Epilepsy and WHO | 17 Oct 20081 |

WHO's six-point agendaWHO's six-point agenda

The overarching health needs1. Promoting development

2. Fostering health security

The strategic ways to meet the health needs3. Strengthening health systems

4. Harnessing research, information and evidence

How WHO can deliver5. Enhancing partnerships

6. Improving performance

Epilepsy and WHO | 17 Oct 20082 |

Measuring performanceMeasuring performance

Impact on:

Health of the people of Africa

Health of women

Mental health Global Action Programme :

Scaling up care for mental, neurological and substance use disorders

Epilepsy and WHO | 17 Oct 20084 |

StrategiesStrategies

Identify priority conditions

Develop the intervention package

Identify countries for intensified support

Scale up services

Build partnerships

Epilepsy and WHO | 17 Oct 20085 |

Priority conditionsPriority conditions

Criteria

High burden (mortality, morbidity, disability)

Large economic cost

Effective intervention available

Affecting vulnerable populations

Epilepsy and WHO | 17 Oct 20086 |

Priority conditions in the area of mental, neurological and substance use disordersPriority conditions in the area of mental,

neurological and substance use disorders Depression

Schizophrenia

Suicide prevention

Epilepsy

Dementia

Disorders due to use of alcohol

Disorders due to illicit drug use

Child mental disorders

Epilepsy and WHO | 17 Oct 20087 |

Intervention packageIntervention package

Scope– conditions of public health priority

– Individual or population based interventions to be identified on the basis of multiple criteria

– Feasibility of delivery through existing health systems

Target audience– Nonspecialists health care providers

– Planning purposes at district level

Epilepsy and WHO | 17 Oct 20088 |

Intervention packageIntervention package

Criteria for identification of interventions– Efficacy

– Cost-effectiveness

– Equity

– Ethical issues such as protection of human rights

– Feasibility and acceptability

Packaging– Many interventions can be delivered by the same person at the same

time

– More cost-effective in terms of training, implementation and supervision

Intervention packageConditionEvidence-based

interventionsExamples of interventions that can be included

EpilepsyTreatment with antiepileptic medicines

First line antiepileptic medicines

Trained primary health professionals

Referral and supervisory support

DementiaInterventions directed towards caregivers

Basic education about dementia

Specific training on managing problem behaviours

Trained primary health professionals

Child mental disorders

Prevention of developmental disorders

Pharmacological and psychosocial interventions

Measures within health sector e.g. provision of skilled care at birth

Public health oriented multisectoral measures e.g. food fortification with folic acid and iodine

Epilepsy and WHO | 17 Oct 200810 |

Scaling upScaling up

"Deliberate effort to increase the impact of health service innovations successfully tested in pilot or experimental projects so as to benefit more people and to foster policy and programme development on a lasting basis"

Innovation: set of interventions, new or perceived as new

Successfully tested: interventions backed by locally generated evidence of programmatic effectiveness and feasibility

Deliberate effort: guided process

Policy and programme development on a lasting basis: Capacity building and sustainability

Epilepsy and WHO | 17 Oct 200811 |

Cost of scaling up epilepsy careCost of scaling up epilepsy care

A study estimated the avertable burden of epilepsy and the population-level costs of treatment with first-line AEDs in developing countries

Extension of coverage of treatment to 50% would avert 13-40% of burden

The annual cost per person would be 0.20-1.33 International Dollars

At a coverage rate of 80%,the treatment would avert 21-62% of the burden

The cost to secure one extra healthy year of life is less than average income per person

Establish a plan for monitoring and evaluation

Assess needsand resources

Develop the intervention package

Facilitate policydevelopment

Deliver the interventionpackage

Strengthen human resources

Mobilize financial resources

Enhancepolitical commitment

Scaling up strategy

Epilepsy and WHO | 17 Oct 200813 |

Partnerships for actionPartnerships for action

WHO in partnership with:

Development agencies e.g. WB

Research Councils and Institutes

International health agencies e.g. UNICEF

Donor agencies and foundations

Health communities in the countries

Nongovernmental organizations

Service users and caregivers

Epilepsy and WHO | 17 Oct 200814 |

GCAE: a successful partnershipGCAE: a successful partnership

135 IBE/ILAE organisations in 103 different countries actively engaged Global Campaign related activities, covering 86% of the world population

Two thirds of Campaign activities reported by the organisations to be either very successful or moderately successful in a recent survey

Ninety percent of those surveyed said they would continue to be active in the Global Campaign in the future

Epilepsy and WHO | 17 Oct 200815 |

GLOBAL CAMPAIGN AGAINST EPILEPSYDeterminants of success

Partnerships - involvement at every stage and level of:

– ILAE, IBE, WHO– Relevant experts: epilepsy, public health– ILAE/IBE Regional Commissions and national chapters– Regional and Country Offices– Governments

Ownership by all parties: political, patient, professional

Epilepsy and WHO | 17 Oct 200816 |

GCAE: Future DirectionsGCAE: Future Directions

Focus on:– Low and middle income countries

– Africa

– Further development of demonstration projects

– Scaling up care

– The place of GCAE in the context of WHO global and regional strategies

Epilepsy and WHO | 17 Oct 200817 |

SEIN InternationaalSEIN Internationaal