7TH – 12TH MARCH 2011 LAUSANNE , SWITZERLAND 4th International Seminar on Epidemiology and Public health Aspects of Non communicable Diseases 7TH – 12TH MARCH 2011 LAUSANNE , SWITZERLAND The Gambia NCD Situation By Mr OMAR BADJIE NATIONAL NCD FOCAL POINT, MOH&SW

COUNTRY PROFILE Projected Population: 1, 500,000 (2003 census) Population Density: 128 person/Sq. KM Annual Growth Rate: 2.74% Crude Birth Rate: 46% Total Fertility Rate: 5.4 Adult literacy rate is 62.2 (GBoS, 2003) 61% of population live below poverty line (2003 census) < 15 years constitute about 44% Women population: 51% Rural Population: 60%

HEALTH SYSTEM Three-tier system Five Directorates Primary Level (492 PHC Villages, ) Secondary Level (32 Minor H/C, 6 Major H/C) Tertiary Level ( 4 General Hospitals, 1 Teaching Hospital) Five Directorates Health Services Planning & Information Social Welfare Food Hygiene and Safety National Public Health Laboratory Six Health Regions (RHTs)

HEALTH INDICATORS Maternal Mortality Rate: 730/100,000 LBs Neonatal Mortality: 28/1000 Infant Mortality: 75/1000 LBs Under Five Mortality: 99/1000 Child Mortality: 135/1000 Immunisation Coverage: 89.2% (MICS 2006) Life Expectancy: 65yrs (female), 63yrs (male) HIV Prevalence Rate: 2.8% (2007)

NCD SITUATION DIABETES MELLITUS adult urban population - 8.6% adult rural population - 1.4% CANCERS cervical cancer(9.4/100,000 liver cancer in men 19.2/100,000 liver cancer in women 5.9/100,000 HYPERTENSION 24.2% of the adult population Mental health disorders- prevalence 20 % Road traffic injuries- average 1000/yr

NCD RISK FACTOR SITUATION (WHO STEP SURVEY 2010) About 2% of the adult population, aged 25 – 64 years, drink alcohol Low consumption of fruits and vegetables, with the average mean number of days for fruits and vegetable consumption among adult males and females estimated at 3.3 and 5.0 respectively

NCD RISK FACTOR SITUATION CONT’D About 22% of the adult population (males and females) have a low level of physical activity, whilst nearly 59% of adults do not engage in rigorous physical activity. on average, Gambian adults spend 231 minutes per day on sedentary activities On average, 41.4% of adult Gambians never had their blood pressure tested.

NCD RISK FACTOR SITUATION CONT about 24.4% of the adult population have raised blood pressure (25.5% for men and 23.4% for women) About 90.5% of adults (92.1% of men and 89% of women) never had their blood sugar tested About 39.5% of the adult population (33.7% for men and 45.3%) are considered overweight with mean BMI >25kgM2

CURRENT ACTIVITIES Finalizing Integrated National NCD Policy & Action Plan Finalizing WHO Step Survey Report for 2010 Routine Sensitization Campaigns on (radio, TV etc) Mobilizing & Strengthening inter-sectoral action for NCD prevention Advocacy for NCD prevention and control Training of Drama groups , TCs & peer Health Educators. School Health programmes Community outreach programmes

CONSTRAINTS Building human capacity for the prevention and control of NCDs in The Gambia. Establishing National Programme for NCD prevention and control Limited trained staff on NCDs in the Public & Private Sectors No NCD Policy and Action Plan No National Budget for NCD Prevention and Control Limited Logistics for monitoring and implementation of NCD activities

challenges Addressing the limited human resource capacity for NCD prevention and control. Prioritizing NCD prevention and control like other diseases e.g Malaria, TB, HIV/AIDS etc Securing high level political commitment for NCD prevention and control. Bridging the treatment gaps

Challenges cont Support for the finalization of policy and strategic plan for NCDs.  Support for transport to facilitate Monitoring and evaluation. Resource mobilization for NCD prevention and control Fostering and sustaining public and private sector collaboration.

Challenges Con’t Enhancing political commitment for NCD prevention and control   Effective monitoring of NCD activities in The Gambia Decentralization of NCD treatment Finalization of national NCD policy and Action plan

Priority Areas for Action Establishment of NCD unit within MOH&SW Strengthening advocacy & Social Mobilisation Fostering intersectoral collaboration Human resource development Community participation & empowerment Strengthening research and knowledge management on NCDs

cont Finalisation of both the NCD Policy & Step Survey report. Strengthening the Primary prevention of NCD

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