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WHO's six-point agenda. The overarching health needs Promoting development Fostering health security The strategic ways to meet the health needs Strengthening health systems Harnessing research, information and evidence How WHO can deliver Enhancing partnerships Improving performance.
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WHO's six-point agenda • The overarching health needs • Promoting development • Fostering health security • The strategic ways to meet the health needs • Strengthening health systems • Harnessing research, information and evidence • How WHO can deliver • Enhancing partnerships • Improving performance
Measuring performance Impact on: • Health of the people of Africa • Health of women
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
Priority conditions Criteria • High burden (mortality, morbidity, disability) • Large economic cost • Effective intervention available • Affecting vulnerable populations
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
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
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
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
Cost of scaling up epilepsy care • A study estimated the avertable burden of epilepsy and the population-level 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
Facilitate policy development Enhance political commitment Scaling up strategy Develop the intervention package Assess needs and resources Deliver the intervention package Establish a plan for monitoring and evaluation Strengthen human resources 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
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
GLOBAL CAMPAIGN AGAINST EPILEPSYDeterminants of success • Partnerships - involvement at every stage and level of: • 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
GCAE: Future Directions • Focus on: • 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