Neurological, Psychiatric, and Developmental Disorders Meeting the Challenge in the Developing World (2001) / Chapter Skim
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4 Findings and Future Strategies
4 Findings and Future Strategies
Pages 97-108
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From page 97... ...
Growing recognition of the prevalence of brain disorders, as well as the availability of cost-effective treatments, may now lead to the adoption of measures designed to achieve significant reductions in the disease burden due to these disorders. This is true even where resources for health care are limited.
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From page 98... ...
Building on the evidence of a limited range of programs, this report proposes strategies for operational research in conjunction with the provision of care. Both therapies and health care delivery systems should be assessed and guided by an iterative process developed to improve clinical care in the local setting while maintaining its affordability.
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From page 99... ...
Utilizing Existing Health Systems Modest investments in and reorientation of existing systems of health care could make it possible to provide and monitor needed treatments for brain disorders and thus substantially reduce the associated disease burden. Integration of care for brain disorders into the primary health care system should occur as part of a national policy to provide comprehensive health care (see Chapter 3~.
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From page 100... ...
Secondary and tertiary centers should train and oversee primary care staff, provide referral capacity, and provide ongoing supervision and support for primary care systems in developing countries. Expanding Use of Cost-Effective Interventions Perhaps the single most encouraging finding of this report is that highly cost-effective interventions exist that can be used to address the enormous disease burden due to brain disorders.
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From page 101... ...
The availability of these relatively affordable drugs could be increased through a combination of targeted aid programs and systematic improvements in the purchasing and distribution systems of developing countries. Every country needs to have in place an effective screening/approval mechanism for new drugs, a cost-effective purchasing mechanism, and an efficient distribution system, with local health care providers being able to get the drugs to the people who need them the most.
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From page 102... ...
Supporting evidence for these recommended interventions is derived from research in both developed and developing countries. Specific discussion of the evidence base for each of these interventions appears in Part 11 of the report.
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From page 103... ...
Strategy 4. Conduct operational research to assess the costeffectiveness of specific treatments and health services in local settings, along with epidemiological research to monitor the incidence, prevalence, and disease burden of brain disorders in developing countries.
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From page 104... ...
. Developing national priorities and strategies for integrating the care of brain disorders into existing health systems; Establishing locally relevant treatment and training guidelines for primary and higher-level care; Training medical professionals who supervise community-level care and who train community-level care providers; Supporting primaly care centers by providing referral care, clinical guidelines, and regular clinical consultation for brain disorders; Conducting operational research on brain disorders including demonstration projects with strong evaluative components to inform the ongoing improvement of health planning and the delivery of care; · Conducting surveillance to support health planning and policy development by national and local governments; Preparing and disseminating educational materials about brain disorders to health ministries, medical schools, community public health programs, physicians, primary care workers, traditional healers, schools, and workplaces; Building networks to enable researchers and health care professionals to exchange information via the Internet; Conducting operational research to evaluate the cost-effectiveness of available therapies and delivery systems; Sponsoring methodological development, epidemiological surveillance, and other locally relevant research concerning the risk factors for brain disorders as well as research on cost-effective models of care management; Contributing to the creation of medical and nursing curricula that are sensitive to local health priorities and cultural practices regarding health care and health-seeking behavior; and Collaborating with nongovernmental and community organizations that provide or promote health services for brain disorders.
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From page 105... ...
Collaborative research with institutions in industrialized countries would provide an opportunity for complementary research activities that would utilize the advantages of each center while eliminating the misuse of limited resources for redundant efforts. The focus of a national center should be on training staff who provide support for primary care workers and conducting operational research on the delivery of cost-effective care for brain disorders in primary care centers.
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From page 106... ...
Substantial and long-term funding will be essential to develop a worldwide network of national centers for training and research and to enable significant participation by researchers in developing countries. A priority for international aid efforts directed at brain disorders should be the creation of a mechanism for competitive funding of research, training, and institutional development.
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From page 107... ...
A broad spectrum of organizations should be enlisted for technical and financial support for this worldwide effort to provide comprehensive health care for brain disorders: National health and finance ministries; · National agencies for international development (such as the U.S. Agency for international Development, Canadian International Development Agency, and Swedish Economic Development Agency)
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From page 108... ...
Through such efforts, affordable reductions in the level of suffering from brain disorders can be achieved in the developing world.
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