**3. The global status and availability of NCDs data**

The incidence of non-communicable diseases (NCDs) is increasing and resulted in the death of 38 million people in 2012, of which 28 million occurred in low- and middle-income countries, causing an estimated US\$ 7 trillion economic loss [7, 9]. A significant number of NCDs, such as cardiovascular disease, diabetes, hypertension, and obesity, can be avoided by addressing the major behavioural and metabolic risk factors associated with such conditions. Their prevention and treatment require reliable, accurate, and timeous information on their symptoms and associated risk factors. The use of credible data has, therefore, become essential to identify current and potential NCDs morbidity, mortality, and related risk factors [4].

The availability of NCDs data at local, regional, and national levels is helpful for decision-makers to prioritise the prevention of NCDs and strengthen distribution and budget allocation in the healthcare system. It is demonstrated that strengthening the health system is a possible way to resist the growing burden of NCDs and ensure enhanced health results. An effective health system is built on a well-functioning information system that collects accurate, reliable, timeous, and relevant health data for optimal healthcare delivery and decision-making. The lack of data in the healthcare system is a hindrance to planning, allocating resources, and implementing appropriate NCDs intervention strategies [4, 71]. The effective prevention of NCDs is based on having consistent morbidity, mortality, and related risk factors data to plan, design, and implement evidence-based decision-making and its preventive strategies at regional and national levels. NCDs surveillance data can be best collected by establishing and implementing data collection standardised protocols in the healthcare system. Such standardised protocols are data collection forms used to obtain morbidity, mortality, and risk factor-related data [4, 72]. A study by Melkamu and Grace [4] indicated that collecting NCDs data alone is not enough to ensure effective prevention and intervention; what is needed is a wellorganised healthcare system that periodically evaluates the data quality and is timeous and accurate on mortality, morbidity, and related NCDs risk factors to ensure effective decision-making. Whilst progress has been made to lead the development of national NCDs monitoring programmes, most low-resourced countries are still struggling to adequately establish robust information systems to help with their intervention, treatment, and related NCDs risk factors [4].

Health information systems store information that is obtained from patient records, surveys, health plans, and other data sources. Most first world and

**19**

associated with NCDs [4].

**4.1 The system approach**

*The Global Burden and Perspectives on Non-Communicable Diseases (NCDs)…*

high-resourced countries, such as North America, Australia and Europe, have established standards and processes in their healthcare sector to obtain ongoing information on morbidity, mortality, NCDs risk factors, as well as determinants of their care services [73]. Middle-income countries, such as South Africa, and low-resourced countries, such as Ghana, Mozambique, Rwanda, Tanzania, and Zambia, conducted studies to investigate the capacity of their national health information systems, which resulted in them developing robust disease surveillance systems to understand the disease profiles of their population. The availability of health information in the healthcare system enabled these countries to exchange health-related data between healthcare providers, organisations, and health service consuming communities. According to Diamantidis and Becker [74], the availability of NCDs-related public health data in the healthcare system enables timeous and appropriate healthcare decisions to be made, quick information retrieval, fast information sharing, improved data storage, improved information screening and reporting, all of which enhances the quality of healthcare. Furthermore, having NCDs mortality, morbidity, and risk factor data about a population can help policymakers and healthcare providers to establish relevant preventive strategies in their national healthcare system. In a healthcare system with accessible, accurate, reliable, timeous, and cleaned health information, it is possible to predict the future burden of NCDs in that country [4, 75]. Globally, various countries have established healthcare strategic plans in order to address the burden of NCDs by explicitly focusing on the four major lifestyle risk factors, these being an unhealthy diet, physical inactivity,

Low-resourced countries have made a concerted effort to improve the health status of its citizens, particularly regarding preventing and treating infectious communicable diseases, such as HIV/AIDS and tuberculosis [77]. However, little attention is devoted to preventing and treating NCDs in these countries, which resulted in an increased burden of such conditions on individuals, communities, and the healthcare system [4]. Despite the growing evidence of NCDs in this population, the operating healthcare system predominantly focuses on preventing and treating infectious communicable disease, with little evidence-based research that evaluates the availability of their morbidity, mortality, and associated risk factors data [78]. In low-resourced countries, the healthcare system must aim to establish the status of NCDs-related data, the presence of mechanisms to periodically evaluate NCDs data quality, reliability and timeliness, and the availability of standardised protocols for NCDs-related data collection.

