Non Communicable Diseases

 

Country Situation

Sri Lanka has made impressive progress in control of communicable diseases, in improving maternal and child health, and virtually eliminating vaccine preventable diseases. Currently, chronic non-communicable diseases (NCDs) are overtaking communicable diseases as the dominant health problem, and are now the leading causes of mortality, morbidity, and disability. It has led to an increase in use of health resources. Aging of the population, urbanization and lifestyle changes are the key factors behind this epidemiological transition.

 

The following major chronic NCDs have a significant disease burden in Sri Lanka; cardiovascular diseases (including coronary heart diseases [CHD], cerebrovascular diseases [CeVD] and hypertension), diabetes mellitus, chronic respiratory diseases, chronic renal disease and cancers.

 

In 2001 chronic NCDs accounted for 71% of all deaths in Sri Lanka, compared with 18% due to injuries, and 11% due to communicable diseases, and maternal and prenatal conditions. Analysis of age- standardized data for 1991-2001 has shown that the chronic NCDs mortality is 20-30% higher in Sri Lanka than in many developed countries (WB ageing study 2008). Moreover, trend analysis suggests that NCD mortality rates have been rapidly increasing during the past decade (Register General, 2008).

 

Strategies

The following strategic areas are identified and prioritized for support in Non Communicable disease prevention and control:

1.      Support prevention of chronic NCDs by strengthening policy, regulatory and service delivery measures for reducing level of risk factors of NCDs in the population

2.      Implement a cost-effective NCD screening program at community level with special emphasis on cardiovascular diseases

3.      Facilitate provision of optimal NCD care by strengthening the health system to provide integrated and appropriate curative, preventive, rehabilitative and palliative services at each service level

4.      Empower the community for promotion of healthy lifestyle for NCD prevention and control

5.      Enhance human resource development to facilitate NCD prevention and care

6.      Strengthen national health information system including disease and risk factor surveillance

7.      Promote research and utilisation of its findings for prevention and control of NCDs

8.      Ensure sustainable financing mechanisms that support cost-effective health interventions at both preventive and curative sectors

9.      Raise priority and integrate prevention and control of NCDs into policies across all government ministries, and private sector organisations

 

NCD Activities

Tobacco Control and National Authority on Tobacco and Alcohol

In 2005, Sri Lanka was the first Asian country to adopt and ratify the Framework Convention on Tobacco Control (FCTC). In collaboration with the WHO and Bloomberg Global Tobacco Initiative, the focus of efforts in Sri Lanka have been to protect young people. Since passage of the National Authority on Tobacco and Alcohol (NATA) Bill (2007), tobacco control policies that have been developed include tax increases on cigarettes and tobacco products; restrictions on sales to youth; and restrictions on public and mass media advertising. Local control efforts include creation of district tobacco control cells with a lead role in implementing the provisions aimed at reducing tobacco use.

 

Clinical Guidelines for Care of Selected NCDs

The hospital efficiency and quality improvement component of the Sri Lanka Health Sector Development Program (a World Bank–financed project in 2005–2010) developed 93 clinical guidelines for care of selected conditions identified by teams of specialists from eight medical colleges (internal medicine, surgery, radiology, microbiology, gynecology and obstetrics, pediatrics, and anesthetics). These clinical guidelines should prove to be a major asset, and currently with the pilot PEN project underway these guidelines are being re visited to assess the applicability at the primary care level

 

Pilot Initiatives for NCDs

NCD Prevention Project (NPP) Project

This initiative is being supported by JICA and is currently being piloted in the Kurunegala and the Polonnaruwa districts

 

NIROGI Lanka Project

The National Initiative to Reinforce and Organise General diabetes care In Sri Lanka (NIROGI Lanka) is being supported by the World Diabetic Foundation. There are three components which include training of diabetic nurse educators, strengthening of primary care services and using of the health promotion approach to empower communities.

 

Package of Essential NCD Interventions in Primary Care in Low resource settings

The Package of Essential NCD (PEN) Interventions pilot is supported by the WHO. The package includes six core activities as well as plans to introduce comprehensive NCD care within the primary care settings and includes assessing human resource availability; providing NCD care knowledge updates for staff; assessing availability of essential equipment needs for NCD care; making necessary changes to the essential drugs list to include first line for NCDs; developing and applying 10-year CVD risk charts to clinic populations; and developing and introducing protocols for follow-up care and management of NCDs. This pilot is being conducted in the UVA province in the Badulla RDHS area and covers a total of 18 facilities within three MoH areas.

Some of Our Focus Areas

*      Chronic Kidney Disease

*      PEN

*      Tobacco Free Initiative

*      Healthy Ageing

 

Mental Health

*      Focus of WHO Sri Lanka on Mental Health

 

Events

*      Quality Improvement For Trauma Care – Sri Lanka

*      BUDGET 2011: A Positive Step Towards the Prevention & Control of Non Communicable Diseases

*      World Stroke Day 2010

*      World Diabetes Day 2010

*      ‘Life is for Living’ – Walk for Cancer