Countries around the world are beginning to address the challenges of asthma management using a variety of approaches, strategies and structures. In the following pages, countries share experiences of pilots and programmes, challenges and improvements in quality of life for patients and inefficiency for health services.
Benin: Revolving fund provides sustainable supply of asthma medicines
Asthma comes under Benin’s National Programme Against Non-Communicable Diseases, but currently there are no national guidelines on asthma management. Instead, Benin’s National Tuberculosis Programme (NTP) has been working on how to provide asthma care. The NTP adapted The Union’s asthma guide and has piloted it in two phases so far: the first was the Comprehensive Approach to Lung Health project in 2008, financed by the World Bank, with technical support from The Union. The second project is still underway and is also supported by The Union, with medicines supplied through the Asthma Drug Facility (ADF).
-Profile by Martin Gninafon, Leon Tawo
Chile: Chile’s de-medicalised programme for ACRD at the primary care level: Impact on asthma control
The mortality rate for chronic respiratory diseases in Chile was 21/100,000 inhabitants in 2008 with a DALY of 567 attributed to the same cause. Therefore, a programme using Primary Health Care Centers (PHCCs) for the outpatient management of Adult Chronic Respiratory Disease (ACRD) was launched in 2001.
ACRD patients have access, free of charge, to spirometry and treatment.
-Profile by Ricardo Sepúlveda
El Salvador: Improving asthma management at the primary health care level
In 2005, the El Salvador Ministry of Health’s National Tuberculosis and Lung Disease Programme adopted the PAL strategy (Practical Approach to Lung Health), as part of its efforts to improve health care for patients with respiratory diseases, including asthma. Since then, the programme has improved the care of the asthma patients at health care facilities throughout the country.
Between 2005, when PAL was started, and 2010, the number of patients being referred from primary level to secondary or tertiary level facilities has dropped by 60%.
-Profile by Francisco Castillo, Julio Garay
Finland: Finnish asthma and allergy programmes: community problems need community actions
In Finland, a comprehensive and nationwide Asthma Programme was undertaken from 1994 to 2004 to improve asthma care and prevent the predicted increase in costs. The main goal was to lessen the burden of asthma on individuals and society.
In Finland, mortality, number of hospital days and disability due to asthma fell 70–90% during the period from 1994 to 2010
-Profile by Tari Haahtela, Anne Pietinalho
Sudan: Asthma management in Sudan
In Sudan, a study of asthma management conducted in 2003 found that 95% of the participating patients paid full cost for their asthma medicines; less than 2% of them received regular treatment from a single facility, and there was no overall asthma management plan. In a country where the daily wage of the lowest paid unskilled government worker is US$ 2.20 per day, the cost of one day of hospitalisation for asthma was $79.60 and patients were responsible or medicines and other costs on top of that.
By 2008, in the Asthma Project pilot sites, the number of emergency room visits for participating patients had been reduced by 97%.
-Profile by Mai El-Tigany, Asma El Sony