Department of African Studies, University of Dschang, Dschang, Cameroon.
Global Health. 2010 Apr 19;6:6. doi: 10.1186/1744-8603-6-6.
Africa faces an urgent but 'neglected epidemic' of chronic disease. In some countries stroke, hypertension, diabetes and cancers cause a greater number of adult medical admissions and deaths compared to communicable diseases such as HIV/AIDS or tuberculosis. Experts propose a three-pronged solution consisting of epidemiological surveillance, primary prevention and secondary prevention. In addition, interventions must be implemented through 'multifaceted multi-institutional' strategies that make efficient use of limited economic and human resources. Epidemiological surveillance has been prioritised over primary and secondary prevention. We discuss the challenge of developing effective primary and secondary prevention to tackle Africa's chronic disease epidemic through in-depth case studies of Ghanaian and Cameroonian responses.
A review of chronic disease research, interventions and policy in Ghana and Cameroon instructed by an applied psychology conceptual framework. Data included published research and grey literature, health policy initiatives and reports, and available information on lay community responses to chronic diseases.
There are fundamental differences between Ghana and Cameroon in terms of 'multi-institutional and multi-faceted responses' to chronic diseases. Ghana does not have a chronic disease policy but has a national health insurance policy that covers drug treatment of some chronic diseases, a culture of patient advocacy for a broad range of chronic conditions and mass media involvement in chronic disease education. Cameroon has a policy on diabetes and hypertension, has established diabetes clinics across the country and provided training to health workers to improve treatment and education, but lacks community and media engagement. In both countries churches provide public education on major chronic diseases. Neither country has conducted systematic evaluation of the impact of interventions on health outcomes and cost-effectiveness.
Both Ghana and Cameroon require a comprehensive and integrative approach to chronic disease intervention that combines structural, community and individual strategies. We outline research and practice gaps and best practice models within and outside Africa that can instruct the development of future interventions.
非洲面临着一种紧迫但被忽视的慢性疾病流行。在一些国家，中风、高血压、糖尿病和癌症导致的成年住院人数和死亡人数超过了艾滋病毒/艾滋病或结核病等传染病。专家提出了一个三管齐下的解决方案，包括流行病学监测、初级预防和二级预防。此外，必须通过“多方面多机构”的战略来实施干预措施，以有效利用有限的经济和人力资源。流行病学监测一直优先于初级和二级预防。我们通过深入研究加纳和喀麦隆的应对措施，讨论了通过发展有效的初级和二级预防措施来应对非洲慢性疾病流行的挑战。
通过应用心理学概念框架指导，对加纳和喀麦隆的慢性疾病研究、干预措施和政策进行了审查。数据包括已发表的研究和灰色文献、卫生政策倡议和报告，以及关于基层社区对慢性疾病反应的现有信息。
加纳和喀麦隆在应对慢性疾病方面的“多机构和多方面的反应”存在根本差异。加纳没有慢性疾病政策，但有一项国家健康保险政策，涵盖了一些慢性疾病的药物治疗，有一种为广泛的慢性疾病争取患者权益的文化，以及大众媒体参与慢性疾病教育。喀麦隆有糖尿病和高血压政策，在全国范围内建立了糖尿病诊所，并对卫生工作者进行了培训，以改善治疗和教育，但缺乏社区和媒体参与。在这两个国家，教堂都为主要慢性疾病提供公共教育。两国都没有对干预措施对健康结果和成本效益的影响进行系统评估。
加纳和喀麦隆都需要采取一种全面和综合的慢性疾病干预方法，将结构、社区和个人策略结合起来。我们概述了非洲内外的研究和实践差距以及最佳实践模式，这些可以为未来干预措施的制定提供指导。
