Non communicable disease prevention and control

Chlara Yunita Prabawati

In this course, I learn about non communicable disease prevention and control (NCDs). This is consist of a non-infectious medical situations, but include of premature mortality, such as  cardiovascular disease, cancer, diabetes, and chronic respiratory diseases. NCDs not yet include at the Millennium Development Goals (MDGs), however it has increased concerns and has include in the United Nations (UN) resolution on Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases in September 2011 (WHO, 2015).

The history of NCDs start at 1990, there were 26·6 million deaths worldwide from NCDs increasing in 2010 to 34·5 million. The global burden of NCDs has increased from 43% (1.08 billion of the total 2.50 billion) in 1990, to 54% (1.34 billion of 2.49 billion) of the total number of disability-adjusted life-years in 2010. Furthermore in 2008, around 57 million deaths were reported globally, of which 36 million (or 63%) were due to NCDs. The most high NCDs contributed to global deaths were cardiovascular diseases, diabetes, cancer and chronic respiratory diseases. From total NCDs deaths worldwide, almost 80% occur in low-and middle income countries. Moreover, the global economic burden of NCDs is large, estimated at US$6·3 trillion in 2010, rising to $13 trillion in 2030. A 10% rise in NCDs leads to a 0·5% decrease in gross domestic product (GDP)(Hogerzeil, 2013; WHO, 2015).

This phenomena also related with demographic and epidemiological transitions. In South Asia life expectancy is increasing and fertility rate is reducing which has leaded to increased health burden of NCDs with 46 percent (55percent including injuries) of burden of disease as a proportion of total forgone due to ill health, disability, and early death (DALYs). It  has been indicated that prevalence of smoking varies in South Asian countries from 16-32%, alcohol consumption between 3-41%, eating less than 5 servings of fruits and vegetable 81-99%, physical inactivity 4-24%, overweight and obesity 9-44%, raised blood pressures 8-42%, raised fasting blood sugar 4-9%, and raised blood cholesterol 13-54%. In 2004, NCDs (inclusive of injuries) accounted for 46 percent in terms of the number of lives lost due to ill health, disability, and early death (DALYs), with the remainder from communicable diseases and maternal and child health issues. And all of the problem lead to Non-communicable diseases (NCDs) (Hogerzeil, 2013; WHO, 2015).

In my opinion the most important think is method and some of intervention of primary, secondary and tertiary act 

include:

1.      Advocacy and work with decision makers, key Interventions :

1)      Develop and implement effective advocacy plans for NCDs and launch campaigns for NCDs prevention and control.

2)      Actively advocate to national, provincial and local community leaders, and other partners (e.g. industries), to enhance their awareness of the magnitude of the NCDs burden and to engender their commitment for instituting effective measures to prevent and control chronic diseases injuries (Vineis, 2014; WHO, 2015; Abu Bakar et al, 2015).

2.      Prevention and Promotion of non-communicable diseases

In my point of view health promotion continues to play a pivotal role in the prevention of NCDs. Media and social marketing to promote healthy lifestyles and to increase knowledge and awareness of NCDs risk factors will be strengthened.

Workplace-based and community-based demonstration programs to empower individuals at high risk or with chronic diseases to develop health literacy take on self-care responsibilities and become a resource for themselves and others in disease prevention and management will be tailored and piloted. The key Interventions such as :

1)      Creating content for health promotion addressing the main risk factors of NCDs; unhealthy eating and physical inactivity

2)      Intensifying media campaigns using television, radio and printed media for dissemination of tailor made IEC/BCC material on NCDs

3)      Strengthening of the Workplace-based Health programs, in both health education and health-promoting activities

4)      Promote Population based interventions

5)      Working with relevant government agencies such as traffic police and others to decrease risks of road traffic injuries and other unintentional injuries (Vineis, 2014; WHO, 2015; Abu Bakar et al, 2015).

3.      Strengthen health system

The community health workers (CHWs) will be promoted to take responsibility for community mobilization and education of community in relation to non-communicable diseases. Community health supervisors at facility level will also be trained to supervise the CHWs at community level and ensure proper reporting from community level injuries (Vineis, 2014; WHO, 2015; Abu Bakar et al, 2015).

What I am still questioning is about how to promote partnerships for the prevention and control of NCDs and how to monitor implementation of the NCDs prevention and control interventions and evaluate progress at the national level?. I think Establishment of national coordination forum for the prevention and control of NCDs and add indicators related to NCDs and its risk factors will be help, but if there is any further guideline that can I adopt to implement in Indonesia will be better for community therapeutic treatment especially in NCDs.   

REFERENCES

Abubakar, I. I., Tillmann, T., & Banerjee, A. (2015). Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 385(9963), 117-171.

Hogerzeil, H. V., Liberman, J., Wirtz, V. J., Kishore, S. P., Selvaraj, S., Kiddell-Monroe, R., ... & Lancet NCD Action Group. (2013). Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN political declaration. The Lancet, 381(9867), 680-689.

Vineis, P., & Wild, C. P. (2014). Global cancer patterns: causes and prevention. The Lancet, 383(9916), 549-557.

WHO. (2015). Report of the 2015 Global NCD Survey. Jenewa : WHO ISBN 978 92 4 156536 3