Asthma programmes in diverse regions of the world: challenges, successes and lessons learnt
International surveys have demonstrated that asthma is still underdiagnosed and undertreated in many parts of the world. Despite improvements in the standard of asthma care delivered in many areas, as evidenced by improved global asthma mortality data, much information on projects and
programmes undertaken in resourcelimited regions of the world is not in the public domain. The aim of this report is to review projects and programmes in diverse regions around the world so that health care providers, planners and consumers may draw on the successes, failures and lessons learnt.
Such real world experiences may contribute to achieving Global Initiative for Asthma goals of asthma control. Asthma projects and programmes in Argentina, Australia, Brazil, China, Japan, Mexico, Philippines, Russia, South Africa and Turkey were discussed by a group of experts in asthma care,
the Advancing Asthma Care Network, from their respective countries, over a course of three satellite meetings in 2010. Collective analyses consistently identi ed low rates of dissemination and implementation of national and in- ternational treatment guidelines, low levels of continuing medical
education and training of primary health care professionals and access and distribution of inhaled corticosteroids to be major barriers that are critical to the overall success of a national asthma management programme. In the less developed asthma programmes, under-recognition and undertreatment
further limited the success of the programmes. Evidence from well-established national asthma management programmes suggests that establishment of a successful programme entails a logical progression through speci c developmental stages, starting with political/stakeholder endorsement and
commitment, followed by epidemiological evaluation, evaluation of disease burden, evaluation of access to care and best therapy, and nally optimisation and maintenance therapy for individual patients.
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ASTHMA EDUCATION AND TRAINING;
ASTHMA MANAGEMENT PROGRAMMES;
Document Type: Review Article
Department of Pulmonology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
GlaxoSmithKline, Uxbridge, UK
First Department of Internal Medicine, Showa University, Tokyo, Japan
Philippine Heart Centre, Quezon City, Philippines
Department of Respiratory Medicine and Allergy, Saint-Petersburg Medical Academy for Postgraduate Studies, St Petersburg, Russia
Pontificia Universidade Catolica Do Rio Grande Do Sul, Porto Alegre, Brazil
Department of Pediatrics, Shanghai No.1 People's Hospital, Shanghai, China
Hospital Angeles Centro Medico del Potosi, San Luis Potosí, México
Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
Chinese-Japanese Friendship Hospital, Beijing, China
Hospital Infantil de las Californias, Tijuana Baja California, Mexico
Respiratory Medicine Unit, 'O. Alassia' Children's Hospital, Sante Fe, Argentina
Paediatric Allergy and Asthma Unit, Hacettepe University, Ankara
Department of Chest Disease, Celal Bayar University, Manisa, Turkey
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
Publication date: December 1, 2011
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