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Addressing the double burden of disease: Improving health systems for non-communicable and neglected Tropical diseases

Nilambar Jha, Sanjib Kumar Sharma, Suman Bahadur Singh, David Beran

Multi-sectoral Action Plan on the Prevention and Control of Non-communicable Diseases (NCD) in Nepal 2014-2020 mentioned that in the South-East Asia Region (SEAR), NCDs are the leading cause of death, accounting for 55% of all deaths. NCDs are estimated to account for 66% of all deaths in Nepal while 30% is from cardiovascular diseases and 4% from diabetes. Because of chronic nature, Non- Communicable Diseases and Neglected Tropical Diseases are known to cause burden on the household and individual in terms of lost productivity, cost of care, disability and death. Using the concept of “tracer conditions” as an example of the response of the health system to the double burden of disease, diabetes, hypertension, and leprosy were studied. The primary health care response to them has lacked adequate response. The need for improved Primary Health Care Responses to tackle double burden of diseases have been underscored by studies. This study explored the non-communicable diseases (diabetes and hypertension) and leprosy management in Nepal, assessed the barriers, enablers and lessons from the policy, health system, community and individual perspective and suggested relevant and contextually adapted evidence-based interventions for the management of diabetes and hypertension and leprosy in Nepal.