COMMUNITY INTERVENTIONS FOR HEALTH SUCCESSES AND CHALLENGES IN MEXICO

1. COMMUNITY INTERVENTIONS FOR HEALTH SUCCESSES AND CHALLENGES IN MEXICO Jorge A. Ramírez, Teresa Fernández, Gabriela Capó, Vianey Cortés, Samanta De Larrosa, Diana López, Marlene Medina, Beatriz Champagne

3. Baselines Data

4. Baseline Data Summary Points School aged children • Low levels of physical activity among school children • Girls are less physical active than boys • Girls are eating more fruits and vegetable than boys • Smokeless tobacco uses is higher in school-aged children compared to adult population • 7.1% of students in lower grade reported smokeless tobacco use as compared with 5.8% of students in upper grades

5. Baseline Data Summary Points Cont… Adults in different settings • Adults in the community report higher level of physical activity than adults in workplaces and clinicians • Adults are not physical active daily • 10.0% males and 14.9% females are doing less than 30 minutes of PA per day on average • Adults are not eating sufficient amounts of fruits and vegetables especially in workplaces • Among adult population clinicians had highest reported level of meeting the recommended fruit and vegetable consumption

6. RATIONALE OF THE INTERVENTIONS • 1. Definemicroregionstopulltogether, in ageographicalarea, cultural & socioeconomiccharacteristics • Pueblos, ( rural traditional) Barrios(urbantraditional) • Barrios ( • Colonias (urban) Blocks of flats

8. RATIONALE OF THE INTERVENTIONS • Schools and healthcare centres as thedrivingforces of intervention. • Up to 20-25% of thecommunityiscontactingthroughthestudents. • 20,000 medicalconsultations are delivered in theprimaryhealthcaresystem of Tlalpan monthy.

11. Rationale of theInterventions • Mainstakeholders

12. Intervention: schools • Nutritioneducation and promotingtheestablishment of canteens • Workingwithdifferentstakeholderstoimprovethetypes of foodoffered in schools

13. School:Interventions Promoting and implementingphysicalactivity • 3 times a week

15. SchoolInterventions • Posters createdbyschoolchildrenonhealthyeating

16. Intervention: health centres • Educatingpatientsonnutrition and physicalactivity

17. Intervention: health centres • Promotingphysicalactivitywithinhealthcarefacilities

18. Health promoters • 100 paid health promoters funded by National Sports Commission and DelegaciónTlalpan (local authority). • Community oriented • 400 trained volunteered promoters • Doctors and health care personnel in contact with patients, teachers and different people in the community. • Target population 200,000 people

20. Intervention: community • Community fiestas • Health promotersactivatecommunitymembers • Educationonnutrition • Creating open air gyms • Creatinghealthmurals

24. Communitymurals

25. Materialspreparedbythecommunity

26. Material preparedwiththecommunity

28. Challenges • Mexico is the most obese country world wide • Time required to cultivate partnership with key stakeholders • Important policies can be passed by decision makers but there are inconsistencies in how policies are implemented • Food environment is not supportive for healthy eating • Lots of high fat food/salt foods, soft drinks are widely consumed and available • A very large informal market in food retail with unhealthy food.

29. Successes • CIH has brought national programmes to Tlalpan • Develop culture of healthy living and physical activity in young people and in the community • Better coordinated efforts to tackling obesity epidemic in Mexico City • Energizing different stakeholders toward action in prevention NCD • CIH being recognized and consulted as experts in NCD prevention

30. Sustainability • Ministry of Health in the City of Mexico is considering scaling CIH activities city wide • CIH trainedhealthprofessionalswillcontinueto prescribe patientsonphyscalactivity, nutrition and tobaccocounselling • Advising on operation of new hospital in Tlalpan • Fundingforhealthpromoterswillcontinueafterwards

31. Thankyou