Instrument to map management of noncommunicable diseases in primary care under development

Marlies Wessels

Experts in discussion at a meeting in January 2012

WHO/Europe is developing a new framework instrument to assess how effectively noncommunicable diseases (NCDs) are managed in primary care, in collaboration with the Netherlands Institute for Health Services Research (NIVEL).

WHO/Europe presented a draft report on the issue – giving an overview of the available evidence and views expressed in international policy papers, and describing the first steps in developing such an instrument – at a meeting in Amsterdam, the Netherlands on 25–26 January 2012. At the meeting, representatives of 37 Member States in the WHO European Region discussed their experience with tackling NCDs and ways to further develop the tool.

The instrument aims to assess primary-care performance and gaps in relation to health promotion and the prevention, management and care of cardiovascular diseases and diabetes mellitus. It focuses on evidence-based interventions that can be used in primary-care settings throughout a person’s lifetime.

The participants proposed steps to improve the tool’s relevance in different countries, with:

  • centralized versus decentralized health care systems;
  • variations in the current involvement of primary care in managing NCDs; and
  • various levels of resources.

They discussed how to improve the tool’s sensitivity to equity issues, and how it could better reflect the changing role of primary care, which increasingly focuses on health promotion.

Participants from countries including Denmark, Kyrgyzstan, the Netherlands and the Republic of Moldova presented their experience with implementing related reforms and initiatives. They explored the factors that need to be considered to enhance the health-service delivery system where key issues are coordination of people-centred care and to tackling of co-morbidities.

The draft report presented at the meeting is a first step in developing the instrument, which WHO/Europe plans to field test in several countries in 2012, with a view to rolling it out by the end of the year.

The instrument will be used to monitor the implementation of the Action Plan for Implementation of the European Strategy for the Prevention and Control of Noncommunicable Diseases 2012–2016, on which by Member States agreed in September 2011.