Addressing the Double Burden of Disease:
Improving Health Systems for Non-Communicable
and Neglected Tropical Diseases
Low and middle-income countries are confronting a change in the diseases they face with decreasing burden due to viruses and bacteria but more with diseases linked to changes in lifestyle. This means that health systems now need to manage a diverse range of diseases with most of the burden of treatment needing to focus on poor and vulnerable populations. The chronic nature of NCDs and NTDs is a burden on individuals and families in terms of lost productivity, cost of care, disability, death, and stigma. Women are particularly vulnerable given the social, gender and economic inequalities.
The COHESION project is addressing health challenges faced in low and middle-income countries related to neglected and tropical diseases (NTDs) and non-communicable diseases (NCDs).
Funded by SNSF and SDC’s Research for Development programme, COHESION is led by Dr. David Beran of the Geneva University Hospitals and the University of Geneva in collaboration with partners in Mozambique, Nepal and Peru as well as the Graduate Institute in Geneva and the Università della Svizzera italiana in Lugano.
1st COHESION blog post: Dr. David Beran explains “who is the COHESION Project”read more
At the beginning of November 2017, COHESION presented the results of its global policy analysis on NCDs at the annual symposium of Medicus Mundi Switzerland entitled «No business as usual against non-communicable diseases » (see here). The aim of this year symposium...read more
The Peru COHESION team travelled to the communities of Pingola and Sicacate on October 28th and 29th, to hold a second set of co-creation meetings with community members and to discuss interventions with local health workers. Dates and times had been previously agreed...read more
Co-creation session in Baniyani. The co-creation process was launched in Nepal in August and aimed at involving stakeholders at different levels in the selection of potential interventions. Two workshops were held in Itahari and Banyani districts. Participants...read more
Our Hypothesis and Objectives
Assess the barriers, enablers and lessons for the management of NCDs and NTDs from the policy, health system and community levels to support a PHC response for NCDs and NTDs
Develop and test a package of scalable, sustainable, gender and context appropriate interventions at policy, health system and community levels to support PHC responses to NCDs and NTDs
Develop a plan for scaling up interventions based on the proof of principles resulting from the evaluation of the impact of the interventions and the implementation of this project
Enable change in delivery of services for NCDs and NTDs at PHC through engaging policy makers, health professionals and communities throughout the project
Why COHESION Matters?
A few reasons from the lead persons in each country:
COHESION uses multiple research methods to assess: global and national policies; national, urban/peri-urban and rural health systems; and community barriers and enablers to care for different diseases. This will enable interventions to be developed and tested that address the challenges identified. They will be developed in partnership with local stakeholders taking into account issues of culture and gender.
Analysis at Global, National and local levels including content, context, process and actors
Assessment of health systems in three countries using the Rapid Assessment Protocols (RAP)
Assess factors at the community and household level
Develop interventions based on local and global evidence and a co-creation process
Implement interventions in each country at the policy, health system, and community levels
Evaluate effectiveness of project and of the interventions including a plan for scaling up