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      Systems modelling as an approach for understanding and building consensus on non-communicable diseases (NCD) management in Cambodia

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          Abstract

          Background

          This paper aims to demonstrate how systems modeling methodology of Group Model Building (GMD) can be applied for exploring and reaching consensus on non-communicable disease (NCD) management. This exercise was undertaken as a first step for developing a quantitative simulation model for generating credible estimates to make an investment case for the prevention and management of NCDs.

          Methods

          Stakeholder engagement was facilitated through the use of a Group Model Building (GMB) approach. This approach combines various techniques in order to gain a whole system perspective.

          Results

          A conceptual qualitative model framework that connects prevention—via risk factors reduction—screening and treatment of non-communicable diseases (NCDs) was developed with stakeholders that draws on stakeholders personal experiences, beliefs, and perceptions through a moderated interactions to gain in-depth understanding of NCDs management.

          Conclusion

          Managing NCDs in Cambodia will require concerted effort to tackle NCD risk factors, identifying individuals with NCDs through screening and providing adequate and affordable consistent care to improve health and outcomes of NCDs.

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          Scripts for group model building

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            Group model building effectiveness: a review of assessment studies

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              Cardiovascular diseases in the developing countries: dimensions, determinants, dynamics and directions for public health action.

              The global burden of disease due to cardiovascular diseases (CVDs) is escalating, principally due to a sharp rise in the developing countries which are experiencing rapid health transition. Contributory causes include: demographic shifts with altered population age profiles; lifestyle changes due to recent urbanisation, delayed industrialisation and overpowering globalisation; probable effects of foetal undernutrition on adult susceptibility to vascular disease and possible gene-environment interactions influencing ethnic diversity. Altered diets and diminished physical activity are critical factors contributing to the acceleration of CVD epidemics, along with tobacco use. The pace of health transition, however, varies across developing regions with consequent variations in the relative burdens of the dominant CVDs. A comprehensive public health response must integrate policies and programmes that effectively impact on the multiple determinants of these diseases and provide protection over the life span through primordial, primary and secondary prevention. Populations as well as individuals at risk must be protected through initiatives that espouse and enable nutrition-based preventive strategies to protect and promote cardiovascular health. An empowered community, an enlightened policy and an energetic coalition of health professionals must ensure that development is not accompanied by distorted nutrition and disordered health.
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                Author and article information

                Contributors
                +65-6601-1215 , john.ansah@duke-nus.edu.sg
                amina.islam@duke-nus.edu.sg
                victoria.koh@u.nus.edu
                hou3@cdc.gov
                herokol@yahoo.com
                david.matchar@duke-nus.edu.sg
                chhunloun@yahoo.com
                lounmondol@gmail.com
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                3 January 2019
                3 January 2019
                2019
                : 19
                : 2
                Affiliations
                [1 ]ISNI 0000 0004 0385 0924, GRID grid.428397.3, Health Services and Systems Research, , Duke-NUS Medical School Singapore, ; 8 College Road, Singapore, 169857 Singapore
                [2 ]Centers for Disease Control and Prevention (CDC), Phnom Penh, Cambodia
                [3 ]GRID grid.415732.6, Ministry of Health Cambodia, ; Phnom Penh, Cambodia
                [4 ]ISNI 0000 0004 1936 7961, GRID grid.26009.3d, Department of Medicine, , Duke University School of Medicine, ; Durham, NC USA
                Article
                3830
                10.1186/s12913-018-3830-2
                6318956
                30606199
                e1ca5776-93d4-4011-a1f5-c83541bac768
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 November 2017
                : 17 December 2018
                Funding
                Funded by: DUKE-NUS INTERNAL RESEARCH FUND
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Health & Social care
                non-communicable diseases,group model building,simulation,cambodia
                Health & Social care
                non-communicable diseases, group model building, simulation, cambodia

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