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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying
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and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Kenya in undergoing an epidemiological transition marked by a decline in morbidity and mortality due to communicable conditions, and an increase in the burden of non-communicable diseases (NCDs), wh
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ich include diseases such as diabetes, cancers, cardiovascular diseases and chronic respiratory infections. The second strategic objective of KHSSP 2014-2018 targets to halt and reverse the rising burden of non-communicable conditions, while the fifth strategic objective is focused on putting into place health promotion interventions that will address risk factors to health.
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Global and regional estimates of violence against women
he report presents the first global systematic review of scientific data on the prevalence of two forms of violence against women: violence by an intimate partner (intimate partner violence)
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and sexual violence by someone other than a partner (non-partner sexual violence). It shows, for the first time, global and regional estimates of the prevalence of these two forms of violence, using data from around the world. Previous reporting on violence against women has not differentiated between partner and non-partner violence. You can download the report in different languages
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Revised edition
The Water, Sanitation, and Hygiene Improvement Training Package is intended to support the training of local outreach workers and their subsequent work in communities to promote improved water, sani
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tation and hygiene (WASH) practices to reduce diarrhea
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DHS Further Analysis Reports No 102
DHS Working Papers No. 92
DHS Further Analysis Reports No. 97
The Demographic Dividend study on Rwanda assessed the socio-economic and human development potential of our country in the short, medium and long-t
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erm period using a comprehensive approach. It generated relevant policy and programme information to guide a well-informed polciy required to propel Rwanda towards achieving its aspirations of being high middle income country by 2035 and high income country by 2050.
The primary objectives of this study were to assess Rwanda’s prospects for harnessing the demographic dividend and demonstrate priority policy and programme options that the country should adopt in order to optimise its chances of earning a maximum demographic dividend in the context of its youthful population and medium, long-term socio-economic development aspirations.
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The aim of this report is to: (1) synthesize the findings from selected maternal and newborn related studies in Nepal conducted during 2011-2014, (2) identify areas of improvement in existing interventions,
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and (3) recommend possible strategies to fulfill such gaps.
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