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Over the past decade, universal health coverage (UHC) has emerged as a major policy goal for many low- and middle-income country governments. Yet, despite the high burden of cardiovascular diseases (CVD), relatively little is known about how to address CVD through UHC. This review covers three major topics. First, we define UHC and provide some context for its importance, and then we illustrate its relevance to CVD prevention and treatment. Second, we discuss how countries might select high-priority CVD interventions for a UHC health benefits package drawing on economic evaluation methods. Third, we explore some implementation challenges and identify research gaps that, if addressed, could improve the inclusion of CVD into UHC.

Many low-income and middle-income countries (LMICs) are unlikely to achieve Sustainable Development Goal 3.4 to reduce premature deaths from non-communicable diseases (NCDs) by one-third by 2030. For some, the prospect is receding: between 2010 and 2020, the decline in premature deaths for the major NCDs slowed compared with the prior decade. Barriers to implementing effective strategies are well known, yet the value of tailored technical support to countries has been overlooked and downplayed. Tailored technical support is specialist guidance for country-specific application of technical tools, and capacity enhancement when needed, that enables an LMIC to advance its NCD priorities and plans. We present a model identifying pivotal junctures where tailored technical support can help surmount implementation obstacles. We draw on our experience preparing NCD investment cases with health ministries, development partners and technical agencies. National investment cases produce evidence based, locally tailored and costed packages of NCD interventions and policies appropriate to national needs and circumstances. They can include analysis of financing needs and point towards sustainable funding mechanisms. Enhancing the NCD-specific knowledge of government and Civil Society Organization leads can capitalise on existing expertise, aid integrative health system developments and unlock capabilities to use global tools and guidance. Investment cases form a platform to develop or review NCD plans and (re)prioritise action, then apply implementation science to trouble-shoot obstacles. Partnering national stakeholders with technical support in this process is critical to develop and implement effective NCD strategies.

Noncommunicable diseases such as cancer, diabetes, chronic lung diseases, and heart diseases are the leading cause of death and disability. In Kenya, the growing prevalence of these diseases is a major public health concern and a hindrance to long-term economic growth. This is because these conditions reduce human capital and divert societal resources. The high cost of managing the growing caseload of noncommunicable diseases (NCDs) also afflicts Kenyan families, businesses, and the government, and increasingly leads to impoverishment. Developing an appropriate policy response to the threat of NCDs requires a clear understanding of the economic impacts as well as the benefits of potential interventions, both from a health and an economic perspective. Such information allows policy makers to evaluate the trade-offs between different investment decisions, with the goal of ensuring that any interventions maximize the rewards to individuals and to society at large. Combating Noncommunicable Diseases in Kenya is one of a few published studies on the economic burden of NCDs in Kenya. It focuses on a limited set of conditions, aligned with the burden of NCDs in Kenya, and demonstrates both the long-term costs of these diseases and the strong health and economic benefits of scaling up interventions. It contributes to a growing body of analysis on NCDs in Kenya—and in Africa—and provides muchneeded evidence to facilitate advocacy and foster dialogue to confront this serious challenge.

peer-reviewed ; Even in our modern and high-tech manufacturing industry, it is often difficult to automate industrial processes which necessities the involvement of human workers. Subsequently, workers are exposed to factors that increase their risk of injury, particular experiencing Musculoskeletal Disorders (MSDs). In addition to contributing to workplace absenteeism and disability rates, injured workers have a negative impact on job productivity and quality.While earlier research and development of exoskeletons is targeted at military and rehabilitation, there is a shifting of interest to target industrial settings. Targeting industrial environments, the Robo-Mate consortium aims to develop a lightweight, flexible, easy-to-wear, easy-to-maneuver, and intelligent exoskeleton that augments the user's personal capabilities while accommodating their physical limitations. The safety of industrial worker exoskeletons is an emerging topic in legislation and standardization. Guidance from standards is only partially possible since no standard exists for industrial exoskeleton technology. This presents a challenging task since an exoskeleton combines technological characteristics of robots (collaborative), machines and appliances, and is used in proximity to and has close contact with the human body. The innovative character of the Robo-Mate technology requires a multidisciplinary approach to the identification of risk and usability while addressing both product safety and workplace safety. This requires a novel safety management approach that governs the life cycle of this new kind of product. This paper will discuss the risk management approach the Robo-Mate project developed and the resulting leading scenarios.

About the Series From its inception, the Disease Control Priorities series has focused attention on delivering efficacious health interventions that can result in dramatic reductions in mortality and disability at relatively modest cost. The approach has been multidisciplinary, and the recommendations have been evidence-based, scalable, and adaptable in multiple settings. Better and more equitable health care is the shared responsibility of governments and international agencies, public and private sectors, and societies and individuals, and all of these partners have been involved in the development of the series. Disease Control Priorities, third edition (DCP3) builds upon the foundation and analyses of the first and second editions of Disease Control Priorities (DCP1 and DCP2) to further inform program design and resource allocation at global and country levels by providing an up-to-date comprehensive review of the effectiveness of priority health interventions. In addition, DCP3 presents systematic and comparable economic evaluations of selected interventions, packages, delivery platforms, and policies based on newly developed economic methods. DCP3 presents its findings in nine individual volumes addressed to specific audiences. The volumes are structured around packages of conceptually related interventions, including those for maternal and child health, cardiovascular disease, infectious disease, and surgery. The volumes of DCP3 will constitute an essential resource for countries as they consider how best to improve health care, as well as for the global health policy community, technical specialists, and students.

