Noncommunicable disease education manual : a primer for policy-makers and health-care professionals

Noncommunicable Disease Education Manual A Primer for Policy-makers and Health-care Professionals Noncommunicable diseases (NCDs) are the leading causes of death and disability in many countries. In 2015, 31 million deaths in low- and middle-income countries were due to NCDs. Of these, roughly 15 million people died before they reached the age of 70 years. In countries with low resources, people at risk for or suffering from NCDs usually have difficulty accessing health-care services, leading to delayed care, disease progression and complications, higher costs of care, and early deaths. NCDs are caused by a combination of genetic, physiological, environmental and behavioural factors; usually have a long duration; and require lifelong management. Successful prevention and control of NCDs depend partly on the willingness of individuals and their families to make daily decisions to practise healthy behaviours, address modifiable risk factors and follow medical advice. In 2010, the World Health Organization (WHO) launched the Package of Essential Noncommunicable Disease Interventions for Primary Health Care in Low-Resource Settings (WHO PEN), which gives guidance to primary health-care staff working with limited resources. Building on WHO PEN, in 2016, WHO and the United States Centers for Disease Control and Prevention (CDC) launched the Global HEARTS Initiative to strengthen action against cardiovascular diseases (CVDs). This Initiative has three technical packages: • HEARTS technical package for CVD management, • SHAKE technical package for salt reduction, and • MPOWER technical package for tobacco control. What are noncommunicable diseases? What is being done to improve NCD prevention and control? NCD EDUCATIONAL MANUAL A PRIMER FOR POLICY-MAKERS AND HEALTH-CARE PROFESSIONALS 2 The HEARTS technical package has six elements packaged into the following modules: The Healthy Lifestyle module provides tools for counselling and self-care. Self-care is the ability of individuals and families to promote health, prevent disease, and cope with illness and disability with, or even without, a health-care provider. However, health information that is written and simply handed out are often not successful in promoting healthy behaviours. Interactive methods, such as face-to-face counselling, have been shown to be more effective in patient engagement and better health outcomes. HEALTHY LIFESTYLE Counselling on tobacco cessation, diet, physical activity, alcohol use and self-care Simple, standardized algorithms for clinical care Access to core set of affordable medicines and basic technology Total cardiovascular risk assessment, treatment and referral Decentralized community-based and patient-centred care Patient data collection and programme evaluation EVIDENCE- BASED TREATMENT PROTOCOLS ACCESS TO ESSENTIAL MEDICINES AND TECHNOLOGY RISK-BASED MANAGEMENT TEAM CARE AND TASK-SHARING SYSTEMS FOR MONITORING NCD EDUCATIONAL MANUAL A PRIMER FOR POLICY-MAKERS AND HEALTH-CARE PROFESSIONALS 3 H E A R T S The Noncommunicable Disease Education Manual for Primary Health Care Professionals and Patients (NCD Education Manual) was published by the WHO Regional Office for the Western Pacific in March 2017 to provide detailed counselling guidance for health-care professionals to use with patients and their families, complementing WHO PEN and the HEARTS technical package. The manual is intended for public or private health-care professionals – medical doctors, assistant doctors, nurses, nurse aides and public health workers – as an aid in counselling patients at a health facility or during home visits. It can also be used during group counselling sessions in a variety of settings. What is the NCD Education Manual? 4 NCD EDUCATIONAL MANUAL A PRIMER FOR POLICY-MAKERS AND HEALTH-CARE PROFESSIONALS The NCD Education Manual consists of three parts and 15 modules: seven modules on the prevention and management of hypertension, seven modules on the prevention and management of diabetes, and one module on tobacco cessation. Part 1 Part 2 Part 3 Module 1 Module 2 Module 3 Module 4 Module 5 Module 6 Module 7 Module 1 Module 2 Module 3 Module 4 Module 5 Module 6 Module 7 Diagnosis and management Healthy lifestyles Healthy eating habits Low-salt diet Physical activity Medication and management of associated diseases Complication prevention Diagnosis and management Healthy lifestyles Healthy eating habits 1 Healthy eating habits 2 Physical activity Taking care of yourself in daily life Complication prevention Prevention and management of hypertension Prevention and management of diabetes Quit smoking Certain modules, such as the Healthy Lifestyles modules in Parts 1 and 2, may also be used to educate healthy individuals. 5NCD EDUCATIONAL MANUAL A PRIMER FOR POLICY-MAKERS AND HEALTH-CARE PROFESSIONALS FOR PATIENTS The content in each module of the NCD Education Manual is easy to understand, and facilitates raising awareness of patients and family members on proper disease management and prevention. During individual patient counselling, the health-care professional and the patient will sit facing each other. The NCD Education Manual module will be between them. On one side of the module is the page marked “For patients”. This side has simple images and key messages that are easy to understand for the patient. On the other side of the flip chart is the “For physicians” page. This page has the same images as those on the “For patients” side, but in addition has more information that the health-care professional can read out during the counselling session. It also contains technical information for the health-care professional to better understand the topic. How do I use the NCD Education Manual in my facility or community? 6 NCD EDUCATIONAL MANUAL A PRIMER FOR POLICY-MAKERS AND HEALTH-CARE PROFESSIONALS FOR PHYSICIANS The modules serve as templates to be adapted to the local context. Anyone can translate and adapt the NCD Education Manual content to better suit local needs (language, culturally appropriate examples, etc.). Selected images have been watermarked and should be replaced with more appropriate local examples. A local working group or task force, composed of health-care professionals, patients and other possible users of the manual, may review the modules, identify content for local adaptation and recommend more appropriate text and images. Template from the manual Local adaptation of the same page in one country 7NCD EDUCATIONAL MANUAL A PRIMER FOR POLICY-MAKERS AND HEALTH-CARE PROFESSIONALS For more information on the NCD Education Manual, contact the NCD and Health Promotion unit of the WHO Regional Office for the Western Pacific (WHO/WPRO/NCD) through wproncd@who.int. Download the NCD Education Manual from http://www.wpro.who.int/ncd. WPR/2018/DNH/002 © World Health Organization 2018 Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license.