Enhancing Health Outcomes for Chronic Diseases in Resource-Limited Settings by Improving the Use of Medicines: The Role of Pharmaceutical Care
(2014; 40 pages)

Systems for Improved Access to Pharmaceuticals and Services (SIAPS). Enhancing Health Outcomes for Chronic Diseases in Resource-Limited Settings by Improving the Use of Medicines: The Role of Pharmaceutical Care. Submitted to the U.S. Agency for International Development by the SIAPS Program. Arlington, VA: Management Sciences for Health.

Abstract

In low- and middle-income countries (LMIC), health systems have historically focused on the prevention and treatment of highly prevalent and frequently fatal acute infectious illnesses such as malaria, diarrhea, and respiratory infections. However, due to changes in health risks, LMIC are experiencing an increasing burden of chronic non-communicable diseases (NCDs) in addition to the existing problems of infectious diseases. These countries and their technical partners, such as the World Health Organization (WHO), have recently highlighted the importance of giving more attention to chronic NCDs such as diabetes, cancer, and cardiovascular and chronic respiratory diseases. In 2008, over 80 percent of the 17 million cardiovascular and 1.3 million diabetes deaths worldwide occurred in LMIC, together with nearly 90 percent of deaths caused by chronic obstructive pulmonary disease. In all but the lowest-income countries, NCDs are already the leading cause of death. WHO projects that by 2030 NCDs will be the most common cause of death in the African region.

Various approaches are needed to reduce the burden of NCD-related morbidity and mortality in LMIC. These include reducing risk factors associated with lifestyle, such as unhealthy diet and tobacco use; preventing the occurrence of these diseases, as well as facilitating early diagnosis; and providing appropriate care. WHO has identified the integration of essential NCD interventions into primary health care as a key strategy to support early diagnosis and timely treatment of these diseases in LMIC.2 However, patient care systems at the primary and higher levels of care will need substantial modification and strengthening to deliver these interventions effectively. Health systems need to adopt different approaches to service delivery that place the patient at the center of care and emphasize interdisciplinary coordination and performance monitoring.

 
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