ABSTRACT
Background: According to the Global Adult Tobacco Survey carried out in Russia in 2009, the country had one of the highest smoking prevalence rates in Europe. In response to this health and economic burden, Russia implemented a comprehensive Tobacco Control Law (TCL) in 2013, which has been associated with a 21.5% relative decline in adult smoking prevalence in 2016 compared with 2009. This study tests the impact of the TCL on cardiovascular disease (CVD) related health outcomes, including morbidity and mortality. Method: The study evaluated the TCL as an intervention in a natural experiment during the period 2003-2015. A synthetic control was created as a comparator, using data from countries that did not have a comparable comprehensive tobacco control intervention. Changes in trends in CVD outcomes - hospital discharge rates (HDRs) and standardized death rates (SDRs) - were then compared to test for an impact associated with the TCL. Results: Pre-intervention trends in CVD-related HDRs were similar between Russia and the synthetic control, but became divergent after the TCL with greater benefit observed in Russia. This implies a beneficial impact of the TCL on CVD related morbidity in the Russian population. Whilst SDRs continued to reduce in both Russia and the control, the impact of TCL is less clear. Conclusion: This study provides further evidence to support comprehensive tobacco control in line with the WHO Framework Convention for Tobacco Control (WHO FCTC). Alongside a reduction in tobacco consumption, smoking-related CVD morbidity appears to benefit quite soon after implementation, whilst smoking-related deaths might need a longer post-intervention period to be detectable.
Subject(s)
Cardiovascular Diseases/epidemiology , Health Policy , Morbidity , Mortality , Nicotiana/adverse effects , Public Health/legislation & jurisprudence , Smoking Prevention , Smoking/legislation & jurisprudence , Tobacco Industry/legislation & jurisprudence , Tobacco Products/adverse effects , Adult , Cardiovascular Diseases/complications , Female , Humans , Male , Morbidity/trends , Mortality/trends , Prevalence , Public Policy , Russia/epidemiology , Smoking/adverse effects , Smoking/epidemiology , Smoking Cessation/statistics & numerical data , Taxes , Tobacco Products/economics , Tobacco Products/supply & distributionABSTRACT
Despite positive trends, life expectancy in Serbia is well below the average for the WHO European Region.The probability of dying from one of the main noncommunicable diseases (NCDs) between the ages of30 and 69 years is 20%. This has significant socioeconomic consequences for the development of thecountry and calls for an immediate strengthening of the health system to respond to the growing burdenof NCDs. Despite significant progress and political commitment in Serbia, the outcomes of NCDs couldstill be improved. This report reviews the challenges and opportunities facing the health system in Serbiain scaling up core services for the prevention, early diagnosis and management of NCDs. The report alsoprovides examples of good practice in care. Policy recommendations are made for further action, based onthe assessment.
Subject(s)
Chronic Disease , Noncommunicable Diseases , Cardiovascular Diseases , Delivery of Health Care , Universal Health Insurance , Primary Health Care , SerbiaABSTRACT
В 2013 году Кыргызстан принял программу и план реализации программы по профилактике и контролюнеинфекционных заболеваний (НИЗ) на 2013–2020 гг. Страна обратилась к Региональному бюро ВОЗ за помощью впроведении среднесрочной оценки реализации программы с целью мониторинга прогресса в достижении целей,выявления проблем и возможностей для улучшения реализации программы и внедрения инноваций на второмэтапе. Проведение оценки программы и плана реализации программы по НИЗ руководствовалось всеобъемлющиммеханизмом, основанным на логической матрице цепочки результатов. Ключевые рекомендации, разработанныеи согласованные с Министерством здравоохранения, касались следующих направлений: активизации усилий вотношении контроля факторов риска НИЗ; наращивания потенциала в области мониторинга и оценки; повышенияэффективности распределения ресурсов; укрепления координации и подотчетности в целях наращиванияпотенциала
Subject(s)
Chronic Disease , National Health Programs , Program Evaluation , KyrgyzstanABSTRACT
Kyrgyzstan adopted a NCD programme and an action plan on noncommunicable diseases (NCDs) for 2013–2020 in 2013. The country requested support from the WHO Regional Office for Europe in conducting a mid-term review on its implementation to monitor progress towards the targets and to identify challenges and opportunities for improvement and innovation in the second part of the term. A comprehensive framework guided the review of the programme and action plan on NCDs based on the logical result-chain matrix. Key recommendations have been identified and discussed with the Ministry of Health in the following areas: accelerating efforts to control the NCD risk factors; increasing capacity in monitoring and evaluation; improving allocative efficiency; and strengthening coordination and accountability to ensure increased capacity.
