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Belize, Feb 2007. Worldwide Situation. The real reasons for endless maladies are known. ... Belize, Feb 2007. Incorporated NCD Management. To encourage and bolster ...
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Slide 1

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)

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Overview Global circumstance National Capacity Survey for Central America Review of viable intercessions Regional Strategy and Plan of Action CAMDI Initiative PAHO Actions Next Steps

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Global Situation Chronic infections are the real reason for death in all nations! 60% of all passings are because of ceaseless maladies. More than 35,000,000 individuals will kick the bucket from incessant illnesses in 2007.

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Global Situation 2 The poorest nations are the most noticeably awful influenced! 80% of interminable infection passings will happen in low-and center salary nations. The issue has a genuine effect.

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Global Situation 3 The hazard variables are broad. The danger is developing. 1,000,000 individuals are overweight or stout.

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Source: WHO, Preventing Chronic Diseases, A Vital Investment.

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Global Situation 4 The worldwide reaction is deficient. 388,000,000 million individuals will kick the bucket in the following 10 years of a constant sickness.

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Global Situation The real reasons for incessant illnesses are known. No less than 80% of coronary illness, stroke and sort 2 diabetes, and 40% of growth can be forestalled. A full scope of financially savvy mediations exist for all areas of the world. Numerous are cheap. We should strike another adjust of counteractive action and control.

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National Capacity Survey/Central America NOTE: X= NOT PRESENT

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National Capacity Survey. Focal America Deficient zones Financial assets. Nature of care/Monitoring System National wellbeing reporting framework, reviews and reconnaissance. National people group based exhibit program.

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What works? A little move in normal populace levels of a few hazard elements can prompt an expansive decrease in constant infections. Populace wide methodologies shape the focal technique for forestalling and controlling ceaseless sickness pandemics, however ought to be joined with intercessions for people. Numerous intercessions are compelling, as well as appropriate for asset obliged settings.

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Review of Effective Interventions Laws and Regulations Tax and Price Interventions Improving the fabricated environment for physical action Advocacy, correspondence and data Community based mediations School-based intercessions Workplace intercessions Screening - CVD, diabetes, HBP, a few tumors Clinical anticipation: concentrate on general hazard Disease Management Rehabilitation Palliative care

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Health Promotion Strategies Improve administration of existing malady Healthy open arrangement Reorienting wellbeing administrations Creating steady situations Strengthening people group activity Developing individual aptitudes Building associations and organizations together

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Role of the Health Sector Advocacy at all times, by all wellbeing laborers Advances in infection aversion (essential, auxiliary and tertiary care) Collaboration with accomplices in wellbeing advancement Catalyst for human security and advancement, working with "all of society"

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

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Goal Indicator A 2% yearly decrease in ceaseless illness passing rates from the major endless ailments, far beyond ebb and flow slants Globally, to counteract 36 million passings in the following 10 years

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Public Policy To guarantee and advance the improvement and usage of viable, coordinated, practical, and prove construct open arrangements in light of unending sickness, their hazard components, and determinants. Reinforce NCD open strategy improvement

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Development & fortifying of ceaseless malady and hazard calculate reconnaissance frameworks Surveillance To energize and bolster the advancement and reinforcing of nations\' ability for better observation of constant infections, their outcomes, their hazard elements, and the effect of general wellbeing intercessions.

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Health Promotion & Prevention To encourage, bolster, and advance social and monetary conditions that address the determinants of unending illnesses and engage individuals to build control over their wellbeing and to embrace solid practices. Tobacco, Alcohol, Diet & Physical Activity Home, School, Community, Workplace

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Provide specialized help to nations in the improvement, fortifying, usage, and assessment of their interminable malady programs Integrated NCD Management To encourage and bolster the reinforcing of the limit and abilities of the wellbeing framework for the incorporated administration of incessant infections and their hazard variables.

