Challenges and opportunities for integrating programs for the prevention and treatment of non-communicable diseases with maternal and child health care

DOI

https://dx.doi.org/10.18565/aig.2024.269

Yarotskaya E.L., Ionov O.V., Sharafutdinova D.R., Khamatkhanova E.M., Axelrod S.V.
1) Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia; 3) World Health Organisation

The article presents a review of literature sources on maternal and child health care related to the prevention and treatment of non-communicable diseases (NCDs) with a particular focus on the countries of the WHO European Region: Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan and Uzbekistan. A range of publications presented in electronic medical databases, including Cochrane Library, Google Scholar, PubMed, PsycINFO, Scopus, Web of Science, CyberLeninka, eLibrary.ru, and regional databases were considered. The period covered was 2000 to 2024.
The state of integration of NCD care systems with maternal and child health care was analyzed. The analysis demonstrated that the relationship between NCDs and pregnancy, obstetric and perinatal outcomes requires a strategic approach to optimize the integration of the two systems, focusing on reducing maternal and child morbidity and mortality.
Conclusion: The interactions and opportunities for integrating programs dealing with NCDs and maternal and child health are diverse. They include screening of at-risk pregnant women, early detection of NCDs, optimizing the management of existing NCDs and addressing risk factors for future development of NCDs in both the woman and the child. It is recommended that large, country-wide studies are conducted to identify the most significant gaps, as well as to assess the contribution of barriers to integration that are known to exist from the experience of other countries.

Authors’ contributions: All authors made equivalent contributions to the preparation of the article for publication.
Yarotskaya E.L. – analysis of literature data, final editing; Ionov O.V. – search for literature data, writing an article; Sharafutdinova D.R. – search for sources, writing an article; Khamatkhanova E.M. – literature analysis, writing an article; Axelrod S.V. – review concept.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was carried out without sponsorship.
For citation: Yarotskaya E.L., Ionov O.V., Sharafutdinova D.R., Khamatkhanova E.M., Axelrod S.V.
Challenges and opportunities for integrating programs for the prevention and treatment
of non-communicable diseases with maternal and child health care.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (3): 160-167 (in Russian)
https://dx.doi.org/10.18565/aig.2024.269

non-communicable diseases

perinatal outcomes

complicated pregnancy

obstetric outcomes

Full text (in Russian)