Healthcare that has accurate data that serves as information for decision-making is imperative within the hastened speed of information-oriented universal environment. In the changing world, the desire of the community to obtain up-to-date health-related information has become crucial in both high-resourced and lowresourced countries. The accessibility of appropriate health-related information is associated with the availability of factual, accurate, timeous, and reliable data

The system approach (SA) was primarily established by Urie Bronfenbrenner in Russia as a human developmental approach in the 1970s. This approach explicates how diverse systems of the community impact the development of an individual. The approach involves the word "system" which refers to the relations of organisms within their setting. Moreover, from the sociological point of view, the system

*DOI: http://dx.doi.org/10.5772/intechopen.89516*

tobacco use, and excessive alcohol consumption [76].

**4. Strategies to prevent the growing burden of NCDs**

#### *The Global Burden and Perspectives on Non-Communicable Diseases (NCDs)… DOI: http://dx.doi.org/10.5772/intechopen.89516*

high-resourced countries, such as North America, Australia and Europe, have established standards and processes in their healthcare sector to obtain ongoing information on morbidity, mortality, NCDs risk factors, as well as determinants of their care services [73]. Middle-income countries, such as South Africa, and low-resourced countries, such as Ghana, Mozambique, Rwanda, Tanzania, and Zambia, conducted studies to investigate the capacity of their national health information systems, which resulted in them developing robust disease surveillance systems to understand the disease profiles of their population. The availability of health information in the healthcare system enabled these countries to exchange health-related data between healthcare providers, organisations, and health service consuming communities.

According to Diamantidis and Becker [74], the availability of NCDs-related public health data in the healthcare system enables timeous and appropriate healthcare decisions to be made, quick information retrieval, fast information sharing, improved data storage, improved information screening and reporting, all of which enhances the quality of healthcare. Furthermore, having NCDs mortality, morbidity, and risk factor data about a population can help policymakers and healthcare providers to establish relevant preventive strategies in their national healthcare system. In a healthcare system with accessible, accurate, reliable, timeous, and cleaned health information, it is possible to predict the future burden of NCDs in that country [4, 75]. Globally, various countries have established healthcare strategic plans in order to address the burden of NCDs by explicitly focusing on the four major lifestyle risk factors, these being an unhealthy diet, physical inactivity, tobacco use, and excessive alcohol consumption [76].

Low-resourced countries have made a concerted effort to improve the health status of its citizens, particularly regarding preventing and treating infectious communicable diseases, such as HIV/AIDS and tuberculosis [77]. However, little attention is devoted to preventing and treating NCDs in these countries, which resulted in an increased burden of such conditions on individuals, communities, and the healthcare system [4]. Despite the growing evidence of NCDs in this population, the operating healthcare system predominantly focuses on preventing and treating infectious communicable disease, with little evidence-based research that evaluates the availability of their morbidity, mortality, and associated risk factors data [78]. In low-resourced countries, the healthcare system must aim to establish the status of NCDs-related data, the presence of mechanisms to periodically evaluate NCDs data quality, reliability and timeliness, and the availability of standardised protocols for NCDs-related data collection.

Healthcare that has accurate data that serves as information for decision-making is imperative within the hastened speed of information-oriented universal environment. In the changing world, the desire of the community to obtain up-to-date health-related information has become crucial in both high-resourced and lowresourced countries. The accessibility of appropriate health-related information is associated with the availability of factual, accurate, timeous, and reliable data associated with NCDs [4].

