DESK REVIEWS | 04.08.05. Please provide your interpretation following the completion of previous parts of this desk review:

DESK REVIEW | 04.08.05. Please provide your interpretation following the completion of previous parts of this desk review:

No, there is nothing officially agreed about that. However, Professor Cleusa Ferri will try to review the guidelines developed in 2017 (Brazilian Ministry of Health, 2017c) through her work in the Health Technology Assessment Unit. The revision may lead to a new version that could be expected by 2022 or 2023.

References:

Brazilian Ministry of Health. (2017c). PCDT Alzheimer. Brazilian Ministry of Health.

The Indian Academy of Neurology (2022) is currently in the process of developing new clinical guidelines to support the diagnosis and management of dementia (Indian Academy of Neurology, 2022).

References:

Indian Academy of Neurology. (2022). Home. IAN. Available from: https://www.ianindia.org/

Yes, as the PERDOSSI clinical guideline was planned only to be effective until 2017 (PERDOSSI, 2015). However, no new guidelines have yet been published (27 February 2020).

References:

PERDOSSI. (2015). Panduan Praktik Klinik: Diagnosis dan Penatalaksanaan Demensia. PERDOSSI.

This is possible in the long-term since there are already evidence-based guidelines that can be used in developing countries such as Kenya to identify dementia and support persons with dementia and their families i.e., the mhGAP which covers priority mental disorders including dementia (World Health Organization, 2016). New clinical guidelines could be developed but a feasible way in the short-term could be to adapt and adopt what is already available. A systematic review on the effectiveness of interventions for dementia in low- and middle-income countries that is in draft form (protocol published) (Salcher-Konrad et al., 2019) could identify what has already been tested and proven to be efficacious, for adoption in Kenya.

References:

Salcher-Konrad, M., Naci, H., McDaid, D., Alladi, S., Oliveira, D., Fry, A., … Ndetei, D. M. (2019). Effectiveness of interventions for dementia in low-and middle-income countries: protocol for a systematic review, pairwise and network meta-analysis. BMJ Open, 9(6), e027851. https://doi.org/10.1136/bmjopen-2018-027851

World Health Organization. (2016). mhGAP Intervention Guide version 2.0. Geneva, Switzerland. https://www.who.int/publications/i/item/9789241549790

No information to indicate this is available.

The Brazilian Ministry of Health, the Brazilian Ministry of Citizenship, dementia associations, the STRiDE team, and national steering group, politicians.

The key stakeholders that can bring about change with respect to dementia in the country are senior representatives from the Ministry of Social Justice and Empowerment and Ministry of Health and Family Welfare. Enhanced coordination between these two ministries is critical to ensure the development of a policy that takes a multidisciplinary approach to care, which is essential for the well-being of persons with dementia.

All sectors of government are expected to bring about policy change.

  • Central government has supporting bodies, such as the Ministry of Health with BKKBN and the public health directorate focusing on older people which work on ageing and mental health issues. The Ministry of Social Affairs has one directorate focusing on older people’s social rehabilitation.
  • Local governments can also bring policy change through their local programmes including Social Service or Health Service. Both programmes also work hand in hand with central government, the Ministry of Social Affairs, and the Ministry of Health.

The following stakeholder institutions/associations could contribute to policy change on dementia:

  • Government e.g., Ministry of Health and Ministry of Labour and Social protection;
  • Advocacy groups e.g., Alzheimer’s and Dementia Organization of Kenya (ADOK);
  • Research organizations e.g., Africa Mental Health Research and Training Foundation (AMHRTF);
  • NGO’s e.g., HelpAge International;
  • National associations e.g., Kenya Hospices and Palliative Care Association (KEHPCA), private and public health care facilities.

Ministry of Health, Ministry of Wellbeing, Ministry of Finance, and Social Security Institutions. In terms of care-specific policies, the National Institute for Women also has an important role.