Health Technology Manual. Improving the Integrated Management of Chronic Diseases at the First Level of Health Care Services

Abstract

[Introduction]. Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries where the problem seems to be worsening. Globally, research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control.1 Meanwhile the premature mortality caused by NCDs remains high in many countries.2 In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formulating national plans to combat NCDs.1 The Pan American Health Organization’s (PAHO’s) Strategy for the Prevention and Control of Noncommunicable Diseases, ratifi ed by the Directing Council in 2012, recommends the reorientation of health systems based on core principles of the integrated management of chronic diseases. These include providing training and capacity-building, as well as paying special attention to the integration of NCD prevention and control in the fi rst-level of health care...