WHO. The Global Health Observatory. Explore a world of health data. Indicators. Available at: https://www.who.int/data/gho/data/indicators
NCD Countdown 2030 collaborators. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet. 2018; 392(10152): 1072-88. https://dx.doi.org/10.1016/S0140-6736(18)31992-5.
Institute for Health Metrics and Evaluation. Global Burden of Disease Study 2019 (GBD 2019) Results. Available at: https://vizhub.healthdata.org/gbd-results/
Akselrod S., Banerjee A., Collins T.E., Acharya S., Artykova N., Askew I. et al. Integrating maternal, newborn, child health and non-communicable disease care in the sustainable development goal era. Front. Public Health. 2023; 11: 1183712. https://dx.doi.org/10.3389/fpubh.2023.1183712.
Министерство здравоохранения Российской Федерации. Российская Федерация вошла в десятку лидеров в борьбе с неинфекционными заболеваниями. Доступно по: https://minzdrav.gov.ru/news/2015/09/28/2551-rossiyskaya-federatsiya-voshla-v-desyatku-liderov-v-borbe-s-neinfektsionnymi-zabolevaniyami [Ministry of Health of the Russian Federation. The Russian Federation entered TOP10 in the fight against non-communicable diseases. Available at: https://minzdrav.gov.ru/news/2015/09/28/2551-rossiyskaya-federatsiya-voshla-v-desyatku-liderov-v-borbe-s-neinfektsionnymi-zabolevaniyami (in Russian)].
Martinez R., Lloyd-Sherlock P., Soliz P., Ebrahim S., Vega E., Ordunez P. et al. Trends in premature avertable mortality from non-communicable diseases for 195 countries and territories, 1990-2017: a population-based study. Lancet Glob. Health. 2020; 8(4): e511-e523. https://dx.doi.org/10.1016/S2214-109X(20)30035-8.
Исакова П.В. Анализ распространенности, структуры и факторов риска младенческой смертности в Российской Федерации. Проблемы стандартизации в здравоохранении. 2017; 5-6: 43-54. [Isakova P.V. Analysis of prevalence, structure and risk factors of infant mortality in the Russian Federation. Health Care Standartization Problems. 2017; (5-6): 43-54. (in Russian)].
Федеральная служба государственной статистики (Росстат). Российский статистический ежегодник 2023. М.; 2023. Доступно по: https://rosstat.gov.ru/storage/mediabank/Ejegodnik_2023.pdf [Federal State Statistics Servic (Rosstat). Russian Statistical Yearbook 2023. Moscow; 2023. Available at: https://rosstat.gov.ru/storage/mediabank/Ejegodnik_2023.pdf (in Russian)].
ВОЗ. Оценка материнской смертности на 100 000 живорожденных (оценка ВОЗ/ЮНИСЕФ/ЮНФПА). [WHO. Estimated maternal mortality per 100 000 live births (WHO/UNICEFF/UNFPA estimates). Available at: https://gateway.euro.who.int/ru/indicators/hfa_97-1220-estimated-maternal-mortality-per-100-000-live-births-whounicefunfpa-estimates/#id=19020&fullGraph=true (in Russian)].
The European Observatory on Health Systems and Policy, Health Systems in action: Kyrgyzstan. Report. 23 November 2021. Available at: https://eurohealthobservatory.who.int/publications/i/health-systems-in-action-kyrgyzstan (accessed 13 September 2023).
Rechel B., Ahmedov M., Akkazieva B., Katsaga A., Khodjamurodov G., McKee M. Lessons from two decades of health reform in Central Asia. Health Policy Plan. 2012; 27(4): 281-7. https://dx.doi.org/10.1093/heapol/czr040.
The European Observatory on Health Systems and Policy, Health Systems in action: Tajikistan. Report. 12 September 2022. Available at: https://eurohealthobservatory.who.int/publications/i/health-systems-in-action-tajikistan-2022. (accessed 21 October 2023).
Habibov N., Fan L. The effect of maternal healthcare on the probability of child survival in Azerbaijan. Biomed. Res. Int. 2014; 2014: 317052. https://dx.doi.org/10.1155/2014/317052.
Агентство Организации Объединенных Наций по оценке детской смертности. Индекс младенческой смертности в странах мира. Доступно по: https://gtmarket.ru/ratings/child-mortality-ranking [United Nations Inter-Agency Group for Child Mortality Estimation. Child mortality index. Available at: https://gtmarket.ru/ratings/child-mortality-ranking].
Федеральная служба государственной статистики (Росстат). Российский статистический ежегодник 2022. М.; 2022. Доступно по: https://rosstat.gov.ru/storage/mediabank/Ejegodnik_2022.pdf [Federal State Statistics Servic (Rosstat). Russian Statistical Yearbook 2022. Moscow; 2022. Available at: https://rosstat.gov.ru/storage/mediabank/Ejegodnik_2022.pdf (in Russian)].
