Promoting Healthy Lifestyles in Kuliyapitiya

Dr. M.D.S. Rajamanthree

DPDHS-Kurunegala

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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

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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

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Part 1: The Burden of Non-Communicable Diseases (NCD) in Kurunegala District

Causes of

Hospitalisations, 2004

59%

41% NCDOthers

Causes of Hospital

Deaths, 2004

54%46% NCD

Others

Source: IMMR, 2004

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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

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POPULATION Groups

SETTINGS

Hospitals Schools Workplaces Village

•Base Hospital Kuliyapitiya

•District Hospital Katupotha

•Rural Hospital Koshena

•Central Dispensary

•10 •Hospitals (6)

•Schools (10) •Garments (1)

•Insurance (1)

•University(1)

•Mahimpitiya (483 residents)

Well population

At risk

Undetected NCDDiagnosed but Uncontrolled NCD

Diagnosed & Controlled NCD

Healthy Lifestyle Programme (EBM Study)

Ongoing Project:

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Advocacy & Communication

Poster competition

Logo Shirts

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Training Programmes• Behavior Change

Communication • Life Skills

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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 materialsDevelopment of indicators for monitoring an evaluation

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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 processLife skill development of the recipients in the selected settings

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Registration

Filling up the questionnaire

Weight/Height measurements

Waist/Hip ratio

Blood pressure

Blood Sugar

Screening programme

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Preliminary resultsPOPULATION Groups

%

SETTINGS

Hospitals(n=173)

Schools (Teachers;

n=326)

Workplaces(n=247)

Village(n=270)

Medical History: DM 8.67 10.42 4.45 2.96

Medical History: Hypertension

8.09 5.82 7.28 4.81

FBS> 110 (6.11) 17.9 31.6 17.6

BP> 130/90 11.00 29.3 22.1

BMI > 25 (Overweight)

< 18 (Under)

24.85 39.11 26.82

17.16 5.04 10.56

Waist/Hip Ratio Male>1

Female>0.8

7.01 21.52 8.75

82.6 91.6 72.7

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POPULATION Groups

% at High Risk

SETTINGS

Hospitals(n=173)

Schools (Teachers;

n=326)

Workplaces(n=247)

Village(n=270)

Smoking 10.77 6.22 14.64 9.375

Alcohol consumption 16.96 4.90 21.45 10.11

Less Physical activities 62.80 71.90 67.24 57.97

Rice > 3 cups per day 80 73.61 74.27 88.88

Fruits < 2 per day 45.50 51.4 54.23 47.26

Vegetables < 3 per day 26.03 22.87 20.33 14.34

Salt > 5g per day 67.28 68.75 66.10 12.84

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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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