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NCD PRESENTATION: JAMAICA. PRESENTER: DR. MARCIA GRAHAM. Rationale. In the past 25 years, we had an epidemiological shift in morbidity and mortality from communicable to chronic non-communicable diseases (NCDs). NCDs account for 56% of deaths in Jamaica
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NCD PRESENTATION: JAMAICA PRESENTER: DR. MARCIA GRAHAM
Rationale • In the past 25 years, we had an epidemiological shift in morbidity and mortality from communicable to chronic non-communicable diseases (NCDs). • NCDs account for 56% of deaths in Jamaica • 2001: economic cost of DM/HTN- US$460.4 million Prevalence of NCDs in Jamaican 15 – 74 years old
Risk factors – Unhealthy Diet Meat preparation: Frying - 31.7% adults, 15-19yrs - 55% > 90% Jamaicans eat less than 3 servings of either fruits or vegetables in a day In15-19 year olds:18% - vegetables at or above optimal levels; 41% - fruit at or above optimal levels (CFNI RDA) 98% kids 10-15 yrs had soft drinks within usual week Risk factor -Tobacco use ADULTS (15-74yrs): 14.5% current smokers in 2008 CHILDREN (13-15yrs): 17%current smokers in 2006 CHILDREN 10-15yrs that ever smoked: 10% CHILDREN 15-19yrs that ever smoked: 22%
I. Public Policy and Advocacy Key strategies: • Advocacy for Policy Changes and Development of Effective Policy • Create Multi-sectorial Partnerships and Networks for Chronic Diseases • Advocate for the establishment of a National Chronic Disease Commission • Establish National Taskforce on NCD & Injuries • Approve and disseminate Cervical Cancer prevention and control guidelines • Review cancer prevention and control policy • Update Diabetes and Hypertension management guidelines
II. Surveillance, Monitoring and Evaluation and Research Key strategies: • Build capacity for Chronic Disease Information generation and utilization • Partnership with Key Stakeholders • Implementation of National Surveillance system for NCDs. • National KAP Survey on NCDs and their risk factors • Cancer research • Support Salt Research project • Identify and support NCD related research.
III. Risk Factor Reduction and Health Promotion Key strategies: • Build capacity for community-based actions • Development of population wide interventions • Create multi-sectorial partnerships and networks for chronic diseases KEY AREAS: PORT OF SPAIN DECLARATION • No tobacco, no harmful use of alcohol • Healthy eating (including elimination of trans fat, reduce intake of sugar, fats & salt) • Increased PHYSICAL ACTIVITY • Community-based programmes especially in schools, workplaces and faith-based settings (Heart Foundation, Cancer Society, CHASE, NHF) • Violence prevention interventions (grief counselling)
IV. Integrated Management of Chronic Diseases and Risk Factors Key Strategies: • Strengthen Health Services for Integrated Prevention and Management of Chronic Diseases. • Reinforce the Competencies of the Health Care Workforce for Chronic Disease Prevention and Management. • Continue implementation of Chronic Care Model (CCM) & Model of Improvement (MI) – Diabetes Project and applying this approach to Hypertension & Cervical Cancer • Implementation of Chronic Diseases Passport & other useful tools from the Project • Implement screening programme for metabolic syndrome
V. Programme Administration and Capacity Building Key strategy: Strengthen of Health System to support the scaling up of Chronic Disease Prevention activities • National Strategic Plan for the prevention and control of NCDs and their risk factors • Establish National Regional Coordinators TWG: done • Establish MoH- Head Office TWG on NCD • Training of Lay Diabetes Educators & Health Promoters • Establish NCD section of new MoH Epi Unit • Assess and advocate for resources, infrastructure, financing for NCD and prevention of risk factors
STRATEGIES TO OVERCOME CURRENT DIFFICULTIES • Try to improve documentation of the magnitude of the problem & contributory factors • Screening at every opportunity • Lobbying for healthier ‘fast food’ options • Advocate for improved manpower, materials, drug supply & remuneration • Chronic Diseases Passport to aid tracking and better coordinate care • Encouraging individuals to take PERSONAL responsibility for their health
Media CampaignPhysical Activity: ‘Mek Wi Move’ Billboards on Wheels – Adverts. Educational Materials SKIP: Setting Knowledge Into Practice
Teens ‘R’ Terrific Camp for adolescents Camp Yellow Bird helping children live with diabetes Healthy zone Healthy Lifestyle school choir