Collins T.E., Akselrod S., Banerjee A., Altymysheva A., Shoismatuloeva M., Nga P.T. et al. Health system readiness to deliver integrated noncommunicable disease and antenatal care in Kyrgyzstan, Tajikistan, and Vietnam. International Journal of Noncommunicable Diseases. 2024; 9(4): 150-9. https://dx.doi.org/10.4103/jncd.jncd_74_24.
Shuvalova M.P., Yarotskaya E.L., Pismenskaya T.V., Dolgushina N.V., Baibarina E.N., Sukhikh G.T. Maternity care in Russia: issues, achievements, and potential. J. Obstet. Gynaecol. Can. 2015; 37(10): 865-71. https://dx.doi.org/10.1016/s1701-2163(16)30019-6.
Firoz T., Pineles B., Navrange N., Grimshaw A., Oladapo O., Chou D. Non-communicable diseases and maternal health: a scoping review. BMC Pregnancy Childbirth. 2022; 22(1): 787. https://dx.doi.org/10.1186/s12884-022-05047-6.
Say L., Chou D., Gemmill A., Tunçalp Ö., Moller A.B., Daniels J. et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob. Health. 2014; 2(6): e323-33. https://dx.doi.org/10.1016/S2214-109X(14)70227-X.
Institute for Health Metrics and Evaluation. Global Health Data Exchange. GBD Results Tool. Available at: http://ghdx.healthdata.org/gbd-results-tool
WHO. The Global Health Observatory. Global health estimates: Leading causes of death. Available at: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-leading-causes-of-death
Задворная О.Л., Борисов К.Н. Развитие стратегий профилактики неинфекционных заболеваний. Медицинские технологии. Оценка и выбор. 2019; 1(35): 43-9. [Zadvornaya O.L., Borisov K.N. Development of prevention strategies for non-communicable diseases. Medical Technologies. Assessment and Choice. 2019; 1(35): 43-9. (in Russian)]. https://dx.doi.org/10.31556/2219-0678.2019.35.1.043-049.
Капустин Р.В., Коптеева Е.В., Алексеенкова Е.Н., Цыбук Е.М., Аржанова О.Н. Анализ факторов риска и структуры перинатальных потерь у беременных с сахарным диабетом. Доктор.Ру. 2021; 20(6): 46-52. [Kapustin R.V., Kopteeva E.V., Alekseenkova E.N., Tsybuk E.M., Arzhanova O.N. Analysis of risk factors and perinatal mortality structure in pregnant patients with diabetes mellitus. Doctor.Ru. 2021; 20(6): 46-52. (in Russian)]. https://dx.doi.org/10.31550/1727-2378-2021-20-6-46-52.
Теплова Н.В., Червякова Г.А., Варданян А.Г., Аракелов С.Э., Джексембеков А.Г., Апокина В.В. Современная терапия хронической артериальной гипертензии у беременных. Клинический случай тяжелой артериальной гипертензии у пациентки в I триместре беременности в условиях терапевтического стационара. Медицинский алфавит. 2021; (25): 20-5. [Teplova N.V., Chervyakova G.A., Vardanyan A.G., Arakelov S.E., Dzheksembekov A.G., Apokina V.V. Nature and frequency of diagnosis of different forms of glomerulonephritis as cause of development and progression of chronic kidney disease in different regions of world, according to clinical and morphological studies with renal biopsy. Medical alphabet. 2021; (25): 20-5. (in Russian)]. https://dx.doi.org/10.33667/2078-5631-2021-25-20-25.
Agrawal A., Wenger N.K. Hypertension during pregnancy. Curr. Hypertens Rep. 2020; 22(9): 64. https://dx.doi.org/10.1007/s11906-020-01070-0.
Rahman A., Waqas A., Nisar A., Nazir H., Sikander S., Atif N. Improving access to psychosocial interventions for perinatal depression in low- and middle-income countries: lessons from the field. Int. Rev. Psychiatry. 2021; 33(1-2): 198-201. https://dx.doi.org/10.1080/09540261.2020.1772551.
GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1151-210. https://dx.doi.org/10.1016/S0140-6736(17)32152-9.
Chen C., Xu X., Yan Y. Estimated global overweight and obesity burden in pregnant women based on panel data model. PLoS One. 2018; 13(8): e0202183. https://dx.doi.org/10.1371/journal.pone.0202183.
Yang Z., Phung H., Freebairn L., Sexton R., Raulli A., Kelly P. Contribution of maternal overweight and obesity to the occurrence of adverse pregnancy outcomes. Aust. N. Z. J. Obstet. Gynaecol. 2019; 59(3): 367-74. https://dx.doi.org/10.1111/ajo.12866.
Sweeting A., Wong J., Murphy H.R., Ross G.P. A clinical update on gestational diabetes mellitus. Endocr. Rev. 2022; 43(5): 763-93. https://dx.doi.org/10.1210/endrev/bnac003.
Kapur A. Links between maternal health and NCDs. Best Pract. Res. Clin. Obstet. Gynaecol. 2015; 29(1): 32-42. https://dx.doi.org/10.1016/j.bpobgyn.2014.04.016.