#### **4. Strategies to prevent the growing burden of NCDs**

#### **4.1 The system approach**

The system approach (SA) was primarily established by Urie Bronfenbrenner in Russia as a human developmental approach in the 1970s. This approach explicates how diverse systems of the community impact the development of an individual. The approach involves the word "system" which refers to the relations of organisms within their setting. Moreover, from the sociological point of view, the system

*Public Health in Developing Countries - Challenges and Opportunities*

**3. The global status and availability of NCDs data**

and potential NCDs morbidity, mortality, and related risk factors [4].

intervention, treatment, and related NCDs risk factors [4].

Health information systems store information that is obtained from patient records, surveys, health plans, and other data sources. Most first world and

developing countries [4].

a community. It is evidenced that health information systems are an essential tool for collecting data about the health conditions and indicators of a country to help with decision-making. It is documented that reliable health data that is collected, analysed, and interpreted can assist policymakers, health organisations, the healthcare system, and healthcare providers in formulating appropriate disease preventive strategies. It has also been demonstrated that health data can be made available to the public through various health information channels, such as healthcare providers, counselling, teaching, and advice; mass media, such as radio television, internet, social media; and telecommunication, such as mobile short message service (SMS) [4, 70]. Despite the wide-ranging health benefits of health information, the attention given to addressing NCDs-related risk factors, morbidity, mortality, the health burden, and preventive mechanisms using the various sources of health information is inadequate in low-resourced countries. Similarly, the attention devoted to the accessibility of health information coverage is deficient in the healthcare system of

The incidence of non-communicable diseases (NCDs) is increasing and resulted in the death of 38 million people in 2012, of which 28 million occurred in low- and middle-income countries, causing an estimated US\$ 7 trillion economic loss [7, 9]. A significant number of NCDs, such as cardiovascular disease, diabetes, hypertension, and obesity, can be avoided by addressing the major behavioural and metabolic risk factors associated with such conditions. Their prevention and treatment require reliable, accurate, and timeous information on their symptoms and associated risk factors. The use of credible data has, therefore, become essential to identify current

The availability of NCDs data at local, regional, and national levels is helpful for decision-makers to prioritise the prevention of NCDs and strengthen distribution and budget allocation in the healthcare system. It is demonstrated that strengthening the health system is a possible way to resist the growing burden of NCDs and ensure enhanced health results. An effective health system is built on a well-functioning information system that collects accurate, reliable, timeous, and relevant health data for optimal healthcare delivery and decision-making. The lack of data in the healthcare system is a hindrance to planning, allocating resources, and implementing appropriate NCDs intervention strategies [4, 71]. The effective prevention of NCDs is based on having consistent morbidity, mortality, and related risk factors data to plan, design, and implement evidence-based decision-making and its preventive strategies at regional and national levels. NCDs surveillance data can be best collected by establishing and implementing data collection standardised protocols in the healthcare system. Such standardised protocols are data collection forms used to obtain morbidity, mortality, and risk factor-related data [4, 72]. A study by Melkamu and Grace [4] indicated that collecting NCDs data alone is not enough to ensure effective prevention and intervention; what is needed is a wellorganised healthcare system that periodically evaluates the data quality and is timeous and accurate on mortality, morbidity, and related NCDs risk factors to ensure effective decision-making. Whilst progress has been made to lead the development of national NCDs monitoring programmes, most low-resourced countries are still struggling to adequately establish robust information systems to help with their

**18**

describes the way humans and the public interact with their natural and artificial atmosphere [79]. The term "approach" incorporates the way people are in constant relation with each other and the setting in which they live [80]. However, these chains could either have an encouraging or discouraging effect on an individual. The system approach is applied in social work as a meta-paradigm which is regularly referred to as "a person in the neighbourhoods". This meta-paradigm explains the way a person and different multifaceted settings interact and impact each other [81, 82]. The primary emphasis of the SA is that people are part of and continuously interact with other organisms in the setting. The system approach has been applied in healthcare to establish intercessions targeted at shifting the intrapersonal, interpersonal, organisational, community, and health policies levels [82].

