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Tailored support for national NCD policy and programme implementation: an over-looked priority
Open accessAbstract
Many low-income and middle-income countries (LMICs) are unlikely to achieve Sustainable Development Goal 3.4 to reduce premature deaths from non-communicable diseases (NCDs) by one-third by 2030. For some, the prospect is receding: between 2010 and 2020, the decline in premature deaths for the major NCDs slowed compared with the prior decade. Barriers to implementing effective strategies are well known, yet the value of tailored technical support to countries has been overlooked and downplayed. Tailored technical support is specialist guidance for country-specific application of technical tools, and capacity enhancement when needed, that enables an LMIC to advance its NCD priorities and plans. We present a model identifying pivotal junctures where tailored technical support can help surmount implementation obstacles. We draw on our experience preparing NCD investment cases with health ministries, development partners and technical agencies. National investment cases produce evidence based, locally tailored and costed packages of NCD interventions and policies appropriate to national needs and circumstances. They can include analysis of financing needs and point towards sustainable funding mechanisms. Enhancing the NCD-specific knowledge of government and Civil Society Organization leads can capitalise on existing expertise, aid integrative health system developments and unlock capabilities to use global tools and guidance. Investment cases form a platform to develop or review NCD plans and (re)prioritise action, then apply implementation science to trouble-shoot obstacles. Partnering national stakeholders with technical support in this process is critical to develop and implement effective NCD strategies.
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Georgia's Ministry of Health used its investment case to support the adoption and partial implementation of comprehensive tobacco control legislation.
“An example is Georgia where the Ministry of Health (MoH) used its investment case to support the adoption and partial implementation of comprehensive tobacco control legislation.”
From Advancing progress on tobacco control in low-income and middle-income countries through economic analysis (2024) · cites this paper as [23]
In “The impact of NCD investment cases” (page not provided), the paper says Georgia’s Health Ministry brought a pilot tobacco-control investment case into debate over stalled legislation, after which Parliament agreed to multiple policy changes. It does not say the legislation was comprehensive or that it was partially implemented. (LLM, conf=0.87)
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Research works printed but not linked: 7
- Hutchinson, 2019, The investment case as a mechanism for addressing the Ncd burden: evaluating the NCD institutional context in Jamaica, and the return on investment of select interventions, PLoS One, 14, 10.1371/journal.pone.0223412 · DOI
- Nugent, 2018, Investing in non-communicable disease prevention and management to advance the sustainable development goals, Lancet, 391, 2029, 10.1016/S0140-6736(18)30667-6 · DOI
- Webb D , Small R . Power dynamics, capacities and incentives that frame the implementation of ncd policies: lessons learned from conducting institutional and context analyses. presentation slides at the American public health association conference 2019.
- Mensah J , Korir J , Nugent R , et al . World bank group working paper: combating noncommunicable diseases in Kenya: an investment case, 2020. Available: https://openknowledge.worldbank.org/handle/10986/33539 · DOI
- Bollyky, 2019, The relationships between Democratic experience, adult health, and cause-specific mortality in 170 countries between 1980 and 2016: an observational analysis, Lancet, 393, 1628, 10.1016/S0140-6736(19)30235-1 · DOI · Paper page
- 10.1186/1748-5908-4-50 · DOI · Paper page
- 10.1136/bmj.l1868 · DOI
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Small, R., Nugent, R., Webb, D., Hutchinson, B., Spencer, G., Ngongo, C., Chestnov, R., & Tarlton, D. (2024) · Tobacco Control · doi:10.1136/tc-2023-058335 · Cited by 14
“9 The economic case against tobacco gathered steam in the late 1990s with an influential World Bank monograph that challenged economic myths around tobacco control and continued in the early 2000s with the adoption and coming into force of the WHO FCTC. 10 11 Reports that have estimated the global economic impacts of…”
BackgroundInfluentialSelf-citationHu, X., Yu, S.-J., Gao, Y.-C., Zhao, Y., He, Y.-S., Liu, Y.-C., Pan, H.-F., & Wang, P. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06344-3 · Cited by 15
Metadata
- Authors
- Jackson-Morris, A., & Nugent, R.
- Affiliations
- RTI International (US)
- Corresponding author
- Jackson-Morris, Angela
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2020-08
- Volume
- 5
- Issue
- 8
- Pages
- e002598
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC7449589
- OpenAlex
- W3080316195
- Cited by
- 12
- References
- 0
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 3 · 2020: 1
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Public Health Policies and Education
- Keywords
- non-communicable diseases, capacity building, low- and middle-income countries, Sustainable Development Goal 3.4, premature mortality, health care financing, implementation science, stakeholder collaboration
- MeSH terms
- Noncommunicable Diseases, Humans, Policy, Mortality, Premature
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