Why A Life-course Approach?
As more focus is placed on mental health issues, I was not surprised to see more research focus on the mental health impact on NCDs. The World Health Organization’s (WHO) mental health action plan for 2013-20 highlighted this link (Stein Dan et al, 2019). Multiple studies’ results showed the significance of the link between NCDs including diabetes and cardiovascular disease, and mental health (Batelaan et al, 2016; Juma et al, 2018; Vancampfort et al, 2016). Many of the mental health issues that adults experience may be a result of negative experiences that they have gone through at the early stages of their lives. Moreover, NCDs may also develop gradually over time and may not be diagnosed at an early stage if there are not frequent medical check-ups or if individuals are not aware of the signs and symptoms of such health issues. Therefore, the incorporation of a life-course approach within NCDs prevention policies and interventions will have a positive impact on the control of these diseases.
A life-course approach has been recommended in the WHO’s global action plan as one of the essential components to combat NCDs ( Mikkelsen et al, 2019 and WHO, 2019). Such an approach is comprehensive and focuses on all age groups to ensure that prevention and control of NCDs start at the earliest possible stage of life ( Mikkelsen et al, 2019 and WHO, 2019). This approach will provide a healthy start from birth and throughout individuals’ lives. It is pertinent to study all factors that may contribute in the development of NCDs in the different stages of life, from gestation to adulthood. Factors such as biological or social determinants of health should be considered. The proper understanding of such factors will help in the planning and implementation of appropriate interventions. For example, maternal factors such as improper diet may lead to the development of certain diseases that may impact the health of the newborn (Baird, et al, 2017). Therefore, by taking a life-course approach, proper interventions that focus on proper diet and fetal development should be put in place (Baird, et al, 2017). Such interventions require a muli-sectoral approach and collaboration from all the diiferent organzations including the primary health care units in African countries.
Pertinent work has been done in the European Region of WHO, in which a life-course approach has been added to Health 2020 and as part of the prevention and control framework of NCDs (Mikkelsen et al, 2019). Similar work has been planned for through the National Strategic Action Plan in Ethiopia (Ministry of Health Ethiopia, 2014). This kind of approach considers different morbidities instead of focusing on a single disease (Mikkelsen et al, 2019). In addition, it encompasses the changes that happens in the individual’s life and at the same time considers the social determinants of health (Mikkelsen et al, 2019). For a life course approach to be integrated into the current protocols, a system thinking approach is required to involve an array of sectors and organizations (Mikkelsen et al, 2019). A life-course approach will be supported by the current efforts to develop new policies to control and prevent NCDs in Africa.
About the author
Olla Wasfi is a part-time student completing her Master of Health Evaluation at the University of Waterloo. She worked in the fields of infection control and microbiology in a number of countries. Olla currently works in the field of infection control, and is highly interested to learn more about the prevention and control of non-communicable diseases (NCDs). The main goal of her practicum at Engage Africa Foundation is to collaborate with other team members to develop a Directory of the available Health Promotion tools targeting NCDs in selected countries in Africa.
Baird, J., Jacob, C., Barker, M., Fall, C. H., Hanson, M., Harvey, N. C., … Cooper, C. (2017). Developmental Origins of Health and Disease: A Lifecourse Approach to the Prevention of Non-Communicable Diseases. Healthcare (Basel, Switzerland), 5(1), 14. doi:10.3390/healthcare5010014
Batelaan, N. M., Seldenrijk, A., Bot, M., Anton J. L. M. Van Balkom, & Penninx, B. W. (2016). Anxiety and new onset of cardiovascular disease: Critical review and meta-analysis. British Journal of Psychiatry, 208(3), 223-231. doi:10.1192/bjp.bp.114.156554
Cohen, E., B., Edmondson, Donald, Kronish, & M., I. (2015, April 24). State of the Art Review: Depression, Stress, Anxiety, and Cardiovascular Disease. Retrieved May 20, 2019, from https://academic.oup.com/ajh/article/28/11/1295/2743312
Juma, P. A., & Wisdom, J. (2018). Introduction: Non-communicable disease prevention policies in six African countries. BMC Public Health, 18(S1). doi:10.1186/s12889-018-5824-8
Mikkelsen, B., Williams, J., Rakovac, I., Wickramasinghe, K., Hennis, A., Shin, H., . . . Breda, J. (2019). Life course approach to prevention and control of non-communicable diseases. Bmj, L257. doi:10.1136/bmj.l257
Ministry of Health-Federal Democratic Republic of Ethipia (2014). National Strategic Action Plan for prevention and control of non-communicable diseases in Ethipia. retrieved from https://www.iccp-portal.org/system/files/plans/ETH_B3_National%20Strategic%20Action%20Plan%20%28NSAP%29%20for%20Prevention%20and%20Control%20of%20Non-Communicable%20Diseases%20-%20Final.pdf
Stein, D. J., Benjet, C., Gureje, O., Lund, C., Scott, K. M., Poznyak, V., & Ommeren, M. V. (2019). Integrating mental health with other non-communicable diseases. Bmj, L295. doi:10.1136/bmj.l295
Vancampfort, D., Correll, C. U., Galling, B., Probst, M., Hert, M. D., Ward, P. B., . . . Stubbs, B. (2016). Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: A systematic review and large scale meta-analysis. World Psychiatry, 15(2), 166-174. doi:10.1002/wps.20309
WHO (2019). Division of noncommunicable diseases and health through the life-course. Retrieved from https://www.who.int/westernpacific/about/how-we-work/ncd-health-through-life-course