Objectives

  • Context

Evidence is accumulating that North African countries are experiencing a fast advancing epidemiological transition. During the last twenty years, infant and child mortality and malnutrition rates have reduced, and life expectancy considerably improved.

Although infectious diseases are still a preoccupation, obesity is increasing and chronic non-communicable diseases (NCDs) related to food and lifestyle changes are rapidly taking precedence along with aging, urbanisation, and economic growth.

This transition has clear economic implications for the health sector, due to the ever rising cost of treatments. These are expected to increase as tobacco smoking and obesity are also appearing in very young people. There is an urgent need to assess the burden of the epidemiological transition and its determinants, poorly documented until now.

The Maghrebian health system is still structured to respond to communicable, maternal and perinatal diseases and the population is not yet involved in promotion of its own health through behavioural change. The health sector needs support to be able to address the newly emerging diseases, supported by integrated strategies aimed at behavioural and societal change.

 

  • General objectives of the research

     - To strengthen the capacity of the health sector to manage the epidemiological transition using a comprehensive and integrated multisectoral strategy;

     - To raise awareness for prevention of NCDs of all other sectors concerned by changes in lifestyles, including food consumption and physical activity patterns.

Two complementary studies are planned in Algeria and Tunisia, on the basis of a ‘risk management’ concept taking into account both epidemiologic evidence and the perceptions of different actors:

     - Assessment of the epidemiological transition, its determinants and impact;

     - Analysis of changes in lifestyle, health problems, attitudes and practices of various actors (population groups, health professionals, and decision-makers) in relation to the transition.

Important underlying questions are : - What cost could be saved by improved management and prevention of the transition-related NCDs ? - What could be the cost-effectiveness of various interventions ? - How much of the knowledge and experience accumulated so far in industrialised countries is applicable to North African countries ? - What could be the specific determinants of potential behaviour changes ?

  • Specific scientific and technical objectives

Objectives

Tools for measurement

    1.To assess the burden of NCDs and its costs for the patients and the health care system

- database on mortality, morbidity and disability

- report on awareness, treatment and control of the main NCDs

- cost analysis report

    2.  To characterise region-specific determinants (food consumption, economic, socio-cultural and environmental risk factors) for NCDs

- reports of baseline studies

- data-consolidated conceptual model

    3. To identify attitudes and practices of populations groups, health professionals and decision-makers towards the transition phenomenon, and their potential capacity and willingness to change lifestyles or policies

- structured database of qualitative data

- reports of studies

    4. To elaborate new intervention strategies jointly with policy-makers through a comprehensive and integrated multidisciplinary approach

- workshop proceedings

- national strategy policy paper (prevention and treatment of NCDs)