Gluckman P.D., Hanson M.A., Beedle A.S. Non-genomic transgenerational inheritance of disease risk. Bioessays. 2007; 29(2): 145-54. https://dx.doi.org/10.1002/bies.20522.
Gluckman P.D., Hanson M.A., Cooper C., Thornburg K.L. Effect of in utero and early-life conditions on adult health and disease. N. Engl. J. Med. 2008; 359(1): 61-73. https://dx.doi.org/10.1056/NEJMra0708473.
Yajnik C.S., Deshmukh U.S. Maternal nutrition, intrauterine programming and consequential risks in the offspring. Rev. Endocr. Metab. Disord. 2008; 9(3): 203-11. https://dx.doi.org/10.1007/s11154-008-9087-z.
Ma R.C., Chan J.C. Pregnancy and diabetes scenario around the world: China. Int. J. Gynaecol. Obstet. 2009; 104 Suppl 1: S42-5. https://dx.doi.org/10.1016/j.ijgo.2008.11.032.
Kuzawa C.W. Fetal origins of developmental plasticity: are fetal cues reliable predictors of future nutritional environments? Am. J. Hum. Biol. 2005; 17(1): 5-21. https://dx.doi.org/10.1002/ajhb.20091.
Kumari N., Kathirvel S., Arora A., Jain V., Sikka P. Pattern of non-communicable diseases during pregnancy and their effect on feto-maternal outcome: A prospective observational study. Int. J. Gynaecol. Obstet. 2022; 156(2): 331-5. https://dx.doi.org/10.1002/ijgo.13678.
Kapur A. Pregnancy: a window of opportunity for improving current and future health. Int. J. Gynaecol. Obstet. 2011; 115 Suppl 1: S50-1. https://dx.doi.org/10.1016/S0020-7292(11)60015-5.
Gluckman P.D., Hanson M.A., Bateson P., Beedle A.S., Law C.M., Bhutta Z.A. et al. Towards a new developmental synthesis: adaptive developmental plasticity and human disease. Lancet. 2009; 373(9675): 1654-7. https://dx.doi.org/10.1016/S0140-6736(09)60234-8.
Kapur A., Hod M. Maternal health and non-communicable disease prevention: An investment case for the post COVID-19 world and need for better health economic data. Int. J. Gynaecol. Obstet. 2020; 150(2): 151-8. https://dx.doi.org/10.1002/ijgo.13198.
Retnakaran R., Shah B.R. Mild glucose intolerance in pregnancy and risk of cardiovascular disease: a population-based cohort study. CMAJ. 2009; 181(6-7): 371-6. https://dx.doi.org/10.1503/cmaj.090569.
Hussein J. Non-communicable diseases during pregnancy in low and middle income countries. Obstet. Med. 2017; 10(1): 26-9. https://dx.doi.org/10.1177/1753495X16684709.
WHO. Integrating services for maternal, newborn and child health and noncommunicable diseases at district-level facilities: Kyrgyzstan, Tajikistan and Viet Nam. 2023. Available at: https://iris.who.int/handle/10665/373539.
Яковлева Т.В., Плутницкий А.Н., Огнева Е.Ю., Каримова Д.Ю., Аверченко Р.Р. Первичное звено здравоохранения — история, этапы, модернизация. Клинический вестник ФМБЦ им. А.И. Бурназяна. 2022; 2: 10-6. [Yakovleva T.V., Plutnitsky A.N., Ogneva E.Yu., Karimova D.Yu., Averchenko R.R. Primary health care - history, stages, modernization. Clinical Bulletin of the Burnazyan Federal Medical Center. 2022; (2): 10-6. (in Russian)]. https://dx.doi.org/10.33266/2782-6430-2022-2-10-16.
Jung J., Karwal E.K., McDonald S., Turner T., Chou D., Vogel J.P. Prevention and control of non-communicable diseases in antenatal, intrapartum, and postnatal care: a systematic scoping review of clinical practice guidelines since 2011. BMC Med. 2022; 20(1): 305. https://dx.doi.org/10.1186/s12916-022-02508-9.
Министерство здравоохранения Российской Федерации. Клинические рекомендации. Гестационный сахарный диабет. 2024. [Ministry of Health of the Russian Federation. Clinical Guidelines. Gestational diabetes mellitus. 2024. (in Russian)].
Министерство здравоохранения Российской Федерации. Клинические рекомендации. Преэклампсия. Эклампсия. Отеки, протеинурия и гипертензивные расстройства во время беременности, в родах и послеродовом периоде. 2021. [Ministry of Health of the Russian Federation. Clinical guidelines. Preeclampsia. Eclampsia. Edema, proteinuria, and hypertensive disorders during pregnancy, delivery, and postpartum. 2021. (in Russian)].
Лопатина М.В., Драпкина О.М. Грамотность в вопросах здоровья выходит на передовые позиции повестки дня в профилактике и контроле неинфекционных заболеваний. Профилактическая медицина. 2018; 21(3): 31-7. [Lopatina M.V., Drapkina O.M. Health literacy is coming to the forefront of the agenda in the prevention and control of noncommunicable diseases. Russian Journal of Preventive Medicine. 2018; 21(3): 31-7. (in Russian)]. https://dx.doi.org/10.17116/profmed201821331.

