Intended for healthcare professionals

Analysis Solutions for Prevention and Control of Non-communicable Diseases

National action plans to tackle NCDs: role of stakeholder network analysis

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1871 (Published 20 May 2019) Cite this as: BMJ 2019;365:l1871
  1. Ruth F Hunter, researcher1 ,
  2. Kremlin Wickramasinghe, technical officer2 ,
  3. Toker Ergüder, national professional officer3 ,
  4. Abdulkadir Bolat, researcher4,
  5. Hakan Oğuz Arı, researcher5 ,
  6. Hasan Hüseyin Yıldırım, researcher5 ,
  7. Pavel Ursu, WHO representative3 ,
  8. Gareth Robinson, researcher6 ,
  9. Joao Breda, head2 ,
  10. Bente Mikkelsen, director7 ,
  11. Paul Connolly, professor6 ,
  12. Mike Clarke, professor1 8,
  13. Frank Kee, professor1
  1. 1Centre for Public Health/UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, UK
  2. 2WHO European Office for Prevention and Control of Non-communicable Diseases, WHO Regional Office for Europe, Moscow, Russia
  3. 3WHO Country Office, Ankara, Turkey
  4. 4Health Sciences University, İstanbul, Turkey
  5. 5Turkish Institute for Health Policies, Health Institutes of Turkey, Ankara, Turkey
  6. 6Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
  7. 7Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Regional Office for Europe, Moscow, Russia
  8. 8Evidence Aid, Oxford, UK
  1. Correspondence to: R Hunter ruth.hunter{at}qub.ac.uk

Network science approaches can enhance global and national coordinated efforts to prevent and manage non-communicable diseases, say Ruth Hunter and colleagues

Recent figures highlight the rising global burden of non-communicable diseases (NCDs),1 and tackling this problem requires global coordinated action. Behavioural risk factors for NCDs at both individual and population level are increasingly recognised to be influenced by multiple factors interacting across multiple sectors.234 No single organisation or sector can therefore solve the problem alone.5 It requires multipronged action across various sectors. The myriad political, economic, environmental, interpersonal, and individual factors are inter-related through a complex and often non-linear feedback process and interactions that give rise to an adaptable system that can be modelled.

Importance of multisectoral collaboration

The global action plan for reducing NCDs published by the World Health Organization outlines “best buys” for tackling key risk factors such as tobacco use, physical inactivity, the harmful use of alcohol, and unhealthy diets. The plan provides policy makers with a menu of policy options to reduce NCDs5 and recommends multisectoral action engaging all of government as well as academia, non-governmental organisations, philanthropies, and the private sector. Stakeholders encompass different levels of governance, including national, subnational, and municipal councils. Thus, the engagement of the whole of government and whole of society is necessary to support countries to reduce NCDs.

Action on NCDs needs to come not only from the health sector but also organisations and agencies that operate outside the traditional sphere of health, such as non-profits, schools, businesses, and other governmental agencies, including transport, planning, and education. Therefore, building national action plans requires the development and implementation of cross-sectoral and multistakeholder networks that can provide a synergistic, concerted, and coherent approach to prevention of these diseases and their risk factors.

A major challenge is how these diverse organisations, …

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