1

NON COMMUNICABLE DISEASESNORTH -WESTERN PROVINCE

Dr.M.D.S.RAJAMANTHRIE DPDHS Kurunegala

Dr. D.I.WIJAYAWARDANAMedical Officer Planning PDHS Office

212th 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

312th Dec 2005

World situation

Mortality 60%

Morbidity 47%

75% of deaths in developing countries

NON COMMUNICABLE DISEASES

412th Dec 2005

South East Asia region including Sri Lanka

Mortality 51% Morbidity 44%

Increase- in alarming proportions

Double burden of communicable & Non communicable diseases

512th Dec 2005

NCDs & all causes of Hospitalization Kurunegala district 2004

NCDs41%

All causes59%

NCDs All causes

Source: IMMR-2004

612th Dec 2005

Major causes of NCDs admitted to hospitals in Kurunegala District 2004

17%

11%

6%

4%

3%

59%

Traumaticinjuries

Diseases of theRes. System

Diseases of theGIT

Diseases of theMus.Ske.sys. &conne.tissue Hypertension

All other causes Source: IMMR-2004

712th Dec 2005

Diseases of the Diseases of the Respiratory systemRespiratory systemTraumatic InjuriesTraumatic Injuries

52% Asthma52% Asthma

LEADINGLEADING HOSPITAL ADMISSIONSHOSPITAL ADMISSIONS

DISEASES OF THE GITDISEASES OF THE GIT

812th Dec 2005

NCDs & All causes of hospital mortality Kurunegala District-2004

54%

46% NCDs

All other causes

Source:IMMR 2004

912th Dec 2005 Source: IMMR-2004

1012th Dec 2005

DISEASES OF THE GITDISEASES OF THE GIT CEREBRO VASCULAR CEREBRO VASCULAR DISEASESDISEASES

DISEASES OF THE DISEASES OF THE RESPIRATORY TRACTRESPIRATORY TRACT

75% ALCOHOLIC LIVER 75% ALCOHOLIC LIVER DISEASEDISEASE

31% ASTHMA31% ASTHMA

LEADING CAUSES OF HOSPITAL DEATHS

1112th Dec 2005

All Poisoning Rate 2004

Kurunegala Puttlam

Cases Deaths Cases Deaths

420.2 19.1 282.9 4.0

Per 100,000 populationPer 100,000 population

All poisoning rate Sri Lanka 256.9/100,000 population (2002)

1212th Dec 2005

DRUG ABUSE TREATMENT ADMISSIONS BY DISTRICT 1996-2000 ( N = 25)

0

1

2

3

4

5

6

7

8

Kurunegala Ratnapura Kandy

1996

1997

1998

1999

2000

GallePutt. Kalutara

Source:National Dangerous Drug control Board

% A

dmis

sion

s

1312th 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

1412th Dec 2005

Number of Thalassaemia Patients registered and Deaths reported(Period 1994-until 01.09.2005)

District Reg. patients Reported Deaths

Kurunegala

Puttlam

Anuradhapura

Matale

Other Districts

356

25

47

39

48

45

03

05

05

02

TOTAL 515 60

Thalassaemia Registry-PH.Kurunegala

1512th Dec 2005

360

57

294

72

382

61

454

60

739

97

0

100

200

300

400

500

600

700

800

Num

ber

2000 2001 2002 2003 2004

Year

Hospitalization and Hospital deaths due to Renal Failure Kurunegala District2000-2004

Cases Deaths

Source: IMMR 2004

1612th Dec 2005

Allocation and the estimate of drugs

Kurunegala District YEARS ALLOCATION

Rs Millions *ESTIMATE

Rs Millions

COST of actual amount of drugs received

2003 125 191 77 million

2004 125 120.8 80 million

2005 126 143.7 97.6 million

(Until30.09.2005)

Source:Divisional Pharmacist Unit, DPDHS, Kurunegala

1712th Dec 2005

Population & Population Growth- 2001 Census

District Population 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

1812th Dec 2005

Problems IdentifiedCauses 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.

1912th 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

2012th Dec 2005

Vision

To build a healthier population in the North Western Province that contributes the nation in its social and economic development.

2112th 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.

2212th Dec 2005

Policy goal

 

To reduce the morbidity and premature mortality related to major non communicable diseases.

2312th 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.

2412th 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.

2512th 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.

2612th 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 - ?

2712th Dec 2005

THANK YOU