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StepWise Implementation Step 3: Desirable Step 2: Expanded Step 1: Core

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Consultation for Central America and Mexico

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Consultation for Central America and Mexico

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Action at Different Levels in Support 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

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What is accessible to us now? Key associations : Interinstitutional: CDC, NHLBI, Canada, banding together colleges, CIP, BID, World Bank, Networks: CARMEN, bike ways, natural products & vegetables, AMNET, RAFA Political advance Tobacco: Ratification of the Framework Convention for Tobacco Control (FCTC) CARMEN Policy Observatory

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What is accessible to us now? Observation instruments Basic Data Initiative, Pan American STEPS Scientific confirmation Promotion & aversion: Healthy Lifestyles Project, Healthy People Integrated administration & reconnaissance: Central American Diabetes Initiative (CAMDI), Veracruz Initiative for Diabetes Awareness (VIDA) Capacity-building CARMEN School

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What is accessible to us now? Solid nourishment 5-a-Day Initiative Healthy Lifestyles Project Physical Activity Urban arranging: Green spaces, safe avenues Alternative types of transport: Bicycle ways Agita (Move!) Movement in São Paulo (RAFA-PANA) Active Cities Contest, Healthy Cities Project http://www.ciudadhumana.org/concursociudades/index.htm

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http://www.dpaslac.org/

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1 Design Final assessment & sharing lessons learned in Latin America. Lessons scholarly and last assessment About the Campaign Initial phase of the crusade, beginning amongst July and August 2006. 5 2 Launching & organizations Between September 2006 and February 2007, battle media messages will scale up and the extent of exercises to advance the crusade will be widened. ID of Best Practices 3 4 Country exercises From March–October 2007, the nations will begin to act. The Roadshow & Best Practices Contest will be a piece of the territorial exercises.

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Central American Diabetes Initiative

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CAMDI Workshops 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: Jac ó , Costa Rica, March 13-15, 2006 VIII: Panama City, November 28-29, 2006

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Main CAMDI Results: Population-Based Survey of Chronic Diseases and Their Risk Factors Preliminary Results

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Sample Size, Survey Participants Tested by Country: The CAMDI 1 Study

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Results of the Risk-Factor Survey, 2003–2006

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Hypertension

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Diabetes Mellitus

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CAMDI: Quality of Care for Chronic Diseases Quality of Diabetes Care: Preliminary Analysis Quality of Hypertension Care: In advance

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Methodology Medical outline audit Primary, optional and tertiary care facilities Centers chose by national groups Standardized information accumulation Records arbitrarily chose

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Use of Medication by Country

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

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Proportion of Patients with Documented Foot and Eye exam, by nation

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Glycemic* and Blood Pressure** Control, by nation * A1C<7 or fasting glucose<130 ** BP<140/90

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Adjusted* Proportion of Cases with Good Glycemic Control, by Country * Adjusted by age, sexual orientation, sort of center and insulin utilize; ** Glycated hemoglobin (A1c) < 7% or Fasting Blood Glucose < 130 mg/dl

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Progress Report Multicenter investigation in advance. Last report for Guatemala City review being distributed. Peer-inspected papers on the procedure and predominance of DM in advance. QUALIDIAB Final Report coursed (Guatemala, Honduras, Nicaragua, El Salvador, Costa Rica).

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Progress Report Health Technology Assessment wrapped up. Subjective investigation: Focus aggregate results accessible for Costa Rica, El Salvador, Guatemala, Honduras, and Nicaragua. Intercession began in Costa Rica. QUALIHIPER information accumulation in advance.

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CAMDI 2: Quality of Care and Health Promotion Intervention going to begin in El Salvador, Guatemala, Honduras and Nicaragua. Give acquired from WDF. CAMDI 3: Surveillance System Expansion to national review utilizing STEPS Centroamericano. Augmentation to nonstop observation. New allow from CDC.

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Actions Internal and outer organization to activate bolster. Entomb automatic gathering under Assistant Director. Specialized consultative gathering to give exploratory direction. Perpetual Forum on Chronic Diseases. Reviving CARMEN vision and mission. Going with CCS forms with the Country Support Unit (CSU).

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Actions Regional level Surv

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