159 7 General Discussion Health systems improvement will improve DM–TB Care The infrastructures in most Sub-Saharan African countries will not sustain the projected increase in DM and TB cases [32,33]. Currently, most country health systems cannot meet health needs; hence, urgent improvement across the different health system components is required [34,35]. Some of the gaps in DM-TB care identified in our study have been described. A comprehensive needs assessment by the local health authority to identify gaps provides a good starting point to better plan for health system improvement. When conducted based on the projected population growth and projected prevalence of communicable and non-communicable disease, this will identify approximate resource needs to achieve different country health targets. The WHO’s analytical framework on the health system has divided it into six components for consideration during health planning [36]. These include leadership and governance, service delivery, health system financing, health workforce, medical products, vaccines and technologies and health information systems. While frequently overlooked, leadership and governance, which coordinate the overall implementation of changes and how the other health system components function, should have sufficient expertise to efficiently allocate and utilize available resources for optimal health outcomes while remaining accountable [37,38]. Commitment from relevant stakeholders to address NCDs is vital Globalization, with advancements in healthcare technology and different healthcare funding models, has significantly changed planning, delivery and access to healthcare interventions [39–41]. With projected increases in diabetes and other NCDs, infectious diseases and future pandemics, key stakeholders’ active participation in planning and delivering healthcare interventions is pivotal to the success of any intervention [39,42]. Policymakers, funders of public health interventions, academia, the private sector, pharmaceutical and biotech companies, non-governmental organizations, and community and civil rights organizations are some of the key stakeholders who should commit to partnering with host governments to address NCD risk factors [39]. Stakeholder participation can range from planning an intervention to address modifiable NCD risk factors in high-risk populations to developing and testing new drugs or medical equipment to treat NCDs. Frequently omitted during planning for health interventions are the recipients of the planned intervention. This omission has dire consequences, as the planned intervention may not be suitable or acceptable to the intended beneficiaries. One approach to overcome this is utilizing the human-centred design (HCD) concept when planning an intervention. HCD, as a concept, uses an iterative engagement process with the
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