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Achievements of Mauritius

Achievements of Mauritius. Seychelles Declaration - 2006 Cap Verde Declaration - 2009. Strengthening emergency preparedness and response to the health aspects of natural disasters and epidemics. National Disaster and Preparedness Committee – High level Chaired ( PMO/ Sec to Cab)

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Achievements of Mauritius

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  1. Achievements of Mauritius Seychelles Declaration - 2006 Cap Verde Declaration - 2009

  2. Strengthening emergency preparedness and response to the health aspects of natural disasters and epidemics • National Disaster and Preparedness Committee – High level Chaired ( PMO/ Sec to Cab) • Health Disaster & Preparedness Committee at level of MOHQL – Chaired by DGHS

  3. The Health Disaster Preparedness & Response Committee • Various Heads of Section Terms of Reference : 1.To validate the P&R plan 2.To activate & implement the plan. 3.Establish intersectoral collaboration

  4. Terms of Reference ( ctd ) 4. Promulgation and Enactment of any Legislation concerned with disaster management 5. Ensure availability of resources 6. Set up a communication unit 7. Training of staff

  5. Operation • Emergency Response Team in each of the 5 Health Regions • An Emergency Response Plan for each Regional Hospital • Capacity Building in collaboration with WHO/ Technical Assistance • Regular meetings • Regular mock exercise • Mechanism set up to call meetings of both of Health Disaster Committee and Response Team to meet at short notice and implement emergency plan.

  6. Emergency Plans • Cyclone • Mass Casualty • Emerging Communicable Diseases ( AH7N9, Chikungunya, Dengue...) • Other Natural Disasters ( Flood, Tsunami...)

  7. Comprehensive and integrated,multisectoral approach to face the increasing problem of drug and, tobacco use and alcohol abuse particularly among the youth • Tobacco - Mauritius signed FCTC on 17 June, 2003 • Mauritius ratified the FCTC on 17 May 2004 - Developed and implemented a National Action Plan on Tobacco Control 2008-2012. Plan 2013 – 2016 currently being finalized - Pass the Public Health (Restrictions on Tobacco Products) Regulations 2008.

  8. The National Action Plan on Tobacco Control GOALS • to reduce tobacco use; • to reduce exposure to tobacco smoke ; • to promote smoking cessation among smokers. Implementation nearly 100%

  9. The Public Health(Restrictions of Tobacco Products) Regulations 2008Main measures: • Ban advertisement, promotion and sponsorship • Protect from tobacco smoke • Reduce access to tobacco products (particularly to minors) • Control illicit trade • Control packaging and labeling • Penalties

  10. Mauritius Pictorial Health Warnings: • Mauritius: first African country to implement pictorial health warnings • Among country to have largest total surface covered by health warnings (65%) • International request for Mauritius health warnings (Togo, Iran, Russia)

  11. Outcomes • Reduction in tobacco consumption from 1.3 billion sticks in 2009 to around 1 billion sticks in 2012. • Information and education of the public • More anti-tobacco programmes in schools • Regular increase in price of tobacco products • Setting up of smoking cessation clinics ( 7 clinics are operational) • Monitoring and research

  12. ALCOHOL • PUBLIC HEALTH (PROHIBITION ON ADVERTISEMENT, SPONSORSHIP AND RESTRICTION ON SALE AND CONSUMPTION IN PUBLIC PLACES, OF ALCOHOLIC DRINKS) REGULATIONS 2008 • National Action Plan on Harmful Use of Alcohol – based on WHO Global Strategy on Harmful Use of Alcohol

  13. OBJECTIVES OF LEGISLATION • Restriction of alcoholic consumption in public places • Ban on advertisement and sponsorship related to alcohol drink • Ban on sale of alcohol to minors • Inclusion of “health warning” on labels of alcoholic drink • Separation of alcoholic drink on shelves at point of sales • New Penalties

  14. Objectives of Plan • To improve health and social outcomes for individuals, families and communities, • To reduce morbidity and mortality due to harmful use of alcohol and their ensuing social consequences. • To develop a mass communication strategy to vulgarize ill effects of alcohol/need to comply with legislation

  15. OUTCOMES • Yearly per capita consumption of alcohol has come down from 40.9 litres in 2009 to 38.0 litres in 2012 ( notwithstanding the fact that number of tourists visiting Mauritius has increased)

  16. DRUG • Body Corporate set up under Act of Parliament ( National Agency for Treatment and Rehabilitation of Substance Abusers Act); • Prevention of drug and substance abuse • Provide support in treatment of drug and substance abusers • Support NGOs in running of Rehabilitation Centres

  17. Challenges • Need to reinforce action to reduce supply • Need for multisectoral approach • Need to integrate drug addicts in the mainstream. • Strengthening Methadone Substitution Therapy as an exit • Development of a National Drug Control Master Plan ( to address both supply and demand) - CSR

  18. Health Sector Response to NCDs Adoption of the 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases as generic plan for Mauritius Development of National Service Framework for Diabetes ( NSFD ) (2007) National Nutrition Action Plan ( 2007-2010) (2013-2017 in preparation) Action Plan for Tobacco Control ( 2008 – 2012) 2013 – 2017 being finalized Action Plan for Cancer Control and Prevention ( 2011 – 2015) National Action Plan for Physical Activity ( 2007 – 2011) ( 2012 – 2016) National Strategy for Mental Health Action Plan for Cardiovascular Diseases ( in pipeline) Action Plan for Prevention of Harmful use of alcohol (Draft ready) Action Plan for Respiratory Diseases ( in pipeline) Strategy for Salt Intake ( in preparation)