Cover -- Half Title -- Title -- Copyright -- Contents -- Foreword -- Introduction -- Preface -- Abbreviations -- PART 1 OBJECTIVES AND CONCLUSION OF DISEASE CONTROL PRIORITIES, THIRD EDITION -- 1. Universal Health Coverage and Intersectoral Action for Health -- 2. Intersectoral Policy Priorities for Health -- 3. Universal Health Coverage and Essential Packages of Care -- PART 2 PROBLEMS AND PROGRESS -- 4. Global and Regional Causes of Death: Patterns and Trends, 2000-15 -- 5. Annual Rates of Decline in Child, Maternal, Tuberculosis, and Noncommunicable Disease Mortality across 109 Low- and Middle-Income Countries from 1990 to 2015 -- 6. Economic Burden of Chronic Ill Health and Injuries for Households in Low- and Middle-Income Countries -- PART 3 ECONOMIC EVALUATION RESULTS FROM DISEASE CONTROL PRIORITIES, THIRD EDITION -- 7. Cost-Effectiveness Analysis in Disease Control Priorities, Third Edition -- 8. Health Policy Analysis: Applications of Extended Cost-Effectiveness Analysis Methodology in Disease Control Priorities, Third Edition -- 9. Benefit-Cost Analysis in Disease Control Priorities, Third Edition -- PART 4 HEALTH SYSTEM TOPICS FROM DISEASE CONTROL PRIORITIES, THIRD EDITION -- 10. Quality of Care -- 11. High-Quality Diagnosis: An Essential Pathology Package -- 12. Palliative Care and Pain Control -- 13. Strengthening Health Systems to Provide Emergency Care -- 14. Community Platforms for Public Health Interventions -- 15. Rehabilitation: Essential along the Continuum of Care -- PART 5 INTERSECTORAL AND INTERNATIONAL TOPICS -- 16. Development Assistance for Health -- 17. Pandemics: Risks, Impacts, and Mitigation -- 18. The Loss from Pandemic Influenza Risk -- 19. Fiscal Instruments for Health in India -- DCP3 Series Acknowledgments -- Volume Editors -- Contributors -- Advisory Committee to the Editors -- Reviewers.

Governments can use fiscal policies or regulation to influence the prices of products with potential health impacts, aiming to change their consumption. In particular, policies aimed at raising prices, such as taxation, have caused concerns because they may impose an unfair financial burden on low-income households. We estimated patterns of expenditure on potentially unhealthy products by socioeconomic status, based on household expenditure surveys, with a primary focus on low- and middle-income countries, and we found that price policies affect the consumption and expenditure of a larger number of high-income than low-income households, and any resulting price increases are financed disproportionately by high-income households. As a share of all household consumption, however, price increases are often a larger burden for low-income households, depending on how much consumption is changed, most consistently in the case of tobacco. Larger health benefits will likely accrue to individual low-income consumers, due to their stronger response to price changes, but depending on initial consumption and associated health risks. In the case of taxing unhealthy products, a potentially larger financial burden on low-income households can be mitigated by a pro-poor use of the tax revenues generated.

BACKGROUND: In China, there are more than 300 million male smokers. Tobacco taxation reduces smoking-related premature deaths and increases government revenues, but has been criticised for disproportionately affecting poorer people. We assess the distributional consequences (across different wealth quintiles) of a specific excise tax on cigarettes in China in terms of both financial and health outcomes. METHODS: We use extended cost-effectiveness analysis methods to estimate, across income quintiles, the health benefits (years of life gained), the additional tax revenues raised, the net financial consequences for households, and the financial risk protection provided to households, that would be caused by a 50% increase in tobacco price through excise tax fully passed onto tobacco consumers. For our modelling analysis, we used plausible values for key parameters, including an average price elasticity of demand for tobacco of -0·38, which is assumed to vary from -0·64 in the poorest quintile to -0·12 in the richest, and we considered only the male population, which constitutes the overwhelming majority of smokers in China. FINDINGS: Our modelling analysis showed that a 50% increase in tobacco price through excise tax would lead to 231 million years of life gained (95% uncertainty range 194-268 million) over 50 years (a third of which would be gained in the lowest income quintile), a gain of US$703 billion ($616-781 billion) of additional tax revenues from the excise tax (14% of which would come from the lowest income quintile, compared with 24% from the highest income quintile). The excise tax would increase overall household expenditures on tobacco by $376 billion ($232-505 billion), but decrease these expenditures by $21 billion (-$83 to $5 billion) in the lowest income quintile, and would reduce expenditures on tobacco-related disease by $24·0 billion ($17·3-26·3 billion, 28% of which would benefit the lowest income quintile). Finally, it would provide financial risk protection worth $1·8 billion ($1·2-2·3 ...