Subregional Meeting
Download
1 / 52

Overview - PowerPoint PPT Presentation


  • 325 Views
  • Updated On :

Subregional Meeting of Representatives and Directors from Central America, Cuba, the Dominican Republic, Haiti, Mexico, and the US-Mexican Border Field Office Session 5:  Noncommunicable Diseases (Belize, 12–16 February 2007). Overview. Global situation

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Overview' - victoria


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.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Slide1 l.jpg

Subregional Meetingof Representatives and Directors from Central America, Cuba, the Dominican Republic, Haiti, Mexico, and the US-Mexican Border Field Office

Session 5: Noncommunicable Diseases

(Belize, 12–16 February 2007)


Overview l.jpg
Overview

  • Global situation

  • National Capacity Survey forCentral America

  • Review of effective interventions

  • Regional Strategy and Plan of Action

  • CAMDI Initiative

  • PAHO Actions

  • Next Steps


Global situation l.jpg
Global Situation

Chronic diseases are the major cause of death in almost all countries!

60% of all deaths are due to chronic diseases.

Over 35,000,000 people will die from chronic diseases in 2007.


Global situation 2 l.jpg
Global Situation 2

The poorest countries are the worst affected!

80% of chronic disease deaths will occur in low- and middle-income countries.

The problem has a serious impact.


Global situation 3 l.jpg
Global Situation 3

  • The risk factors are widespread.

  • The threat is growing.

  • 1,000,000 people are overweight or obese.


Source who preventing chronic diseases a vital investment l.jpg
Source: WHO, Preventing Chronic Diseases, A Vital Investment.


Global situation 4 l.jpg
Global Situation 4

  • The global response is inadequate.

  • 388,000,000 million people will die in the next 10 years of a chronic disease.


Global situation10 l.jpg
Global Situation

  • The major causes of chronic diseases are known.

  • At least 80% of heart disease, stroke and type 2 diabetes, and 40% of cancer can be prevented.

  • A full range of cost-effective interventions exist for all regions of the world. Many are inexpensive.

  • We must strike a new balance of prevention and control.



National capacity survey central america12 l.jpg
National Capacity Survey.Central America

  • Deficient areas

    • Financial resources.

    • Quality of care / Monitoring System

    • National health-reporting system, surveys and surveillance.

    • National community-based demonstration program.


What works l.jpg
What works?

  • A small shift in average population levels of several risk factors can lead to a large reduction in chronic diseases.

  • Population-wide approaches form the central strategy for preventing and controlling chronic disease epidemics, but should be combined with interventions for individuals.

  • Many interventions are not only effective, but suitable for resource-constrained settings.


Review of effective interventions l.jpg
Review of Effective Interventions

  • Laws and Regulations

  • Tax and Price Interventions

  • Improving the built environment for physical activity

  • Advocacy, communication and information

  • Community based interventions

  • School-based interventions

  • Workplace interventions

  • Screening - CVD, diabetes, HBP, some cancers

  • Clinical prevention: focus on overall risk

  • Disease Management

  • Rehabilitation

  • Palliative care


Health promotion strategies l.jpg
Health Promotion Strategies

  • Improve management of existing disease

  • Healthy public policy

  • Reorienting health services

  • Creating supportive environments

  • Strengthening community action

  • Developing personal skills

  • Building partnerships and alliances


Role of the health sector l.jpg
Role of the Health Sector

  • Advocacy at all times, by all health workers

  • Advances in disease prevention (primary, secondary and tertiary care)

  • Collaboration with partners in health promotion

  • Catalyst for human safety and development, working with “all of society”


Slide17 l.jpg
Regional Strategy and Plan of Action on an Integrated Approach to the Prevention & Control of Chronic Diseases


Goal indicator l.jpg
Goal Indicator

  • A 2% annual reduction in chronic disease death rates from the major chronic diseases, over and above current trends

  • Globally, to prevent 36 million deaths in the next 10 years


Slide19 l.jpg

Public Policy

To ensure and promote the development and implementation of effective, integrated, sustainable, and evidence-based public policies on chronic disease, their risk factors, and determinants.

Strengthen NCD public policy development


Slide20 l.jpg

Development & strengthening of chronic disease and risk-factor surveillance systems

Surveillance

To encourage and support the development and strengthening of countries’ capacity for better surveillance of chronic diseases, their consequences, their risk factors, and the impact of public health interventions.


