1. Promoting Healthy Lifestyles in Kuliyapitiya Dr. M.D.S. Rajamanthree DPDHS-Kurunegala

2. 2 Purpose of the Presentation To share the experiences of an ongoing initiative to deal with the growing burden of Non-Communicable Diseases in Kurunegala To solicit suggestions from the Annual Health Forum participants

3. 3 Outline of Presentation 1.Part 1- NCD Burden in Kurunegala 2.Part 2- Initial Actions to Address the Burden Advocacy and Communication Training Screening 3.Part 3- Issues for Discussion

4. 4 Part 1: The Burden of Non-Communicable Diseases (NCD) in Kurunegala District Source: IMMR, 2004

5. 5 Part 2: Initial Actions to Address the Burden Initial Project : Programme in 2005 Reduction of Overcrowding in Medical Clinics in BH Kuliyapitiya Due to Chronic Lifestyle Related Disease Morbidity in Kurunegala District, Sri Lanka

6. 6 POPULATION Groups SETTINGS HospitalsSchoolsWorkplacesVillage Base Hospital Kuliyapitiya District Hospital Katupotha Rural Hospital Koshena Central Dispensary 10Hospitals (6) Schools (10) Garments (1) Insurance (1) University (1) Mahimpitiya (483 residents) Well population At risk Undetected NCD Diagnosed but Uncontrolled NCD Diagnosed & Controlled NCD Healthy Lifestyle Programme (EBM Study) Ongoing Project :

7. 7 Advocacy & Communication Poster competition Logo Shirts

8. 8 Training Programmes Behavior Change Communication Life Skills

9. 9 Training Programme on Behavior Change Communication Objectives  To train the trainees on Behavior Development Communication & Behavior Change Communication methods related to healthy life style Date  06-10 November 2006 Resource Persons  Dr. Kanthi Ariyaratne, Deputy Director, Health Education Bureau and Mr.Bandara Kotagepitiya, HEO from Health Education Bureau Participants  40 (MOH staff, schools, hospitals, work places and HEOO) Outputs  Identification of problems and risk factors for healthy life style  Capacity building and skill development of the trainers in BCC and BDC Way forward  The participants will act as resource persons in improving healthy life style Trainers will be strengthened further in their capacities  Training in development of education materials  Development of indicators for monitoring an evaluation

10. 10 Training Programme on Life Skills Objectives  To train the trainers on Life Skills Development regarding NCD prevention and health promotion Date  21-23 November 2006 Resource Persons  Consultant Psychiatrist Dr. Neil Fernando, Dr. Uthpala, Amarasinghe, Community Medical Officer, Dr. Nelee Rajaratne,School medical Officer, Mrs. Rathna Weththasinghe, Master teacher DR. P.A.D. Premaratne MO/ NCD, Mr. Suneth PHI, Participants  38 (MOH staff, schools, hospitals, work places and HEOO) Outputs  capacity building and skill development of the trainers  Behavior change of the trainers Way forward  The participants will act as resource persons in improving healthy life style  Trainers will be strengthened further in their capacities in the implementation process  Life skill development of the recipients in the selected settings

11. 11 Registration Filling up the questionnaire Weight/Height measurements Waist/Hip ratio Blood pressure Blood Sugar Screening programme

12. 12 Preliminary results POPULATION Groups % SETTINGS Hospitals (n=173) Schools (Teachers; n=326 ) Workplaces (n=247) Village (n=270) Medical History: DM8.6710.424.452.96 Medical History: Hypertension 8.095.827.284.81 FBS> 110 (6.11)17.931.617.6 BP> 130/9011.0029.322.1 BMI > 25 (Overweight) < 18 (Under) 24.8539.1126.82 17.165.0410.56 Waist/Hip Ratio Male>1 Female>0.8 7.0121.528.75 82.691.672.7

13. 13 POPULATION Groups % at High Risk SETTINGS Hospitals (n=173) Schools (Teachers; n=326 ) Workplaces (n=247) Village (n=270) Smoking10.776.2214.649.375 Alcohol consumption16.964.9021.4510.11 Less Physical activities62.8071.9067.2457.97 Rice > 3 cups per day8073.6174.2788.88 Fruits < 2 per day45.5051.454.2347.26 Vegetables < 3 per day26.0322.8720.3314.34 Salt > 5g per day67.2868.7566.1012.84

14. 14 Part 3- Some Issues for Discussion Now that the epidemiological burden has shifted to NCD, –shouldn’t resources (e.g. drugs, equipment, personnel and finance) be mobilized accordingly? –shouldn’t the existing guidelines be updated or new protocols/guidelines be developed? What should be the roles of the primary health care system (including MOH) in the prevention and management of NCD?

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