Received 29.10.2024

Accepted 03.03.2025

Ekaterina L. Yarotskaya, Dr. Med. Sci., Associate Professor, Head of the Department of International Cooperation, V.I. Kulakov NMRC for OG&P, Ministry of Health
of Russia, 4, Ac. Oparin str., Moscow, 117997, Russia, +7(495)438-11-66, e_yarotskaya@oparina4.ru
Oleg V. Ionov, Dr. Med. Sci., Head of the of the Prof. A.G. Antonov Neonatal Intensive Care Unit of the Institute of Neonatology and Pediatrics, V.I. Kulakov NMRC
for OG&P, Ministry of Health of Russia, 4, Ac. Oparin str., Moscow, 117997, Russia; Professor at Neonatology Department of the Faculty of Pediatrics, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), 2-4, Bolshaya Pirogovskaya str., Moscow, 119435, Russia, +7(495)438-22-77, o_ionov@oparina4.ru,
https://orcid.org/0000-0002-4153-133X
Diiana R. Sharafutdinova, PhD, Neonatologist at the Prof. A.G. Antonov Neonatal Intensive Care Unit of the Institute of Neonatology and Pediatrics, Teaching Assistant at the Department of Continuing Professional Education and Simulation Technologies, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 4, Ac. Oparin str., Moscow, 117997, Russia; Associate Professor at the Department of Neonatology, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University),
2-4, Bolshaya Pirogovskaya str., Moscow, 119435, Russia, dikarush@gmail.com, d_sharafutdinova@oparina4.ru, https://orcid.org/0000-0001-9626-5481
Elizaveta M. Khamatkhanova, Dr. Med. Sci., MBA, Head of the Department of Educational Simulation Technologies in Medicine, Head of the Department of Postgraduate Education, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, 4, Ac. Oparin str., Moscow, 117997, Russia, liz39@yandex.ru
Svetlana V. Axelrod, PhD, Director of the Global Platform of the World Health Organization on Noncommunicable Diseases, dr.axelrod@yandex.ru,
https://orcid.org/0000-0002-5176-3388

Challenges and opportunities for integrating programs for the prevention and treatment of non-communicable diseases with maternal and child health care

Yarotskaya E.L., Ionov O.V., Sharafutdinova D.R., Khamatkhanova E.M., Axelrod S.V.

Keywords

References

About the Authors

Similar Articles