Slide21 l.jpg

Health Promotion & Prevention risk-factor surveillance systems

To foster, support, and promote social and economic conditions that address the determinants of chronic diseases and empower people to increase control over their health and to adopt healthy behaviors.

Tobacco, Alcohol, Diet & Physical Activity

Home, School, Community, Workplace


Slide22 l.jpg

Provide technical assistance to countries in the development, strengthening, implementation, and evaluation of their chronic- disease programs

Integrated NCD Management

To facilitate and support the strengthening of the capacity and competencies of the health system for the integrated management of chronic diseases and their risk factors.


Slide23 l.jpg

StepWise Implementation development, strengthening, implementation, and evaluation of their chronic- disease programs

Step 3: Desirable

Step 2: Expanded

Step 1: Core


Consultation for central america and mexico l.jpg
Consultation for Central America and Mexico development, strengthening, implementation, and evaluation of their chronic- disease programs


Consultation for central america and mexico25 l.jpg
Consultation for development, strengthening, implementation, and evaluation of their chronic- disease programsCentral America and Mexico


Action at different levels in support of strategy in central america l.jpg
Action at Different Levels in development, strengthening, implementation, and evaluation of their chronic- disease programsSupport of Strategy in Central America

  • National Ministry of Health

    • Local and Municipal

    • PAHO/WHO Country Offices

  • Subregional, e.g. PAHO/INCAP, SICA, RESCA,

  • Regional, e.g. PAHO-Washington, OAS, Summits

  • Global, e.g. WHO-Geneva


What is available to us now l.jpg
What is available to us now? development, strengthening, implementation, and evaluation of their chronic- disease programs

  • Strategic partnerships:

    Interinstitutional: CDC, NHLBI, Canada, partnering universities, CIP, BID, World Bank,

    Networks: CARMEN, bicycle paths, fruits & vegetables, AMNET, RAFA

  • Political progress

    Tobacco: Ratification of the Framework Convention for Tobacco Control (FCTC)CARMEN Policy Observatory


What is available to us now28 l.jpg
What is available to us now? development, strengthening, implementation, and evaluation of their chronic- disease programs

  • Surveillance instruments

    Basic Data Initiative, Pan American STEPS

  • Scientific evidence

    Promotion & prevention: Healthy Lifestyles Project, Healthy People

    Integrated management & surveillance: Central American Diabetes Initiative (CAMDI), Veracruz Initiative for Diabetes Awareness (VIDA)

  • Capacity-building

    CARMEN School


What is available to us now29 l.jpg
What is available to us now? development, strengthening, implementation, and evaluation of their chronic- disease programs

  • Healthy food

    • 5-a-Day Initiative

    • Healthy Lifestyles Project

  • Physical Activity

    • Urban planning: Green spaces, safe streets

    • Alternative forms of transport: Bicycle paths

    • Agita (Move!) Movement in São Paulo (RAFA-PANA)

    • ActiveCities Contest, Healthy Cities Project

http://www.ciudadhumana.org/concursociudades/index.htm


Slide30 l.jpg

http://www.dpaslac.org/ development, strengthening, implementation, and evaluation of their chronic- disease programs


Slide31 l.jpg

1 development, strengthening, implementation, and evaluation of their chronic- disease programs

Design

Final evaluation & sharing lessons learned in Latin America.

Lessons learned

and

final evaluation

About the

Campaign

Initial stage of the campaign, starting between July and August 2006.

5

2

Launching &

partnerships

Between September 2006 and February 2007, campaign media messages will scale up and the scope of activities to promote the campaign will be broadened.

Identification ofBest Practices

3

4

Country activities

From March–October 2007, the countries will start to act. The Roadshow & Best Practices Contest will be part of the regional activities.