The system approach has four stages or levels of impact known as M4, namely a micro-system, meso-system, macro-system, and mega-system [83]. The microsystem is the stage where the individual belongs, and it includes the impact relating to the person, which can come from the individuals' family, peer groups, and the neighbourhood collectively stated as social agents. Social agents interrelate directly with an individual and affect a persons' health behaviour either positively or negatively. For example, using networked communication such as sneezes, it will be easier for individuals to inform their families and friends about risk factors associated with NCDs and possible prevention mechanisms through verbal expression. Sneezes are imperative in NCDs prevention, and healthcare leading organisations need to ascertain who they are and give them incentives and motivations to blowout the conversation of the mouse. The meso-system is the level where the social representatives will be operating, and it is interrelated to the micro-system where the family experiences are associated to the peers' experiences and the peers' experiences to the neighbourhood experiences—for example, by using schmoozed messages such as hive, a community who has a common culture, religion, custom, rules, beliefs, and traditions can increase the spread information related to NCDs and its associated risk factors, so that awareness can be easily created [83, 84]. The macro-system is the stage where organisations are involved and demonstrate an individual's activities within it. An organisation can affect an individual's life by encouragement or discouragement and vice-versa. For example, by using diversified mediums and amplifiers such as posters, images, slogans or phrases, school mini-media, television and radio broadcasts, short message services (SMS), webpages, and the internet as a means of transmitting information related to NCDs can increase the strength of information as it gets passed across a broad audience. The mega-system level illustrates the state that reflects the culture in which individuals live. Also, the mega-system level incorporates advancement, industrialisation, urbanisation, socio-economic status, poverty, religion, and ethnicity. For example, by applying velocity and smoothness through high government officials involvement, NCDs-related messages can swiftly and efficiently reach a higher number of the public who can be reminded to abstain from behavioural practices that lead to NCDs. Likewise, working with multi sectors such as governmental and non-governmental organisations, developmental partners, religious institutions, and urban planners to increase access and availability to parks, public open spaces, and recreational facilities can lead to effective transfer of information related to NCDs to a large number of the community and its prevention [82–84].

#### **4.2 The view of the systems approach**

The system approach, as illustrated in **Figure 5,** is constructed on a supposition that when an individual, community, healthcare organisations, and the

**21**

increases.

**Figure 5.**

*4.2.1 Mega level*

*Systems approach for NCDs prevention.*

tional level [1, 4].

*4.2.2 Macro level*

strategies [1, 4].

*The Global Burden and Perspectives on Non-Communicable Diseases (NCDs)…*

leading government authority are linked and operating together in a setting of a supportive system, the efficiency of preventing and controlling NCDs also

The mega-system level help to review and understand the existing NCDs prevention strategy, the practice of health information, the availability and status of data related to NCDs morbidity, mortality, and risk factors for decision-making at a national level. This level of the ecological system theory focuses on the status and availability of data related to NCDs at national level, so that plenty of information can be utilised in the healthcare system for effective decision-making for the prevention of NCDs. Availability of quality and timeous NCDs data and evaluating its status periodically help policymakers to redesign and strengthen the existing healthcare system to revert the growing burden of NCDs at national and interna-

The macro-level of the system approach explores and recognises strategies used by healthcare organisations such as health facilities, clinics, and hospital to prevent NCDs. The system approach at the macro level emphasises health professionals' perceptions of NCDs risk factors and how healthcare professionals use appropriate preventative strategies to prevent NCDs risk factors at the various healthcare organisations. Exploring the perceptions of healthcare professionals can help to understand the magnitude of the disease burden and help healthcare organisations to establish and implement local specific NCDs prevention

*DOI: http://dx.doi.org/10.5772/intechopen.89516*

*The Global Burden and Perspectives on Non-Communicable Diseases (NCDs)… DOI: http://dx.doi.org/10.5772/intechopen.89516*

#### **Figure 5.** *Systems approach for NCDs prevention.*

leading government authority are linked and operating together in a setting of a supportive system, the efficiency of preventing and controlling NCDs also increases.
