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)