Addressing noncommunicable diseases in emergencies: a regional framework for action

Addressing NCDs in emergencies Information and data, digital health and research Community engagement, communication and trust building Leadership, collaboration and advocacy Resource mobilization and finance Service delivery, human resources, medications and technologies Addressing noncommunicable diseases in emergencies A regional framework for action © World Health Organization 2024 Some rights reserved. Taken from document EM/RC70/3-Rev.1 https://applications.emro.who.int/docs/NCDs-emergencies-eng.pdf?ua=1 WHO-EM/NCD/154/E Risk reduction and preparedness phase Domain Strategic intervention Indicator Leadership, collaboration and advocacy  Advocate for the integration of noncommunicable diseases (NCDs) management in emergency response, preparedness and recovery plans incorporating an all-hazards approach.  Advocate and support legislation to ensure that people living in humanitarian crises, displaced populations, refugees and migrants have access to a quality NCD (minimum/essential or basic) package.  Availability of an NCD emergency plan within the national preparedness plan taking an all-hazards approach Resource mobilization and finance   Allocate special funding to support essential NCD services and medicines as part of the pool of funding in preparedness plans.  Develop a transparent and realistic financial preparedness  plan and procurement mechanisms for NCD medicines and technologies covering all relevant stakeholders.  Ensure mechanisms for financial protection for people living with  NCDs in emergency settings, regardless of national status.  Conduct and use investment cases for NCD management and related risk factors.  Availability of a specific NCD  fund within the preparedness plan  Availability of financial protection  mechanisms including people living with NCDs Service delivery, human resources, medications and technologies  Define a minimum/essential service package based on WHO  packages for NCDs, including guidelines and protocols.  Develop national operational guidance/standard operating procedures (SOPs) for NCDs, which are regularly reviewed and updated (including for life-threatening conditions, specialized care and continuity of services).  Promote awareness and self-care management for NCDs.  Develop a plan or mechanism to secure and distribute essential NCD medications and supplies, including the NCD emergency kit.  Build capacity of health care providers on NCD management and appropriate interventions during an emergency.  Existence of national operational guidance/ SOPs for responding to NCDs during emergency  Existence of national plans/mechanisms to secure NCD medicines and supplies during an emergency Information and data, digital health and research  Strengthen NCD surveillance and regularly update data on NCDs and related risk factors, including lists of patients with complications, life-threatening conditions and specialized care.  Integrate NCDs into existing emergency assessment tools such as public health surveillance assessment, the 4Ws (i.e. who is doing what, where, when), the Health Resources Availability Mapping System (HeRAMS) and facility readiness.  Scale up the use of digital health, including telemedicine adapted to emergency setting.  Ability of surveillance systems to collect data on NCD and related risk factors Community engagement, communication and trust building  Raise awareness and engage and empower communities and people living with NCDs regarding their needs and plan the response to an emergency based on the WHO framework for meaningful engagement of people living with NCDs, and mental health and neurological conditions.  Strengthen the capacity of community health workers, volunteers and peer educators and individuals with lived experience to provide NCD health services in emergency settings.  Establish feedback mechanisms and platforms for dialogue and information exchange between communities, health authorities and other stakeholders.  Availability of platforms/networks for dialogue and feedback mechanisms Response phase Domain Strategic intervention Indicator Leadership, collaboration and advocacy  Assign an NCD focal point in emergency response teams and platforms.  Establish a national multisectoral working group (strategic and technical) responsible for addressing NCDs in emergency response.  Strengthen collaboration and coordination among different  sectors/organizations and stakeholders, humanitarian agencies, and the other relevant sectors (e.g. nutrition, water and sanitation) engaged in NCD prevention, treatment and care in emergencies.  Integrate NCDs into the emergency preparedness and response process, adopting an all-hazards approach.  Incident management is to be considered in the preparedness phase.  Availability of assigned NCD focal point within the emergency response team or platform Resource mobilization and finance   Mobilize and coordinate resources to ensure the availability of sufficient flexible funding to cover priority NCD urgent needs.  Review and adapt contingency funding to prioritize NCD needs during the emergency.  Ensure the integration of NCDs in funding proposals to donors.  Availability of contingency funding to cover NCD needs during the emergency response Service delivery, human resources, medications and technologies  Integrate and include NCDs in the national health sector response plan during the acute phase of the emergency.  Ensure the provision of uninterrupted NCD care and essential NCD services and interventions during emergencies based on the available resources and the context, including establishing temporary health care facilities, mobile clinics or telemedicine services focusing on primary health care with referral pathways to secondary and tertiary care.  