Emergence of Non Communicable Diseases in Sri Lanka Facing the Challenge Dr. Lakshmi C. Somatunga Director/Non Communicable Diseases Ministry of Health, Sri Lanka

Trends in Hospital Mortality (Deaths per 100,000 pop)

Demography Transition in the demographic profile Increasing trend in the proportion of the older age groups Median age 21.3 yrs until 1981 25.6 yrs by 1994 (Demo. Survey 1994) Life expectancy at birth 70.7 for males 75.4 for females

Life Style Changes in Sri Lanka Tobacco Use National level statistics –Around 25% prevalence among males < 1% among females (So far) Around 80% of smoked tobacco used as cigarettes

Life Style Changes in Sri Lanka continues; Diet Traditionally; Rice and curry are staples of the Sri Lankan diet; favorite dishes include "mallung," consisting of Greeny leafy Veg,coconut, red onions, and lime, The Trend; fast food chains, No cooking at home Increased consumption of animal fats Consumption of salty,sugary and fatty snacks

Do we eat adequate vegetables? Is it available at reasonable cost?

Do we have a habit of consuming fruits every day?

Food Consumption Pattern (Per capita per day) Wheat-based food Urban Rural 1978 348.6 301.9 1996 371.6 413.6 Meat 9.8 3.1 10.7 4.5 Eggs 3.9 2.2 6.9 4.6

Life Style Changes in Sri Lanka continues; Diet Consumption of Fruits (per day) 71% <1 serving 21% 1 serving 8% 2 or more (Survey by NCD Unit, Ministry of Health, 2003)

Life Style Changes in Sri Lanka continues; Physical Activity All occurring within a context of reduced levels of physical activity (Cricket is the trademark spectator sport. People keep watching for hours but, not engaged in sport for a few minutes)

Clean Air Those days in-built Physical Activity

Facing the challenge; Guiding Principle Prevention is the most cost effective way

Facing the challenge; Strategic Objective To promote healthy life style across the life span

To launch an integrated NCD prevention programme General Objective To launch an integrated NCD prevention programme in Sri Lanka

Key Result Areas Coordination between sectors Behavioral change among children Community, exposed to correct messages Quality of management of major NCD improved Systematic collection of information for action – Surveillance improved Demand for prevention is created

Routine Activities Achieved/On-going Establishment of a NCD prevention and control network Train professionals on issues related to tobacco Incorporate NCD prevention into existing school curriculum Mobilizing youth towards prevention of NCD Piloting the WHO Stepwise approach for NCD surveillance Strengthen health clubs in the schools Produce and distribute media materials on NCD prevention Tobacco & Alcohol bill passed in the parliament

Major Activities Establishment of a NCD surveillance mechanism (A national NCD risk factor survey is being conducted in Sept- Nov 2006 and thereafter to repeat in every 5 years) Launching of an island-wide Social Marketing Programme

Major Activities planned for year 2007; Formulation of National NCD Policy and Strategy Development of National Action Plan on Prevention and Control of major NCD Printing Text book insert for school children on promoting Healthy Lifestyle to prevent NCD

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