Integrating NCDs into other programme areas :

Examples of WDF supported partnerships

Presented to GCM Working Group 3.1.

WHO Geneva 26 September 2016

WORLD DIABETES FOUNDATION

• Founded in the year 2002

• Supported by endowments from Novo Nordisk A/S totalling USD 275 million

between 2002-2024

• Registered in Denmark as an independent trust

• Board of Directors and Secretariat

VISION

To alleviate human suffering related to diabetes and its complications

among those least able to withstand the burden of diabetes

• World Health Organization and its regional

offices (esp. PAHO) • International NGOs and societies incl FIGO,

The Union, NCD Alliance, IDF etc.

• Public Health Institutions and Agencies • Academia

• Ministries of Health

• Local Diabetes Associations • Local NGOs/grassroot organisations • Local health authorities and institutes,

universities • Professional societies

WDF PROJECT PORTFOLIO (2002 - SEP. 2016 )

488 country level projects (260 active)

116 countries (83 active)

WDF has funded USD 127 million

Total portfolio value USD 360 million (incl. in-cash / in-kind co-funding)

FUNDING MODALITIES

INTERVENTION/FOCUS AREAS, CLUSTERS OF ELIGIBILITY

Intervention areas : access to care, prevention, advocacy

Focus areas : type 2 diabetes and foot/eye complications, diabetes and pregnancy,

TB-diabetes co-morbidity, (diabetes/hypertension)

Capacity building-HRH : training, training material/guideline/protocol development,

logistics, facilitation, etc.

Services improvement : basic and advanced equipment, registries, e-health etc.,

screenings, primary care/referral care

Health promotion, prevention : education/awareness material, campaigns, community

mobilisation, non-medical staff training, civil society strenghthening,

primary care↔community linkages (CHWs)

Monitoring : on-site supervision, coordination, data collection, stakeholder sensitisation

Non-eligible : medication; health care staff salaries; construction works

PROGRAMME APPROACH

ADAPTATION AND REFINEMENT 2002→2016

Diabetes

NCDs

Integration of NCDs into health systems

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

COUNTRY CASE EXAMPLES

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

COUNTRY CASE: KENYA

WDF GRANT: USD 2.1 MILLION (AGGREGATED)

PARTNERS: MINISTRY OF HEALTH, DMI

FRAMEWORK: NATIONAL NCD STRATEGY/ACTION PLAN 2011→

RESULTS: 100 SERVICE UNITS/800 HCP

EXPECTED RESULTS: 350 SERVICE UNITS/600 HCP

INTEGRATION:

NCDS AT PRIMARY LEVEL/SECONDARY LEVEL

MCH (DIABETES AND PREGNANCY)

PREVENTION/HEALTH PROMOTION - CHW/CIVIL SOCIETY*

*VARIOUS OTHER WDF FUNDED PROJECTS

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

COUNTRY CASE: MALAWI

WDF GRANT: USD 1.2 MILLION (AGGREGATED)

PARTNERS: MINISTRY OF HEALTH, BHT, COM, DAM, WHO-CO

FRAMEWORK: NATIONAL NCD RESPONSE/NCD ACTION PLAN 2012→

RESULTS: 25 SERVICE UNITS/400 HCP

EXPECTED RESULTS: 70 SERVICE UNITS/300 HCP

INTEGRATION:

NCDS AT PRIMARY LEVEL/SECONDARY LEVEL – PEN MODEL

PREVENTION/HEALTH PROMOTION - CHW/CIVIL SOCIETY*

*VARIOUS OTHER WDF FUNDED PROJECTS

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

COUNTRY CASE: SRI LANKA

WDF GRANT: USD 1.3 MILLION (AGGREGATED)

PARTNERS: MINISTRY OF HEALTH, SLMA, SLCE, WHO-CO

FRAMEWORK: NATIONAL NCD RESPONSE

RESULTS: 15 SERVICE UNITS/>1,000 HCP

EXPECTED RESULTS: 250 SERVICE UNITS/>3,000 HCP

INTEGRATION:

NCDS AT PRIMARY LEVEL/SECONDARY LEVEL – PEN MODEL

DIABETES-HYPERTENSION/CVD

MCH (DIABETES AND PREGNANCY) - MIDWIVES TRAINING

PREVENTION/HEALTH PROMOTION - CHW/CIVIL SOCIETY

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

COUNTRY CASE: UZBEKISTAN

WDF GRANT: USD 800.000 (AGGREGATED)

PARTNERS: MINISTRY OF HEALTH, UMID

FRAMEWORK: NATIONAL NCD RESPONSE/NATIONAL MCH PROGRAM

RESULTS: 55 SERVICE UNITS/1.100 HCP

EXPECTED RESULTS: 200 SERVICE UNITS/2.400 HCP

INTEGRATION:

NCDS AT PRIMARY LEVEL/SECONDARY LEVEL

MCH (DIABETES AND PREGNANCY)

