Introducing the Policy Options Framework

Introducing the Policy Options Framework

While the health sector bears most of the burden in the prevention and treatment of NCDs, many of the interventions to control NCDs lie outside the health sector. This book introduces a policy options framework that applies to any country.

It provides policy makers with a framework to make broader systemic decisions that aim at balancing interventions and providing the optimal strategic mix of population-based interventions in the community, and of individual-based interventions within the clinical setting. For purposes of exposition, these two broad intervention modes are given below. Population-based interventions reduce the risk factors for NCDs and avoid or delay onset of disease and

are delivered in community and/or population-based settings outside the clinical care system.

A relatively small number of behavior risk factors, tobacco use, poor diet, physical inactivity (the latter two leading to obesity) are risk factors common to the major chronic NCDs—CVD, diabetes, cancer, and chronic respiratory disease. The dual goals of population-based interventions are first to avoid development of risk factors and second, when present, to reduce or eliminate them.

Examples of this mode are tobacco tax policies and community-level behavior change for health lifestyles (diet, exercise, and helmet and seat belt use to prevent injury).

Individual-based interventions include preventive and treatment services delivered to individuals within the clinical care system.

Treatment services include screening to detect undiagnosed cases, clinical management, and addressing complications among persons with disease. Preventive clinical services can and should be delivered by the health care system and include (but are not limited to) clinic-based health workers delivering individual education and counseling to reduce risk factors and to prevent disease onset.