Chronic Disease Is Heavy Burden in Developing World

Integrated approach in primary care needed to tackle non-communicable and chronic illnesses
By Jane Parry
HealthDay Reporter

FRIDAY, Sept. 12 (HealthDay News) -- Although many countries have made significant progress in reducing mortality, the burden of chronic and non-communicable disease remains heavy and requires integrated strategies to tackle it, according to three papers published in the Sept. 13 issue of The Lancet, which has a special focus on the legacy of the 1978 International Conference on Primary Health Care in Alma-Ata.

Stephen M. Tollman, of the University of Witwatersrand in Johannesburg, South Africa, and colleagues write that delivery of antiretroviral therapy needs to be scaled within a framework of integrated chronic care if the burden of HIV/AIDS and tuberculosis is to be adequately addressed. Joy Lawn of Saving Newborn Lives/Save the Children-US in Cape Town, South Africa, and colleagues write that the progress in primary care made by many countries, notably Thailand, illustrates many lessons, including the importance of a nationally agreed package of primary health care provision, attention to district management systems and investment in primary care extension workers linked to the health system.

Robert Beaglehole, of the University of Auckland in New Zealand, and colleagues describe how the burden of chronic disease -- including heart disease, cancer, diabetes and mental illness -- must be tackled by a substantially stronger primary health care system.

"In the many countries with shortages of primary care doctors, non-physician clinicians will have a leading role in preventing and managing chronic diseases, and these personnel need appropriate training and continuous quality assurance mechanisms," Beaglehole and colleagues write.

Abstract - Tollman
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Abstract - Lawn
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Abstract - Beaglehole
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