Ensure a continuous supply of essential medicines and technologies using NCD emergency kits.  Adapt and implement national operational guidance to support national emergency responses.  Ensure adequate deployment of NCD workforce including community-based health workers and provide rapid training in NCD management in emergency settings.  NCDs integrated in the national health sector response plan during the acute phase  Number of NCD kits deployed during the acute phase of an emergency Information and data, digital health and research  Integrate NCDs in emergency initial rapid assessment tools and regular mapping of service needs.  Ensure the integration of NCD information and surveillance as part of the emergency dashboard in the Health Emergency Operation Centre (HEOC).  Develop a plan or mechanism for real-time data collection and use evidence to report on NCD service provision from health facilities to inform response efforts.  Availability of NCD rapid assessment data/report as part of emergency assessments  Availability of regular health facility reporting mechanism on NCD service provision Community engagement, communication and trust building  Ensure full participation of the communities and individuals with lived experience of NCDs in priority-setting and response.  Establish communication exchange channels during emergencies for access to relevant NCD information on health promotion, risk factors and self-management.  Foster collaboration among community networks, nongovernmental organizations and the private sector to align response efforts in addressing NCDs in emergencies.  Existence of community representation for people living with NCDs  People living with NCDs are part of priority-setting committees or working groups  Implementation of health promotion campaign on NCDs and related risk factors during emergencies Recovery phase Domain Strategic intervention Indicator Leadership, collaboration and advocacy  Establish operational NCD technical working groups, an NCD national committee and high-level committee to address NCDs during the recovery phase.  Integrate NCDs in the national health strategy/development agenda as part of the recovery plan, humanitarian-development- peace nexus and building back better.  Develop and implement a comprehensive NCD recovery plan addressing key areas such as restoring essential services, re- establishing supply chains, ensuring adequate resources and promoting community engagement.  Advocate and foster multisectoral collaboration among diverse stakeholders, including health care providers, government agencies, civil society organizations and community representatives.  Adapt and implement the WHO regional framework for action on prevention and control of NCDs.  Existence of a developed and implemented NCD costed early recovery plan  Existence of operational NCD technical working groups, NCD national committee and high- level committee Resource mobilization and finance   Conduct a comprehensive assessment of the resource requirements for NCDs.  Develop a funding plan to ensure uninterrupted NCD services during the transition from humanitarian to domestic funds.  Develop national financial plan to mobilize resources to secure  sustainable financing for NCD care using innovative financing  mechanisms such as taxation of harmful products (alcohol, sugar- sweetened beverages) and public–private partnerships.  Existence of financial  plan with allocated budget for NCD programme in emergencies and emergency response phases Service delivery, human resources, medications and technologies  Strengthen and orient the health system to address the prevention and control of NCDs and related risk factors through people- centred primary health care and universal health coverage.  Strengthen human resources and institutional capacities to ensure the continuity and quality of NCD care.  Implement evidence-based interventions (best buys) for NCD risk factors (e.g. tobacco control, salt reduction, physical activity promotion and alcohol harm reduction).  Expand the scope and quality of NCD services such as early detection, palliative care and rehabilitation.  Ensure the availability, affordability and quality of NCD medicines  and technology based on WHO guidance, while ensuring equity and equality for the vulnerable and for marginalized groups and avoiding discrimination.  Percentage of primary health care facilities that have integrated NCD prevention and control services into their service delivery (availability of essential medical equipment and supplies in NCD care facilities) Information and data, digital health and research  Conduct capacity assessments and mapping of services during the transition to recovery on NCD services.  Strengthen, build and resume NCD surveillance system activities guided by WHO NCD global targets and indicators.  Strengthen the integration of NCD surveillance into the existing health information system.  Promote the use of digital health care solutions, such as electronic health records, telemedicine platforms, mobile health applications and other digital tools and dashboards.  Document and share knowledge on best practices, country experiences and lessons learned to build back better.  Availability of NCD capacity assessment and service mapping report  Availability of recent population-level information on NCD burden (STEPS) Community engagement, communication and trust building  Engage and empower the community and people with NCDs to ensure their full participation in the recovery planning process.  Establish and strengthen community support groups for people with NCDs to provide a platform for sharing experiences, information and psychosocial support.  Enhance mechanisms for multisectoral collaboration and feedback.  Availability of community and patient support groups