1 / 15

The Non Communicable Disease Crisis and Reproductive Health

The Non Communicable Disease Crisis and Reproductive Health. PSRH BIENNIAL MEETING APIA, SAMOA, 9-12 JULY, 2013 PROF RAJAT GYANESHWAR FIJI NATIONAL UNIVERSITY. OUTLINE OF PRESENTATION. BACKGROUND LITERATURE REVIEW ANALYSIS OF IMPLICATIONS FOR THE PACIFIC RECOMMENDATIONS . DEFINITIONS.

keiran
Download Presentation

The Non Communicable Disease Crisis and Reproductive Health

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Non Communicable Disease Crisis and Reproductive Health PSRH BIENNIAL MEETING APIA, SAMOA, 9-12 JULY, 2013 PROF RAJAT GYANESHWAR FIJI NATIONAL UNIVERSITY

  2. OUTLINE OF PRESENTATION • BACKGROUND • LITERATURE REVIEW • ANALYSIS OF IMPLICATIONS FOR THE PACIFIC • RECOMMENDATIONS

  3. DEFINITIONS • DIABETES • CARDIOVASCULAR DISEASE • CHRONIC RESPIRATORY DISEASE • CANCER • SEXUAL HEALTH • FAMILY PLANNING AND INFERTILITY • MATERNAL AND CHILD HEALTH • STIs & CANCER NCDs RH

  4. NCD RISK FACTORS • SMOKING - foetal and maternal issues • NUTRITION - Diabetes, hypertension • ALCOHOL - foetal alcohol synd, STIs, preg, cervical ca. • PHYSICAL ACTIVITY - obesity, osteoporosis

  5. OBESITY • MENSTRUAL PROBLEMS • FERTILITY ISSUES • INCREASED PREGNANCY RISKS • URINARY AND FECAL INCONTINENCE • PELVIC FLOOR LAXITY • POST MENOPAUSAL BREAST CANCER • ENDOMETRIAL AND OTHER CANCERS.

  6. OBESITY AND MENSTRUAL PROBLEMS • Polycystic Ovarian Syndrome – obesity, excessive body hair and anovulation • Common problem in the Pacific • Weight loss is first line of treatment ( Hollmann et al. Human Reproduction. 1996;11:1884-91) • Life style factors important in achieving weight loss. ( Huber-Buchoholz M et al. J ClinEndocrinol Met. 1999;84:1490-4

  7. OBESITY AND FERTILITY • REDUCED FECUNDITY AND INCREASED TIME TO CONCEPTION ( WiseL LA et al. Human Reprod. 2010; 25:253-264) • HIGH RATES OF INFERTILITY ( British Fertility Society Policy and Practice Guidelines) • LOWER RATES OF SUCCESSFUL PREGNANCY AFTER FERTILITY TREATMENT ( Maheshwari A et al. Human Reproduction Update. 2007;13:433-444)

  8. OBESITY AND PREGNANCY INCREASED RISK OF : • DIABETES (x2 – 5 depending on BMI) • HYPERTENSION AND PET (X3.5) • PRE TERM DELIVERY • LARGE BABY AND SHOULDER DYSTOCIA • CAESAREAN DELIVERY (Linear assoc with BMI) • PPH • PULMONARY EMBOLUS • COST AND LENGTH OF STAY (( Weiss JL et al. Am J ObstetGynecol 2004, O’Brien TE eta al. Epidemiology 2003, Kabrehel C et al. Obesity 2009, Scott-Pillai R et al 2013, BJOG Torloni MR et al. J MaternFetal Neonatal Med. 2009)

  9. OBESTITY AND CANCER • INCREASED RATES OF : - POST MENOPAUSAL BREAST CANCER - ENDOMETRIAL CANCER - OTHER CANCERS - gut , liver, gall bladder, pancreas and kidney (Renehan AG et al. Lancet 2008;371(9612): 569) (Calle EE et al. N Engl J Med. 2003;348(17):1625)

  10. NCDs and Female Mortality • Each day : 50,000 women die from NCDs 1000 maternal deaths • More women die due to : cardiovascular disease cancer respiratory disease (WHO list of 10 leading causes of death in women)

  11. OBESITY IN THE PACIFIC • 33% of Fijian women (15-24 age group) are overweight or obese ( 2002 STEPS survey) • Obesity rates have trebled between 1993 and 2004. ( Fiji National Nutrition Survey 2004) • Obesity rates of between 30- 75% reported in 25-64 year olds in the Pacific (STEPS surveys)

  12. NCD RISK FACTORS - STEPS SURVEY • SMOKING – 53.2 % of women in Nauru smoke. Rates high for Kiribati,Tokelau, Wallis and Fortuna ) • ALCOHOL – 50% Cook Is women • HYPERTENSION – 27.5% American Samoan women • DIABETES – 42.4% - 12%

  13. OPPORTUNITY TO MAKE A DIFFERENCE • RISK FACTORS COMMON AND MODIFIABLE • HEALTH PRIOR TO, DURING, AND AFTER PREGNANCY AND CHILDBIRTH CAN HAVE LONG TERM HEALTH IMPLICATIONS • MCH PROGRAMS SHOULD INCLUDE NCD INTERVENTIONS

  14. PRACTICAL SUGGESTIONS • Empower women and girls to care for their health better – menstrual problems, fertility issues, pregnancy care. • New approach to pregnancy care – weight gain, - nutrition, - cancer screening, - physical activity

  15. Caring for women and girls • Emphasis on health education • Empowering women to take sound decisions about risk taking behaviour. • Take opportunity during antenatal visits to counsel, educate

More Related