The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge?

Journal article


Shawa, I. and Consortium 2021. The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge? Journal of Hepatology. 76 (4), pp. 771-780. https://doi.org/DOI:10.1016/j.jhep.2021.10.025
AuthorsShawa, I. and Consortium
Abstract

Background & Aims
Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas.

Methods
We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemiology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied.

Results
The highest scoring countries were India (42.7) and the United Kingdom (40.0), with 32 countries (31%) scoring zero out of 100. For 5 of the domains a minority of countries were categorised as high-level while the majority were categorised as low-level. No country had a national or sub-national strategy for NAFLD and <2% of the different strategies for related conditions included any mention of NAFLD. National NAFLD clinical guidelines were present in only 32 countries.

Conclusions
Although NAFLD is a pressing public health problem, no country was found to be well prepared to address it. There is a pressing need for strategies to address NAFLD at national and global levels.

KeywordsNon-alcoholic fatty liver disease (NAFLD); non-alcoholic steatohepatitis (NASH); liver health; global public health; policy preparedness; health policy; multiple correspondence analysis
Year2021
JournalJournal of Hepatology
Journal citation76 (4), pp. 771-780
PublisherElsevier
ISSN0168-8278
Digital Object Identifier (DOI)https://doi.org/DOI:10.1016/j.jhep.2021.10.025
Web address (URL)https://pubmed.ncbi.nlm.nih.gov/34895743/
https://www.journal-of-hepatology.eu/article/S0168-8278(21)02168-1/fulltext
Output statusPublished
Publication dates
Online08 Dec 2021
Publication process dates
Deposited06 Jun 2023
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