1. 1 NON COMMUNICABLE DISEASES NORTH -WESTERN PROVINCE Dr.M.D.S.RAJAMANTHRIE DPDHS Kurunegala Dr. D.I.WIJAYAWARDANA Medical Officer Planning PDHS Office

2. 2 12 th Dec 2005 NCD -The world situation Situation in Developing Countries South-East Asia NWP- Kurunegala District Problems identified- causes & effects Policy Vision Mission Objectives Strategies Options FOCUS

3. 3 12 th Dec 2005 World situation Mortality60% Morbidity47% 75% of deaths in developing countries NON COMMUNICABLE DISEASES

4. 4 12 th Dec 2005 South East Asia region including Sri Lanka Mortality 51% Morbidity 44% Increase- in alarming proportions Double burden of communicable & Non communicable diseases

5. 5 12 th Dec 2005

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7. 7 Diseases of the Respiratory system Traumatic Injuries 52% Asthma LEADING HOSPITAL ADMISSIONS DISEASES OF THE GIT

8. 8 12 th Dec 2005 NCDs & All causes of hospital mortality Kurunegala District-2004 54% 46% NCDs All other causes Source:IMMR 2004

9. 9 12 th Dec 2005 Source: IMMR-2004

10. 10 12 th Dec 2005 DISEASES OF THE GIT CEREBRO VASCULAR DISEASES DISEASES OF THE RESPIRATORY TRACT 75% ALCOHOLIC LIVER DISEASE 31% ASTHMA LEADING CAUSES OF HOSPITAL DEATHS

11. 11 12 th Dec 2005 All Poisoning Rate 2004 KurunegalaPuttlam CasesDeathsCasesDeaths 420.219.1282.94.0 Per 100,000 population Per 100,000 population All poisoning rate Sri Lanka 256.9/100,000 population (2002)

12. 12 12 th Dec 2005 DRUG ABUSE TREATMENT ADMISSIONS BY DISTRICT 1996-2000 ( N = 25) Galle Putt. Kalutara Source:National Dangerous Drug control Board % Admissions

13. 13 12 th Dec 2005 Mental & Behavioural Disorders - 2004 Mental & Behavioural disorders Kurunegala cases Puttalam cases Due to Alcohol 752 244 Due to other psychoactive substance use 213 29 Source:DPDHS Kurunegala & Puttalam

14. 14 12 th Dec 2005 Number of Thalassaemia Patients registered and Deaths reported(Period 1994-until 01.09.2005) DistrictReg. patientsReported Deaths Kurunegala Puttlam Anuradhapura Matale Other Districts 356 25 47 39 48 45 03 05 02 TOTAL51560 Thalassaemia Registry-PH.Kurunegala

15. 15 12 th Dec 2005 Source: IMMR 2004

16. 16 12 th Dec 2005 Allocation and the estimate of drugs Kurunegala District YEARSALLOCATION Rs Millions *ESTIMATE Rs Millions COST of actual amount of drugs received 200312519177 million 2004125120.880 million 2005126143.797.6 million (Until30.09.2005) Source:Divisional Pharmacist Unit, DPDHS, Kurunegala

17. 17 12 th Dec 2005 Population & Population Growth- 2001 Census DistrictPopulation in ‘000 Growth rate% Population >60yrs.(2001) Sri Lanka Kurunegala Puttlam 19,253 1,491 744 1.1 0.9 1.8 9.3 9.7 7.5

18. 18 12 th Dec 2005 Problems Identified Causes Ageing of the population Changes in the social, economic and cultural pattern of living that contribute to elevated risk of NCD Unfavorable effects -Urbanization, Industrialization, Mechanization and Migration of the people Lack of concern on Prevention and health promotion strategies Inadequate recognition of the impact of NCDs on economic development.

19. 19 12 th Dec 2005 Effects Premature mortality/long term disability/Dependency on treatment Limitations/modifications to the patient’s normal life & Patient dis- satisfaction Imbalance to the family economy, life style, social and structural disruptions and even psychiatric illnesses Over crowded hospital clinics Increased Hospital admissions High health costs - drugs, technology, infrastructure, trained man power Increased burden at 2ry and tertiary care hospitals Economic loss to the country

20. 20 12 th Dec 2005 Vision To build a healthier population in the North Western Province that contributes the nation in its social and economic development.

21. 21 12 th Dec 2005 Mission To adopt feasible, cost effective policies and strategies for the prevention and control of non communicable diseases of major importance to public health in the province.

22. 22 12 th Dec 2005 Policy goal To reduce the morbidity and premature mortality related to major non communicable diseases.

23. 23 12 th Dec 2005 Policy objectives Strengthen provincial/District capacities to develop efficient strategies and models for intervention and working partnerships for controlling major non communicable diseases. Establish Primary prevention and health promotion aimed at fostering healthy lifestyle among the population. Improve patient care management and rehabilitation of patients with major NCDs. Establish epidemiological surveillance system for NCDs and their risk factors within the framework of National Surveillance System.

24. 24 12 th Dec 2005 Policy strategies Establishment of mechanisms to strengthen intra- sectoral and inter-sectoral co-operation and collaboration on prevention of NCDs. Promotion of healthy life style to prevent major NCDs through holistic approach to health in the province. Improved patient care management and rehabilitation of patients with non communicable diseases.

25. 25 12 th Dec 2005 Cont….. Prohibition of inaccurate/wrong /mis information on alcohol, tobacco and food items from all government & private places and mass media. Revise and strengthen the existing policy on import/sale/publicity on alcohol, tobacco and other related substances and not facilitate/promote/market such substances/products by the government.

26. 26 12 th Dec 2005 Policy Options NCD prevention and control Establishment of working partnership in the province - ? Primary prevention, secondary prevention and health promotion - ? Improve patient care management and patient rehabilitation - ?

27. 27 12 th Dec 2005 THANK YOU