Tackling the non-communicable disease epidemic: a framework for policy action in low- and middle-income countries.

Health policy frameworks for the prevention and control of non-communicable diseases have largely been developed for application in high-income countries. Limited attention has been given to the policy exigencies in lower- and middle-income countries where the impacts of these conditions have been most severe, and further clarification of the policy requirements for effective prevention is needed. This paper presents a policy approach to prevention that, although relevant to high-income countries, recognizes the peculiar situation of low-and middle-income countries. Rather than a narrow emphasis on the implementation of piecemeal interventions, this paper encourages policymakers to utilize a framework of four embedded policy levels, namely health services, risk factors, environmental, and global policies. For a better understanding of the non-communicable disease challenge from a policy standpoint, it is proposed that a policy framework that recognizes responsible health services, addresses key risk factors, tackles underlying health determinants, and implements global non-communicable disease conventions, offers the best leverage for prevention.

Analyzing Two Decades of Literature on Experiences of Familial Mental Illness Stigma in Four Advanced Countries (2000-2020).

BACKGROUND: Mental illness-related stigma does not only emanate from the public but also within families of persons with mental illnesses. Familial mental illness stigma implies family members perpetuating stigma against their loved ones with mental illnesses. AIMS: The aim of this review was to analyze the empirical literature on experiences of familial mental illness stigma in four countries. METHODS: Using seven databases, we reviewed 133 empirical studies with 26 meeting the inclusion criteria. Each of the 26 studies spoke to various forms of familial mental illness stigma that potentially impact the self-esteem and self-worth of the affected person. RESULTS: Findings from this review show the existence of familial mental illness stigma in high-income countries, highlighting the need for evidence-based policies to safeguard affected persons at the family level. Close relatives stigmatizing their loved ones due to mental illnesses have contributed to the concealment of mental illness diagnoses within families, which often results in poor prognoses. CONCLUSIONS: Family members' understanding of mental illnesses is key in confronting the stigma associated with mental disorders in our communities, but this is contingent on continuous comprehensive familial program and education. Constant social support from community services and family members is essential in the recovery of persons with mental illnesses. This underscores the need for a stigma-free environment at all levels of society to ensure all-inclusiveness which calls for a comprehensive strategy that targets policy changes, public education, and media representations of mental health-related problems.

Exploring health promotion efforts for non-communicable disease prevention and control in Ghana.

Noncommunicable diseases (NCDs) are a growing public health challenge in Ghana. Health promotion can provide useful avenues to reduce the incidence of NCDs in the country. We used the Ottawa Framework to assess health promotion efforts for the prevention and control of NCDs in Ghana. Data were collected using key informant interviews and documentary sources. A content analysis approach was adopted for data analysis using Nvivo 11 Software. We found a strong policy framework for NCD prevention in Ghana with the ratification of several international protocols and resolutions and the development of national and specific NCD-related policies. Implementation of these policies, however, remains achallenge due to limited resources and the overconcentration on communicable diseases. Attempts have been made to create a supportive environment through increased access to NCD services but there are serious challenges. Respondents believe the current environment does not support healthy eating and promotes unhealthy use of alcohol. The Community-based Health Planning and Services (CHPS) program engenders community participation in health but has been affected by inadequate resources. Personal skills and education programs on NCDs are erratic and confined to a few municipalities. We also found that NCD services in Ghana continue to be clinical and less preventative. These findings have far-reaching implications for practice and require health planners in Ghana to pay equal attention in terms of budgetary allocations and other resources to both NCDs and communicable diseases.