NCD EG

Eleventh Meeting (1)

Moscow, Russian Federation

8 April 2016

Reference /
NCD EG meeting 11 (1) 2016_04_1
Title /
Project idea “DOWN with NCDs”
Submitted by /
NCD EG Secretariat
Summary / Note / Discussion

Project idea form

Submitted by
Name and family name / Rafael Oganov
E-mail /
Expert Group name / Non-communicable Diseases
Preferred funding source (choose one only)
X ENI funding
Project idea
Project title / “DOWN with NCDs!”
Better comprehensive national health system response to reduce NCD burden in the Northern Dimension area
Thematic area(s) covered /
  • Strengthening prevention and addressing lifestyle-related risk factors of NCDs.
  • Reducing social and health harm from alcohol and tobacco.
  • Addressing health and social needs related to chronic conditions and demographic changes.

Geographical area(s) covered / 4 countries would be selected, tentatively Latvia, Lithuania, Russian Federation and Belarus. 3 of these countries are NDPHS/NCD-EG members (Russia being the chairing country since 1.1.2016 and Belarus 0bserver NDPHS country). The process to seek participating countries agreement is on-going. Should some of them not wish to participate, to identify willing alternates from among other NDPHS member countries is not foreseen to be a problem.
WHO-EURO has developed the NCD Assessment Guide[1] in 2014 and has successfully piloted it in practice.Until now 5 NCD assessments (EST, KGZ, MDA, TDZ, TUR) have been made and published in 2014 - 2015. As WHO-EURO will be NCD EG co-chairing organization in 2016, it will strengthen an important practical collaborative link with NDPHS.
As Estonia has already undergone the NCD Country Assessment, it would not be an eligible candidate here. However, the Estonian experience could be used as reference. Especially for Latvia and Lithuania it would be an important asset and help for their project implementation and analysis.
The innovation of this project would be to form one pair of NDPHS partner countries, which would do the analyses side by side and organize feed-back seminars together. Latvia & Lithuania, and FinlandSweden could form such pairs. This project would seek added value of having the 2 pairs of neighboring countries “sparring” each other in the process, and encouraging to make new interpretations of the situation and to identify fresh solutions to their public health problems.
Final candidates and agreement of the participating 4 countries would be made during the 2nd phase of the application process, if this project idea is awarded for further elaboration.
Indirectly: All 9 NDPHS countries). If the results of this project are good, continuation of the work would be discussed in other NDPHS partner countries.
Objectives / Overall objective:
Improved comprehensive national health system response to reduce the NCD burden in project implementing countries
Specific objectives:
  • Strengthening prevention of lifestyle-related risk factors.
  • Strengthening and promoting multi-sectoral approaches.
  • Strengthening integration and coordination of care and prevention throughout the life course at the primary care level.

Type of activities to be implemented / # Analytical work:
  • Baseline NCD situation assessment.
  • Baseline NCD health system performance situation assessment.
  • Score card development for core population interventions and individual services.
# Fact finding:
  • Health system challenges and opportunities mapping.
  • Policy recommendations identification and formulation.
# Meetings and workshops
  • Conclusions and recommendations preparation and dissemination.
# Fact sheets, good practice briefs and reports
# Accelerated roadmap to enhance evidence-informed NCD-policy making in the project implementing countries
Target group(s) / The project in selected (4) countries will focus on the public health situation of the total population, as the focus will be on the operation of the whole national health system. The mentioned target groups’ representative will be included when the assessment is made and again when the findings and recommendations are publicised. There needs to be a well-planned work package for information dissemination and media collaboration.
  • National, regional and local politicians and decision-makers (incl. ministries of finance, which is an important target group. Presently non-action is the most expensive option for them and NCD prevention and good treatment will save national financial resources)
  • Public health institutions, incl. doctors and nurses of PHC-clinics and health centres
  • Health insurance administrators
  • Employer and labour organisations
  • National NCD-related patient organisations
  • NGOs related with health and social development
  • Media
  • Representatives of academic institutions and professional associations

Final beneficiaries /
  • Whole populations of participating countries as NCDs in our region form over 80 percent of disease burden (premature morbidity and mortality. Therefore, the improvements of preventive measures of health systems vis-à-vis e.g. hypertension and cardiovascular diseases, diabetes (obesity), tobacco use related cancers, harmful use of alcohol, low physical activity, etc.
  • The biggest directly benefiting groups are the people in risk and already suffering from NCDs.
  • National economies would benefit ofbig savings if only the growing trend of NCDs could be stopped.