PREVENTION/HEALTH PROMOTION - CIVIL SOCIETY

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

COUNTRY CASE: PARAGUAY

WDF GRANT: USD 750.000

PARTNERS: MINISTRY OF HEALTH, WHO/PAHO-CO

FRAMEWORK: NATIONAL NCD ACTION PLAN 2014-2024

RESULTS: 112 SERVICE UNITS/450 HCP

INTEGRATION:

NCDS AT PRIMARY LEVEL/SECONDARY LEVEL – ‘CHRONIC CARE MODEL’

PREVENTION/HEALTH PROMOTION - CHW/CIVIL SOCIETY

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

COUNTRY CASE: INDIA (UTTAR PRADESH STATE)

WDF GRANT: USD 550.000 (AGGREGATED)

PARTNERS: GOV. OF INDIA NRHM, JAIN

FRAMEWORK: U.P. STATE HEALTH PROGRAMME

RESULTS: 130 SERVICE UNITS/>1.500 HCP

EXPECTED RESULTS: >1.000 SERVICE UNITS/>3.000 HCP

INTEGRATION:

MCH

NCDS AT PRIMARY LEVEL

PREVENTION/HEALTH PROMOTION – CHW/CIVIL SOCIETY

POLICY IMPACT

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

COUNTRY CASE: CHINA / INDIA

WDF GRANT: USD 300,000

PARTNERS: THE UNION, WHO, NATIONAL HEALTH AUTHORITIES

FRAMEWORK: NATIONAL TB PROGRAMMES

RESULTS: 80 SERVICE UNITS/100 HCP

INTEGRATION:

TB

PREVENTION/HEALTH PROMOTION - CIVIL SOCIETY

POLICY IMPACT: WHO/UNION COLLABORATIVE FRAMEWORK ON TB/DIABETES

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

FURTHER EXAMPLES: RWANDA, MOZAMBIQUE, GAMBIA, MAURITIUS, PERU,

BRAZIL, MEXICO, GUATEMALA, GUYANA, HONDURAS, COLOMBIA

(UNRWA)

→SIMILAR PARTNERSHIP APPROACHES

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

PARTNERSHIP MODEL

→HEALTH AUTHORITY OWNERSHIP

→NATIONAL NCD RESPONSE IMPLEMENTATION

→NATIONAL STAKEHOLDER CO-OWNERSHIP

→ALIGNMENT WITH WHO GAP/NCD 2013-2020

→INTEGRATION: PHC LEVEL (UHC)

CHW-PREVENTION

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

WDF LEARNINGS

ASSETS

PARTNERSHIP MODEL (IMPLEMENTATION)

DEMAND DRIVEN / CONTEXT SPECIFIC APPROACHES

SCALE-UP FEASIBILITY

MULTIPLE STAKEHOLDER MOBILISATION

POLICY ENVIRONMENT DYNAMICS

CHALLENGES

SUPPLY CHAIN (CONSUMABLES, MEDICATION ETC.)

STAFF ATTRITION

PATIENT REGISTRIES/RECORDS (HMIS INTEGRATION/NCD DATA)

MONITORING

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

PERSPECTIVES

→GCM WORKING GROUP 3.1. REPORT / RECOMMENDATIONS

R1: EVIDENCE (PHC, PREVENTION, HEALTH AUTHORITY LEADERSHIP)

R2: EVIDENCE (PEN MODEL TOOL)

R3: STRONG EVIDENCE (SCALE UP FEASIBILITY, NATIONAL PRIORITIES)

R4: STRONG EVIDENCE (TRAINING OF HCP-INSTITUTIONAL TUITION)

R5: PARTIAL EVIDENCE (MULTISECTORAL MECHANISMS-CIVIL SOCIETY)

R6: STRONG EVIDENCE (PHC INTEGRATION-PEN MODEL/CCM ETC.)

R7: EVIDENCE (COUNTRY CASE EXAMPLES-LESSONS LEARNED)

R8: STRONG EVIDENCE (TASK SHIFTING-PHC-CHW RECOGNITION)

R9: PARTIAL EVIDENCE (E-HEALTH/M-HEALTH)

INTEGRATION OF NCDS INTO HEALTH SYSTEMS

DIABETES/NCDS AND OTHER PROGRAMME AREAS

PERSPECTIVES

WDF GOING FORWARD (→2024)

→CONTINUED SUPPORT TO IMPLEMENTATION OF NATIONAL NCD RESPONSES

→CONTINUED SUPPORT TO INTEGRATED PHC / PREVENTION-CHW

→CONTINUED ALIGNMENT WITH WHO GAP/NCD 2013-2020 / SDG

→CONTINUED ACTIVE PARTICIPATION IN WHO-GCM

→CONTINUED PROACTIVE SEARCH FOR PARTNERSHIPS WITH GOVERNMENTS

AND KEY NATIONAL/INTERNATIONAL STAKEHOLDERS (WHO, NCD-ALLIANCE,

THE UNION, FIGO ETC.)

→ENHANCED FOCUS ON OUTCOMES (CARE, PREVENTION)