The Role of Health Care Providers in Managing Non-Communicable Diseases WHAT, WHY, & WHO Dr. I.F. Korubo MB.BS, FWACP, FACE, FCIA, Consultant Physician/ Endocrinologist Certified Diabetologist (St. Andrews University, UK) / Fellow, Institute of co-operative Administrators Honorary Doctorate (London Business School) / VP South-South Diabetes Association of Nigeria NMA NEC Chairman, Non-Communicable Diseases MD, St. Patrick’s Hospital Ltd.

Definition of Non-Communicable Diseases (N.C.D.) List NCD Outline What? Definition of Non-Communicable Diseases (N.C.D.) List NCD Brief description of each one Why? Statistics Disease epidemiology, age affected, mortality rate Who? Common management strategies

They are of long duration and generally may have a slow progression Introduction NCD, also known as chronic diseases are not passed on from person to person They are of long duration and generally may have a slow progression 4 main types: Cardiovascular diseases Cancers Chronic respiratory diseases (Asthma, COPD, etc) Diabetes Mellitus (DM)

Epidemiology Low income and middle income countries are most affected About 75% of NCD deaths (28 X 106) occur among these group NCDs kill 38 X 106 people each year 16 X 106 NCD deaths occur before the age of 70 82% of these premature deaths occurred in low and middle income countries Cardiovascular disease  17.5 X 106 deaths annually Cancers  8.2 X 106 deaths annually Respiratory diseases  4 X 106 deaths annually DM  1.5 X 106 deaths annually

Nigeria: W.H.O. Fact file in Nigeria

Nigeria: W.H.O. Fact file in Nigeria

Nigeria: W.H.O. Fact file in Nigeria

Forces driving these diseases include: Globalization Risk Factors Global phenomenon Often associated with older age groups but deaths are occurring in middle aged and young Forces driving these diseases include: Globalization Rapid unplanned urbanization Globalization of unhealthy life style

Modifiable Behavioral Risk Factors Tobacco use 6 X 106 deaths annually ↑↑ to 8 X 106 by year 2030 Physical Inactivity 3.2 X 106 deaths annually directly attributed to physical inactivity Harmful use of alcohol 3.3 X 106 deaths Poor Diet 1.7 X 106 in 2010  deaths due to excess salt usage

Resultant Effects of Risk Factors; High blood pressure Overweight/ obesity High blood glucose levels Dyslipidaemias

Socio-Economic Impact of N.C.D.s NCDs pose a serious threat to the sustainable development goals Rapid rise in NCDs is predicted to impede poverty reduction initiatives The “poor” get sicker and die sooner than the “privileged”. ↑ exposure to harmful products Unable to access health care Out of pocket expenditure

Prevention & Control of NCDs Health Care Provider (HCP): A doctor of medicine, dentist, nurses, clinical social worker, optometrist, etc That is authorized to practice by the state and performing within the scope of their practice as defined by the state law (Berkeley- University of California) For the purpose of this discussion, the scope of who a HCP will be widened. Anybody, people or establishment involved in providing healthcare for the people should be classified and are classified as HCP. This will include; Policy makers Regulatory authorities Financing bodies Agencies involved in infrastructure development- town planning People involved in oversight functions People involved in direct patient care

Health Finance Education Agriculture Parliament A Comprehensive approach is needed in preventing NCDs involving all sectors Health Finance Education Agriculture Parliament

↓ risk factors associated with NCDs Target of Prevention ↓ risk factors associated with NCDs MAP he epidemics of NCDs and their risk factors Primary health care approach (strategize early detection and timely treatment) Health public policies that promote NCDs prevention Health care system requires re-orientation ********** Health insurance scheme  Practicable & realizable

Data collection/ collation State focus point/ officer  N.M.A. State Effort NCD desk officers Data collection/ collation State focus point/ officer  N.M.A. ↑ tax on tobacco sale and alcohol Domicile NCDs at office of the Deputy Governor and SSG Better urban planning that takes health into consideration Global approach

Nigeria: NCD control programme National Effort Nigeria: NCD control programme WORKSHOP: Joint conduct of the analysis of non-communicable diseases prevention policies in Africa (ANPPA) final project report; Took place on 27th September 2016 at Abuja National NMA  National executive council committee on NCDs (Chairman, Dr. I.F. Korubo)

W.H.O. Efforts 2011 Global action plan for prevention and control of NCDs 2013 – 2020  ↓ deaths from NCDs by 25% by 2025 2018  U.N. general assembly- third high level meeting on NCDs to take stock of national progress in attaining the voluntary global targets

CONCLUSION The NCDs affect our development as a nation directly and indirectly If we are to achieve sustainable development goals then we must honestly tackle NCDs