  19. Research • NCD Surveys ( 1987, 1992, 1998, 2004 and 2009) • National Nutrition Survey in 2004 and 2012 • Salt Intake Study in 2012 • Trans fatty Acid in fast food and snacks in 2010 • Study on re-used oil in 2010 • Mauritius Type 2 DM Prevention Study ( 2012 to 2015) • DM Surveillance (1987 to 2004)

  20. National Service Framework for Diabetes (launched in 2007) Cases sent abroad for advanced Eye Surgery usually due to diabetes Ten Year Aims • To reduce new cases of blindness due to diabetes by one third or more • To reduce end-stage diabetic renal failure by at least one third • To reduce limb amputations for diabetic gangrene by one half • To reduce morbidity and mortality from coronary heart disease

  21. Tobacco Graphic Warnings - 2008

  22. A general decreasing trend has been observed in regards to first attendances at Primary Health Care Centres between 2006 and 2011 due to both diabetes (from 25,156 to 15,868) and hypertension (from 29,464 to 17,775) respectively.

  23. Trends in Cancer Incidence in Mauritius : ASR of incidence of cancers for 2005-2008 compared to 1997-2000

  24. National Cancer Control Programme Action Plan 2010-2014 The Objectives of the Mauritius Cancer Programme are: • 1. To prevent cancer through public education • 2. To reduce the morbidity and mortality due to cancer • 3. To promote early detection of cancer • 4. To provide adequate therapy • 5. To develop an effective palliative care service

  25. Some Measures For Cancer Care • Sensitization campaigns • National Cervical Cancer Screening Programme • Breast Examination and Breast Self Palpation • New Digital Colposcopy machines for treatment of cervical cancer. • New Cobalt machine for Radiotherapy • New Brachytherapy machine for cancer of the cervix. • Endoscopy equipment for detection of intestinal cancer.

  26. Some Measures For Cancer Care ctd.. • A New Children Cancer Unit with all facilities for chemotherapy was set up in 2008. • Decentralization of chemotherapy services • Molecular testing for Human Papilloma virus prior to considering vaccination for cervical cancer. • Two new digital mammography machines have been installed for screening and diagnosis

  27. Challenges • Ageing population – increase prevalence of NCDs • Multi ethnicity – complex human, social and economic issues. • Globalization – more exposed to unhealthy lifestyle • Strong lobbies like the food industry – fast food chains, resistance to reformulation of food items • Capacity building

  28. Recommendations • Identify and implement the ‘Best Buys’ • Set reasonable targets (bear in mind the limited resources in this region) • Develop an efficient NCD Surveillance System for each country • Encourage more regional collaboration. Learn from experiences of other countries. Exchange of expertise

  29. HIV/AIDS SITUATION IN MAURITIUS 1987 - 2012 5508 Mauritians 4375 M + 1333 F Sex Ratio M : F 3.9 : 1 623 death cases

  30. HIV/AIDS SITUATION IN MAURITIUS • Estimated prevalence of HIV in the population aged 15 -49 years : 0.97 % (2012). From 1.8% in 2008. • Estimated number of People Living with the Disease is between 8000 – 10,000

  31. Modes of transmission of new cases from 2000 to 2005

  32. RESPONSE TO THE EPIDEMIC • NATIONAL MULTISECTORAL HIV AND AIDS STRATEGIC FRAMEWORKS (2007 – 2012 & 2013- 2017) • Harm Reduction Strategy - METHADONE SUBSTITUTION THERAPY - NEEDLE EXCHANGE PROGRAMME • PUBLIC AWARENESS CAMPAIGNS • DECENTRALISATION OF HIV TESTING SERVICES AND FACILITIIES • DECENTRALISATION OF CARE & TREATMENT

  33. OUTCOMES • Following the introduction of Harm Reduction measures in 2006, transmission among the PWID steadily decreased to reach 68.1% of all detected cases in 2011.

  34. Average monthly of new cases dropped from 45 to about 27 cases as from 2011

  35. KEY OUTCOMES OF HARM REDUCTION MEASURES • Reduction of new HIV cases • Increased knowledge of PWIDS on safe injection drug practices • Prevalence of HIV infection among PWIDS – stable between 2009 to 2012 • Good Monitoring and evaluation system

  36. Challenges • 50% of cases need to be detected 10, 000 estimated cases – 5508cases reported • Follow up at National Day Care Centre treatment : 3811 but only 75 % compliance rate • estimated no of cases needing ARV treatment 2000-2500 • 50% on ARVs are diagnosed at AIDS Stage

  37. MALARIA • Last case of indigenous case of malaria in 1996 • An average of 40 imported cases of malaria yearly

  38. Eradication Plan • Surveillance • Intra-domiciliary spraying over a period of three years in all active foci. • Fogging operations in specific regions. • Larviciding. • Environmental management. • Strengthening of laboratory and entomology services. • Health Education. • Provision of logistic support.

  39. Challenges on SIDS Declaration • Identify weaknesses in terms of collaboration among SIDS member states to support each other in the implementation of declarations. For example : - Institutionalize SIDS Expert Technical Working Group with defined TOR. • Set up a mechanism for virtual networking among National experts (teleconference/intranet ...) • Formalize the cooperation with other organizations/network ( proposal of IOC to join WHO Afro SIDS Network)

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