Transcript WHO's six-point agenda  The overarching health needs 1. Promoting development 2. Fostering health security  The strategic ways to meet the health needs 3.

WHO's six-point agenda
 The overarching health needs
1. Promoting development
2. Fostering health security
 The strategic ways to meet the health needs
3. Strengthening health systems
4. Harnessing research, information and evidence
 How WHO can deliver
5. Enhancing partnerships
6. Improving performance
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Epilepsy and WHO | 17 Oct 2008
Measuring performance
Impact on:
 Health of the people of Africa
 Health of women
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Mental health Global Action Programme:
Scaling up care for mental, neurological and substance use
disorders
Strategies
 Identify priority conditions
 Develop the intervention package
 Identify countries for intensified support
 Scale up services
 Build partnerships
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Epilepsy and WHO | 17 Oct 2008
Priority conditions
Criteria
 High burden (mortality, morbidity, disability)
 Large economic cost
 Effective intervention available
 Affecting vulnerable populations
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Epilepsy and WHO | 17 Oct 2008
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
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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
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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
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Epilepsy and WHO | 17 Oct 2008
Intervention package
Condition
Evidence-based
interventions
Examples of interventions
that can be included
Epilepsy
Treatment with antiepileptic
medicines
First line antiepileptic medicines
Trained primary health professionals
Referral and supervisory support
Dementia
Interventions directed
towards caregivers
Basic education about dementia
Specific training on managing
problem behaviours
Trained primary health professionals
Child mental
disorders
Prevention of
developmental disorders
Measures within health sector e.g.
provision of skilled care at birth
Pharmacological and
psychosocial interventions
Public health oriented multisectoral
measures e.g. food fortification with
folic acid and iodine
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
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Epilepsy and WHO | 17 Oct 2008
Cost of scaling up epilepsy care
 A study estimated the avertable burden of epilepsy and the populationlevel 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
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Epilepsy and WHO | 17 Oct 2008
Facilitate policy
development
Assess needs
and resources
Enhance
political commitment
Scaling up strategy
Develop the
intervention package
Deliver the intervention
package
Strengthen
human resources
Establish a plan for
monitoring and evaluation
Mobilize financial
resources
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
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Epilepsy and WHO | 17 Oct 2008
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
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Epilepsy and WHO | 17 Oct 2008
GLOBAL CAMPAIGN AGAINST EPILEPSY
Determinants of success
 Partnerships - involvement at every stage and level
of:
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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
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Epilepsy and WHO | 17 Oct 2008
GCAE: Future Directions
 Focus on:
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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
Epilepsy and WHO | 17 Oct 2008
SEIN Internationaal
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Epilepsy and WHO | 17 Oct 2008