles et les croyances religieuses qui pourraient influencer les soins.

accéder à l’article

Le renoncement aux soins: un patient sur 10 concerné en Suisse Romande

La troisième session de la formation continue “Migration et Santé”, organisée par la PMU a abordé ce sujet qui a été relayé dans plusieurs médias suisses romands, suite aux résultats de l’étude CERESO, portant sur le renoncement aux soins pour des raisons économiques.

Ainsi,  sur la base de questionnaires distribués à 2030 patients dans 47 cabinets médicaux de Suisse romande, l’étude a pu mettre en évidence que 1 patient sur 10 a du renoncer à des soins médicaux (y compris soins dentaires) pour des raisons économiques au cours de l’année précédente.

 Ainsi, «Durant les douze derniers mois, avez-vous eu de la peine à payer les factures de votre ménage ?» est la question-clé qui va permettre au médecin (et aux autres soignants) d’ ouvrir la porte à la discussion avec le patient, concernant son éventuelle difficulté à accéder aux soins nécessaires pour des raisons financières.

Article: Bodenmann, P. et al. (2014). Renoncement aux soins : comment appréhender cette réalité en médecine de premier recours?. Rev Med Suisse, 10, 2258-63.

HIV/AIDS Treatment as Prevention works!

The PARTNER study, involving more than 750 discordant heterosexual and homosexual couples,  are showing that an effective treatment by antiretroviral therapy (ART) prevents the transmission of HIV to the seronegative partner.

This study brings evidence showing  that treatment as prevention works.

learn more about the study

Results were  reported at the 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) in Boston, in March 2014

learn more about Treatment as Prevention