Estimated results /
  1. Clear understanding of the latest available situation analysis of 25 NCD indicators including premature losses of life measured through PYLL-indicator (Potential Years of Life Lost).
  2. Updated list of main causes of NCDs in priority order.
  3. Review of evidence based interventions to tackle the priority problem areas and assessment of their comprehensive population based use in the target country.
  4. Strategic plan on how to further accelerate the implementation of evidence based interventions, and how and when the outcome of this action would need to be re-assessed, and relevant indicators re-measured

Main activities /
  • Assessment of the baseline situation on the information collected according to Europe Barcelona Office for Health System Strengthening Assessment Guide 2014 and adapted to the Northern Dimension specificity.
  • Analysis of the health system performance in each chosen NDPHS Partner Country in relation to WHO targets.
  • Development of a score card for core population interventions and individual services, with linkages to health behavior and outcomes.
  • Analysis of the health system challenges and opportunities that impede or facilitate the deliveryof core services.
  • Highlighting good practices and innovations in the health system, with evidence of their impact onNCD-related core services and outcomes.
  • Provision of policy recommendations for each chosen NDPHS Partner Country to address healthsystem barriers and provide input into NCD and HSS (health systems strengthening) actionplans.
  • Preparation and dissemination of conclusions and recommendations (via national workshop and “shared bi-national”[2] conference, the NDPHS website,newsletter and media events) to national ministries and relevant public health authorities, including health insurance agencies.

Duration of the project (months) / Preparation phase 2 mo + Implementation phase 13 mo + Reporting and final reporting 3 months = 18 mo
Estimated total cost and main types of expenditure (EUR) / TOTAL 300,000EUR
Country-pair No 1 Country-pair No 2[3] (as see left)
10,000 - Planning & administration
80,000 - Consultancy
30,000 - Travel
10,000 - Feed-back seminars
10,000 - Final reporting
TOTAL: 150,000 EUR + TOTAL: 150,000 EUR
Funding sought from the EU (EUR) / 150,000 EUR per each country pair (á 75,000 EUR per single country)
TOTAL 2 x 150,000 EUR = 300,000 EUR
Estimated own contribution by the project proponent(s) (EUR) / None if ENI funding would be granted
(however, no fees or expenses could be paid to the target country officials or for use of local facilities)
Other information / Through ENI funding (EuropeAid/132633/C/SER/multi RfS2015/366-721/v2) and collaboration with the NDPHS/NCD-EG an 8 months’ project has started 4 January 2016 on international comparison of differences in Premature deaths and their causes in NDPHS partner countries measured by “potential Years of Life Lost (PYLL) indicator. Countries to be covered are Estonia, Finland, Germany, Latvia, Lithuania, Poland, Sweden and Belarus. The results of this study will greatly benefit and provide value added to the suggested continuation focusing on the main causes of preventable premature losses of live caused by NCDs. Later (ca. 3 – 5 years)repeated PYLL-analysis will also act as indicator for measuring the trends and effect of interventions implemented to correct the situation.
During this preparatory planning phase WHO-EURO Director of NCD & Health promotion (DrGaudenGalea) has been consulted and he considers this proposal favorably.
This project idea is in line with NDPHS Strategy and Action Plan 2020 and EUSBSR. NCDs are by far causing the biggest disease burden in the ND area. The findings will have direct impact on national and European health policies and strategies.
The same methodology (but not as pairs of 2 countries) is already implemented in Estonia, Moldova, Kyrgyzstan, Tajikistan and Turkmenistan by WHO-EURO. In these countries there is clear signs of the acceleration of public health action after the assessment. The NDPHS country network though its regular high level meetings and collaboration with EU and Baltic Region Parliamentarians can act as an appropriate forum for disseminating the project results to political decision making level.

1

NCD project idea.docx

[1] See ANNEX 1: WHO-EURO NCD Assessment Guide 2014

[2] N.B: This project is suggested to be implemented in country pairs. Therefore, first a national workshop needs to discuss the results and recommendations and after that both countries should come together, present their cases and discuss their suggested solutions.

[3] N.B. This project could be implemented only in 2 countries (one country pair), in which cases the total budget would be 150.000 €