Short (6-minute) video introduces the PEN-Plus model for decentralizing integrated chronic care services for type 1 diabetes, sickle cell disease, rheumatic heart disease, and other severe NCDs that cause tens of thousands of avoidable deaths every year among the world’s poorest children and young adults. Video includes statements of support from leaders of WHO/AFRO, which has adopted a regional strategy to implement PEN-Plus continent-wide, UNICEF, WHO headquarters, the World Bank, and the Helmsley Charitable Trust.
Chantelle Boudreaux, Prebo Barango, Alma Adler, Patrick Kaobre, Amy McLaughlin, Mohamed Ould Sidi Mohamed, Paul H. Park, Steven Shongwe, Jean Marie Dangou, Gene Bukhman
Health Policy and Planning 2022
Addressing severe chronic NCDs across Africa:
measuring demand for the Package of Essential Non-communicable Disease Interventions-Plus (PEN-Plus)
Severe chronic non-communicable diseases (NCDs) pose important challenges for health systems across Africa. This study explores the current availability of and demand for decentralization of services for four high-priority conditions: insulin-dependent diabetes, heart failure, sickle cell disease, and chronic pain. Countries reported widespread gaps in service availability at all levels. We found that just under half (49%) of respondents report that services for insulin-dependent diabetes are generally available at the secondary level (district hospital); 32% report the same for heart failure, 27% for chronic pain and 14% for sickle cell disease. Reported gaps are smaller at tertiary level (referral hospital) and larger at primary care level (health centres). Respondents report ambitious plans to introduce and decentralize these services in the coming 5 years. Respondents from 32 countries (86%) hope to make all services available at tertiary hospitals, and 21 countries (57%) expect to make all services available at secondary facilities. These priorities align with the Package of Essential NCD Interventions-Plus. Efforts will require strengthened infrastructure and supply chains, capacity building for staff and new monitoring and evaluation systems for efficient implementation. Many countries will need targeted financial assistance in order to realize these goals. Nearly all (36/37) respondents request technical assistance to organize services for severe chronic NCDs.
This 11-minute video shows how decentralizing and integrating chronic care services for type 1 diabetes, sickle cell disease, rheumatic and congenital heart disease, and other severe NCDs has brought lifesaving care to poor rural communities in Rwanda, Malawi, and Haiti … and how this PEN-Plus model is now expanding to other lower-income countries in Africa and South Asia.
