2025-03-03-世界卫生组织-Evaluation_of_the_Pan_American_Health_Organization_Technical_Cooperation_in_Noncommunicable_Disease_Prevention_and_Control_in_the_Americas_September_2023_63页_5mb

This is a summary of the evaluation of the Pan American Health Organization's (PAHO) technical cooperation in noncommunicable disease (NCD) prevention and control in the Americas. The evaluation examines the relevance, coherence, effectiveness, efficiency, sustainability, and impact on gender, equity, human rights, and COVID-19 response.

Overview

PAHO's work remains highly relevant in addressing NCDs, which cause significant morbidity and mortality in the Americas. However, the evaluation recommends updating the current Plan of Action due to evolving global priorities like mental health and air pollution. COVID-19 disrupted services and progress, emphasizing the need for resilience in health systems.

Relevance

• NCDs remain a major priority, with gaps in achieving targets due to limited progress, especially in tobacco control and risk factors like alcohol and diet.
• PAHO's technical cooperation is valued by partners but lacks focus on integrating mental health and addressing industry influences.
• The POA should be revised to reflect broader NCD agendas and include new priorities.

Coherence and Coordination

• PAHO demonstrates strong coherence internally and with government partners but faces challenges in cross-departmental coordination and external alignment.
• Multisectoral collaboration is uneven, with opportunities to enhance linkages within PAHO and with intergovernmental bodies.
• United Nations agencies and country-specific partnerships require stronger integration.

Effectiveness

• Significant progress in tobacco control (e.g., smoke-free environments) exists, but limited success on outcomes like reduced alcohol consumption and obesity.
• The HEARTS program showed a statistically significant positive impact on hypertension management in the region.
• Research gaps exist, particularly on the effectiveness of integrated health services and equity issues.
• Disease-specific programs could be enhanced by a health systems-focused approach.

Efficiency

• No formal efficiency metrics exist, but qualitative feedback indicates that PAHO delivers “a great deal with limited resources” through strategic partnerships and embedded responses.
• More efficient resource allocation could be achieved by prioritizing high-cost, high-impact interventions and utilizing digital tools.

Sustainability

• PAHO retains high credibility and trust in the region but depends on a few funders, a $// potential threat to long-term sustainability.
• Virtual training models and digital health innovations (e.g., Pahola) offer sustainable solutions, but vertical programs may not be sustainable without context integration.

Cross-Cutting Themes

• Gender equality, equity, and human rights are well-integrated in surveillance but require addressing disparities in data collection and service delivery.
  -", COVID-19 exposed health system gaps, while innovations like e-health and community engagement offer recovery opportunities.

Conclusions and Recommendations

• Revise the regional POA to align with global NCD gaps while maintaining inclusivity.
• Strengthen interagency coordination and engage non-state actors to improve coherence across technical cooperation.
• Scale up effective programs like HEARTS and ensure integration into primary health care.
• Develop metrics for efficiency and broaden funding sources for sustainability.
• Prioritize equity, human rights, and resilience in NCD responses.

This evaluation provides comprehensive findings and actionable recommendations for strengthening PAHO's NCD technical cooperation in the Americas.