NON COMMUNICABLE DISEASES NORTH -WESTERN PROVINCE
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NON COMMUNICABLE DISEASESNORTH -WESTERN PROVINCE
Dr.M.D.S.RAJAMANTHRIE DPDHS Kurunegala
Dr. D.I.WIJAYAWARDANAMedical Officer Planning PDHS Office
212th Dec 2005
NCD -The world situation
Situation in Developing Countries
South-East Asia
NWP- Kurunegala District
Problems identified- causes & effects
Policy Vision Mission Objectives Strategies Options
FOCUS
312th Dec 2005
World situation
Mortality 60%
Morbidity 47%
75% of deaths in developing countries
NON COMMUNICABLE DISEASES
412th Dec 2005
South East Asia region including Sri Lanka
Mortality 51% Morbidity 44%
Increase- in alarming proportions
Double burden of communicable & Non communicable diseases
512th Dec 2005
NCDs & all causes of Hospitalization Kurunegala district 2004
NCDs41%
All causes59%
NCDs All causes
Source: IMMR-2004
612th Dec 2005
Major causes of NCDs admitted to hospitals in Kurunegala District 2004
17%
11%
6%
4%
3%
59%
Traumaticinjuries
Diseases of theRes. System
Diseases of theGIT
Diseases of theMus.Ske.sys. &conne.tissue Hypertension
All other causes Source: IMMR-2004
712th Dec 2005
Diseases of the Diseases of the Respiratory systemRespiratory systemTraumatic InjuriesTraumatic Injuries
52% Asthma52% Asthma
LEADINGLEADING HOSPITAL ADMISSIONSHOSPITAL ADMISSIONS
DISEASES OF THE GITDISEASES OF THE GIT
812th Dec 2005
NCDs & All causes of hospital mortality Kurunegala District-2004
54%
46% NCDs
All other causes
Source:IMMR 2004
912th Dec 2005 Source: IMMR-2004
1012th Dec 2005
DISEASES OF THE GITDISEASES OF THE GIT CEREBRO VASCULAR CEREBRO VASCULAR DISEASESDISEASES
DISEASES OF THE DISEASES OF THE RESPIRATORY TRACTRESPIRATORY TRACT
75% ALCOHOLIC LIVER 75% ALCOHOLIC LIVER DISEASEDISEASE
31% ASTHMA31% ASTHMA
LEADING CAUSES OF HOSPITAL DEATHS
1112th Dec 2005
All Poisoning Rate 2004
Kurunegala Puttlam
Cases Deaths Cases Deaths
420.2 19.1 282.9 4.0
Per 100,000 populationPer 100,000 population
All poisoning rate Sri Lanka 256.9/100,000 population (2002)
1212th Dec 2005
DRUG ABUSE TREATMENT ADMISSIONS BY DISTRICT 1996-2000 ( N = 25)
0
1
2
3
4
5
6
7
8
Kurunegala Ratnapura Kandy
1996
1997
1998
1999
2000
GallePutt. Kalutara
Source:National Dangerous Drug control Board
% A
dmis
sion
s
1312th Dec 2005
Mental & Behavioural Disorders - 2004
Mental & Behavioural disorders
Kurunegala
cases
Puttalam
cases
Due to Alcohol 752 244
Due to other psychoactive substance use
213 29
Source:DPDHS Kurunegala & Puttalam
1412th Dec 2005
Number of Thalassaemia Patients registered and Deaths reported(Period 1994-until 01.09.2005)
District Reg. patients Reported Deaths
Kurunegala
Puttlam
Anuradhapura
Matale
Other Districts
356
25
47
39
48
45
03
05
05
02
TOTAL 515 60
Thalassaemia Registry-PH.Kurunegala
1512th Dec 2005
360
57
294
72
382
61
454
60
739
97
0
100
200
300
400
500
600
700
800
Num
ber
2000 2001 2002 2003 2004
Year
Hospitalization and Hospital deaths due to Renal Failure Kurunegala District2000-2004
Cases Deaths
Source: IMMR 2004
1612th Dec 2005
Allocation and the estimate of drugs
Kurunegala District YEARS ALLOCATION
Rs Millions *ESTIMATE
Rs Millions
COST of actual amount of drugs received
2003 125 191 77 million
2004 125 120.8 80 million
2005 126 143.7 97.6 million
(Until30.09.2005)
Source:Divisional Pharmacist Unit, DPDHS, Kurunegala
1712th Dec 2005
Population & Population Growth- 2001 Census
District Population in ‘000
Growth rate%
Population
>60yrs.(2001)
Sri Lanka
Kurunegala
Puttlam
19,253
1,491
744
1.1
0.9
1.8
9.3
9.7
7.5
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Problems IdentifiedCauses Ageing of the population Changes in the social, economic and cultural pattern
of living that contribute to elevated risk of NCD
Unfavorable effects -Urbanization, Industrialization, Mechanization and Migration of the people
Lack of concern on Prevention and health promotion strategies
Inadequate recognition of the impact of NCDs on economic development.
1912th Dec 2005
Effects
Premature mortality/long term disability/Dependency on treatment
Limitations/modifications to the patient’s normal life & Patient dis-satisfaction
Imbalance to the family economy, life style, social and structural disruptions and even psychiatric illnesses
Over crowded hospital clinics Increased Hospital admissions
High health costs - drugs, technology, infrastructure, trained man power
Increased burden at 2ry and tertiary care hospitals
Economic loss to the country
2012th Dec 2005
Vision
To build a healthier population in the North Western Province that contributes the nation in its social and economic development.
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Mission
To adopt feasible, cost effective policies and strategies for the prevention and control of non communicable diseases of major importance to public health in the province.
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Policy goal
To reduce the morbidity and premature mortality related to major non communicable diseases.
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Policy objectives
Strengthen provincial/District capacities to develop efficient strategies and models for intervention and working partnerships for controlling major non communicable diseases.
Establish Primary prevention and health promotion aimed at fostering healthy lifestyle among the population.
Improve patient care management and rehabilitation of patients with major NCDs.
Establish epidemiological surveillance system for NCDs and their risk factors within the framework of National Surveillance System.
2412th Dec 2005
Policy strategies
Establishment of mechanisms to strengthen intra-sectoral and inter-sectoral co-operation and collaboration on prevention of NCDs.
Promotion of healthy life style to prevent major NCDs through holistic approach to health in the province.
Improved patient care management and rehabilitation of patients with non communicable diseases.
2512th Dec 2005
Cont…..
Prohibition of inaccurate/wrong /mis information on alcohol, tobacco and food items from all government & private places and mass media.
Revise and strengthen the existing policy on import/sale/publicity on alcohol, tobacco and other related substances and
not facilitate/promote/market such substances/products by the government.
2612th Dec 2005
Policy Options
NCD prevention and control Establishment of working partnership in the
province - ?
Primary prevention, secondary prevention and health promotion - ?
Improve patient care management and patient rehabilitation - ?
2712th Dec 2005
THANK YOU