NCD PRESENTATION: JAMAICA PRESENTER: DR. MARCIA GRAHAM 1

Prevalence of NCDs in Jamaican 15 – 74 years old Rationale In the past 25 years, we had an epidemiological shift in morbidity and mortality from communicable to chronic non-communicable diseases (NCDs). NCDs account for 56% of deaths in Jamaica 2001: economic cost of DM/HTN- US$460.4 million Prevalence of NCDs in Jamaican 15 – 74 years old Disease Condition JHLS- 2000 JHLS 2- 2008 Diabetes Mellitus 7.2 7.9 Hypertension 20.9 25.2 Pre-hypertension 29.9 35.3 High Cholesterol 14.6 11.7 Physical Inactivity 17.4 29.5

Risk factors – Unhealthy Diet Meat preparation: Frying - 31.7% adults, 15-19yrs - 55% > 90% Jamaicans eat less than 3 servings of either fruits or vegetables in a day In 15-19 year olds: 18% - vegetables at or above optimal levels; 41% - fruit at or above optimal levels (CFNI RDA) 98% kids 10-15 yrs had soft drinks within usual week Risk factor -Tobacco use ADULTS (15-74yrs): 14.5% current smokers in 2008 CHILDREN (13-15yrs): 17% current smokers in 2006 CHILDREN 10-15yrs that ever smoked: 10% CHILDREN 15-19yrs that ever smoked: 22% Frying most frequent method of preparing meat (46%) 3

I. Public Policy and Advocacy Key strategies: Advocacy for Policy Changes and Development of Effective Policy Create Multi-sectorial Partnerships and Networks for Chronic Diseases Advocate for the establishment of a National Chronic Disease Commission Establish National Taskforce on NCD & Injuries Approve and disseminate Cervical Cancer prevention and control guidelines Review cancer prevention and control policy Update Diabetes and Hypertension management guidelines

II. Surveillance, Monitoring and Evaluation and Research Key strategies: Build capacity for Chronic Disease Information generation and utilization Partnership with Key Stakeholders Implementation of National Surveillance system for NCDs. National KAP Survey on NCDs and their risk factors Cancer research Support Salt Research project Identify and support NCD related research.

III. Risk Factor Reduction and Health Promotion Key strategies: Build capacity for community-based actions Development of population wide interventions Create multi-sectorial partnerships and networks for chronic diseases KEY AREAS: PORT OF SPAIN DECLARATION No tobacco, no harmful use of alcohol Healthy eating (including elimination of trans fat, reduce intake of sugar, fats & salt) Increased PHYSICAL ACTIVITY Community-based programmes especially in schools, workplaces and faith-based settings (Heart Foundation, Cancer Society, CHASE, NHF) Violence prevention interventions (grief counselling)

IV. Integrated Management of Chronic Diseases and Risk Factors Key Strategies: Strengthen Health Services for Integrated Prevention and Management of Chronic Diseases. Reinforce the Competencies of the Health Care Workforce for Chronic Disease Prevention and Management. Continue implementation of Chronic Care Model (CCM) & Model of Improvement (MI) – Diabetes Project and applying this approach to Hypertension & Cervical Cancer Implementation of Chronic Diseases Passport & other useful tools from the Project Implement screening programme for metabolic syndrome

V. Programme Administration and Capacity Building Key strategy: Strengthen of Health System to support the scaling up of Chronic Disease Prevention activities National Strategic Plan for the prevention and control of NCDs and their risk factors Establish National Regional Coordinators TWG: done Establish MoH- Head Office TWG on NCD Training of Lay Diabetes Educators & Health Promoters Establish NCD section of new MoH Epi Unit Assess and advocate for resources, infrastructure, financing for NCD and prevention of risk factors

STRATEGIES TO OVERCOME CURRENT DIFFICULTIES Try to improve documentation of the magnitude of the problem & contributory factors Screening at every opportunity Lobbying for healthier ‘fast food’ options Advocate for improved manpower, materials, drug supply & remuneration Chronic Diseases Passport to aid tracking and better coordinate care Encouraging individuals to take PERSONAL responsibility for their health

Media Campaign Physical Activity: ‘Mek Wi Move’ Educational materials Billboards on Wheels – Adverts. Educational Materials SKIP: Setting Knowledge Into Practice 10

Camp Yellow Bird helping children live with diabetes Teens ‘R’ Terrific Camp for adolescents Camp Yellow Bird helping children live with diabetes Healthy zone Healthy Lifestyle school choir

THANK YOU!