Slide32 l.jpg

Central American Diabetes Initiative development, strengthening, implementation, and evaluation of their chronic- disease programs


Camdi workshops l.jpg
CAMDI Workshops development, strengthening, implementation, and evaluation of their chronic- disease programs

I: San Salvador, March 8-9, 2000

II: Tegucigalpa, November 13-14, 2000

III: Guatemala City, August 12-14, 2002

IV: Tegucigalpa, July 8-9, 2003

V: Montelimar, Nicaragua April 29-30, 2004

VI: Miami, FL, May 4-5, 2005

VII: Jacó, Costa Rica, March 13-15, 2006

VIII: Panama City, November 28-29, 2006


Main camdi results population based survey of chronic diseases and their risk factors l.jpg

Main CAMDI Results: development, strengthening, implementation, and evaluation of their chronic- disease programs Population-Based Survey of Chronic Diseases and Their Risk Factors

Preliminary Results


Slide35 l.jpg

Sample Size, Survey Participants Tested by Country: development, strengthening, implementation, and evaluation of their chronic- disease programs The CAMDI 1 Study


Slide36 l.jpg

Results of the Risk-Factor Survey, 2003–2006 development, strengthening, implementation, and evaluation of their chronic- disease programs


Slide37 l.jpg

Hypertension development, strengthening, implementation, and evaluation of their chronic- disease programs


Slide38 l.jpg

Diabetes Mellitus development, strengthening, implementation, and evaluation of their chronic- disease programs


Camdi quality of care for chronic diseases l.jpg

CAMDI: development, strengthening, implementation, and evaluation of their chronic- disease programsQuality of Care for Chronic Diseases

Quality of Diabetes Care: Preliminary Analysis

Quality of HypertensionCare:In progress


Methodology l.jpg
Methodology development, strengthening, implementation, and evaluation of their chronic- disease programs

  • Medical chart review

  • Primary, secondary and tertiary care clinics

  • Centers selected by national teams

  • Standardized data collection

  • Records randomly selected


Slide41 l.jpg

Use of Medication by Country development, strengthening, implementation, and evaluation of their chronic- disease programs


Slide42 l.jpg

Proportion of Records with A1c Results, and Information on Blood Pressure and Height, by country


Slide43 l.jpg

Proportion of Patients with Documented Blood Pressure and Height, by countryFoot and Eye exam, by country


Slide44 l.jpg

Glycemic* and Blood Pressure and Height, by countryBlood Pressure** Control, by country

* A1C<7 or fasting glucose<130 ** BP<140/90


Slide45 l.jpg

Adjusted* Proportion of Cases with Blood Pressure and Height, by countryGood Glycemic Control, by Country

  • * Adjusted by age, gender, type of clinic and insulin use;

  • ** Glycated hemoglobin (A1c) < 7% or Fasting Blood Glucose < 130 mg/dl


  • Progress report l.jpg
    Progress Report Blood Pressure and Height, by country

    • Multicenter analysis in progress.

    • Final report for Guatemala City survey being published.

    • Peer-reviewed papers on the methodology and prevalence of DM in progress.

    • QUALIDIAB Final Report circulated (Guatemala, Honduras, Nicaragua, El Salvador, Costa Rica).


    Progress report47 l.jpg
    Progress Report Blood Pressure and Height, by country

    Health Technology Assessment finished.

    Qualitative analysis: Focus group results available for Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua.

    Intervention started in Costa Rica.

    QUALIHIPER data collection in progress.


    Camdi 2 quality of care and health promotion l.jpg
    CAMDI 2: Quality of Care and Health Promotion Blood Pressure and Height, by country

    Intervention about to start in El Salvador, Guatemala, Honduras and Nicaragua.

    Grant obtained from WDF.

    CAMDI 3: Surveillance System

    • Expansion to national survey using STEPS Centroamericano.

    • Extension to continuous surveillance.

    • New grant from CDC.


    Actions l.jpg
    Actions Blood Pressure and Height, by country

    • Internal and external partnership to mobilize support.

    • Inter programmatic group under Assistant Director.

    • Technical advisory group to give scientific guidance.

    • Permanent Forum on Chronic Diseases.

    • Refreshing CARMEN vision and mission.

    • Accompanying CCS processes with the Country Support Unit (CSU).


    Actions50 l.jpg
    Actions Blood Pressure and Height, by country

    • Regional level

      • Surveillance STEPs

      • Policy and Advocacy

      • Prevention and Promotion

      • Integrated Management

      • Cancer

    • Supportive Strategies

      • Communication strategy

      • Resource mobilization


    Next steps l.jpg
    Next Steps Blood Pressure and Height, by country

    • Advocacy and collaboration at national and subregional levels.

    • Integrated approach to the double burden of undernutrition and overnutrition.

    • Improving implementation of current plans, projects, support to countries.

    • Planning for chronic disease in BPB 08-09.

    • Technical Cooperation in the Countries (TCC) project possibilities.


    Slide52 l.jpg

    Conclusions Blood Pressure and Height, by country