Ran Annim Moria Shomour Chuuk NCD Coordinator

The Chuuk Declaration

What has happened after the Chuuk declaration? We have identified that food insecurity was another problem contributing to ncds Chuuk director request assistance from WHO thru FSM Health & Social Affairs to conduct a food summit. October 2012, Food Security and NCD Stakeholders Meeting conducted by Richard Hoes

Food Security & NCD Stakeholders Consultation Meeting Chuuk is facing a double burden of malnutrition with the co-existence of under-nutrition and obesity within the state as well as within households and communities. the urgent need to map out actions and mobilise resources to address the growing burden of NCDs and to look at measures in place in Chuuk to control and manage NCD risk factors Unhealthy diets and food insecurity has been identified as one of the main risk factors to NCDs With the FSM National Food Security Policy and NCD Strategy it is an opportunity to plan on implementation of the two issues at state level

Chuuk NCD Strategic Action Plan 'ONLY IN CHUUK (OIC)’ NCD EMERGENCY RESPONSE TOWARDS A HEALTHY CHUUK STATE Action Plan 2011-2015

Chuuk NCD Plan of Action I Advocacy and Coordination of NCD Government and public sectors Hospital and Dept of Health II Food Security (Nutrition and Physical Activity) Salt Reduction, Fruits and vegetables promotion, Physical Activity Policy & Legislation Strengthening Community Action School, Workplace, Church & Villages III Tobacco & Alcohol Control) Policy, legislation, taxation Cessation initiatives IV Primary Health Care and NCD Strengthening Primary and secondary health services Community Mobilization V Monitoring, evaluation & surveillance NCD STEPS and Mini-STEPS Vital Registration

Tobacco, Alcohol & Betel Nut Free Hospital Gov. Johnson declared hospital tobacco, alcohol & betel nut free environment On the premises, including hospital vehicles (on and off the premises)

Governor Elimo With Director Marar Opened New Chuuk Wellness Center (Supported by Chuuk Health Sector Grant FY2011)

Inside the Wellness Center

Services offer at the Wellness Center NCD Screening NCD Counseling/education Exercise

Healthy Workforce Program Launched Within the Department Of Health

Basic NCD Registry is in place

Monthly walkathon

Health Promoting Schools

School Outreach School garden NCD Education

“Apach” meeting Adopt a Community Project Climate Change Meeting NGO ( CWC)

Promote fruits & vegetables at department functions.

Promote Gardening Home Garden Hospital Garden Home Garden

NCD Multidisciplinary Committee Provide evidence based medical care for NCD patients (core mission) Develop an evidence based best care process for diabetes type II (Done!) Support in everyway possible the development of an information system for clinical care and data analysis Identify specific goals based on evidence based guidelines that can be monitored by available data. Partner with government and civic groups to work on prevention and screening NCD programs Forum to resolve on-going operational issues between organizations

Diabetes Guideline for HAs

Diabetes Care Process

NCD Policies????? Bill introduce within the house of senate to ban tobacco products still pending Clean indoor Act passed by house of representative and now at house of senate Working our ways to win the support from our policy makers

Environmental Protection Agency Rotary Agriculture NCD Team National State govt Chuuk Women's Council Land grant DOE Environmental Protection Agency Rotary Agriculture Chuuk Medical Association Legislators Chuuk Nurse's Association Chuuk Conservation Society/ Climate Change YOUTH Religious groups Recreation HOOPS n Other NGOs