WHO's six-point agenda

1
WHO's six-point agenda

• The overarching health needs
• Promoting development
• Fostering health security
• The strategic ways to meet the health needs
• Strengthening health systems
• Harnessing research, information and evidence
• How WHO can deliver
• Enhancing partnerships
• Improving performance

2
Measuring performance

• Impact on
• Health of the people of Africa
• Health of women

3
Mental health Global Action Programme Scaling
up care for mental, neurological and substance
use disorders
4
Strategies

• Identify priority conditions
• Develop the intervention package
• Identify countries for intensified support
• Scale up services
• Build partnerships

5
Priority conditions

• Criteria
• High burden (mortality, morbidity, disability)
• Large economic cost
• Effective intervention available
• Affecting vulnerable populations

6
Priority conditions in the area of mental,
neurological and substance use disorders

• Depression
• Schizophrenia
• Suicide prevention
• Epilepsy
• Dementia
• Disorders due to use of alcohol
• Disorders due to illicit drug use
• Child mental disorders

7
Intervention package

• Scope
• conditions of public health priority
• Individual or population based interventions to
  be identified on the basis of multiple criteria
• Feasibility of delivery through existing health
  systems
• Target audience
• Nonspecialists health care providers
• Planning purposes at district level

8
Intervention package

• Criteria for identification of interventions
• Efficacy
• Cost-effectiveness
• Equity
• Ethical issues such as protection of human rights
• Feasibility and acceptability
• Packaging
• Many interventions can be delivered by the same
  person at the same time
• More cost-effective in terms of training,
  implementation and supervision

9
Intervention package
Examples of interventions that can be included Evidence-based interventions Condition
First line antiepileptic medicines Trained primary health professionals Referral and supervisory support Treatment with antiepileptic medicines Epilepsy
Basic education about dementia Specific training on managing problem behaviours Trained primary health professionals Interventions directed towards caregivers Dementia
Measures within health sector e.g. provision of skilled care at birth Public health oriented multisectoral measures e.g. food fortification with folic acid and iodine Prevention of developmental disorders Pharmacological and psychosocial interventions Child mental disorders
10
Scaling up

• "Deliberate effort to increase the impact of
  health service innovations successfully tested in
  pilot or experimental projects so as to benefit
  more people and to foster policy and programme
  development on a lasting basis"
• Innovation set of interventions, new or
  perceived as new
• Successfully tested interventions backed by
  locally generated evidence of programmatic
  effectiveness and feasibility
• Deliberate effort guided process
• Policy and programme development on a lasting
  basis Capacity building and sustainability

11
Cost of scaling up epilepsy care

• A study estimated the avertable burden of
  epilepsy and the population-level costs of
  treatment with first-line AEDs in developing
  countries
• Extension of coverage of treatment to 50 would
  avert 13-40 of burden
• The annual cost per person would be 0.20-1.33
  International Dollars
• At a coverage rate of 80,the treatment would
  avert 21-62 of the burden
• The cost to secure one extra healthy year of life
  is less than average income per person

12
Facilitate policy development
Enhance political commitment
Scaling up strategy
Develop the intervention package
Assess needs and resources
Deliver the intervention package
Establish a plan for monitoring and evaluation
Strengthen human resources
Mobilize financial resources
13
Partnerships for action

• WHO in partnership with
• Development agencies e.g. WB
• Research Councils and Institutes
• International health agencies e.g. UNICEF
• Donor agencies and foundations
• Health communities in the countries
• Nongovernmental organizations
• Service users and caregivers

14
GCAE a successful partnership

• 135 IBE/ILAE organisations in 103 different
  countries actively engaged Global Campaign
  related activities, covering 86 of the world
  population
• Two thirds of Campaign activities reported by the
  organisations to be either very successful or
  moderately successful in a recent survey
• Ninety percent of those surveyed said they would
  continue to be active in the Global Campaign in
  the future

15
GLOBAL CAMPAIGN AGAINST EPILEPSYDeterminants of
success

• Partnerships - involvement at every stage and
  level of
• ILAE, IBE, WHO
• Relevant experts epilepsy, public health
• ILAE/IBE Regional Commissions and national
  chapters
• Regional and Country Offices
• Governments
• Ownership by all parties political, patient,
  professional

16
GCAE Future Directions

• Focus on
• Low and middle income countries
• Africa
• Further development of demonstration projects
• Scaling up care
• The place of GCAE in the context of WHO global
  and regional strategies

17
SEIN Internationaal