|
|
|
Areas of Work
|
|
Non-communicable
diseases, injuries and mental health
|
|
Background
|
|
The burden of disease in Thailand is gradually shifting to
non-communicable diseases, injuries and mental health. The greatest public
health benefits are gained through prevention of NCD (cardiovascular
diseases, cancers and diabetes mellitus in particular), injuries and mental
health disorders. This can be achieved if the risk factors are identified and
appropriate interventions implemented to reduce or avoid these risk factors.
In addition, if NCDs and mental illnesses are
detected at an early stage and appropriate controls initiated, their severity
can be reduced. It should be noted here that the burden of non-communicable
diseases usually falls disproportionately on the poor who often have
excessive exposure to risk factors and limited access to health services.
Diseases such as diabetes, cancers and heart illnesses are often not detected
until they are at an advanced level. Aware of the increasing trends of NCDs and injuries, the Thai Government has placed high
priority on prevention and control initiatives. The Bureau of
Non-communicable Diseases is responsible for NCDs,
injury prevention, and tobacco and alcohol control programmes.
The Bureau has made appreciable progress in monitoring the burden of NCDs and injuries and identifying major behavioural risk factors classified by their provinces.
The Bureau also plans to improve the collection and analysis of NCD and
injury mortality and morbidity data in order to monitor trends and evaluate
the success of interventions. Due to the unreliability of incidence data for
selected NCDs, injuries and mental illnesses among
the population, cases of hospitalization with more accurate diagnosis are presented to ascertain the trends in the burden of disease depicted in Morbidity
rates of selected diseases/conditions in Thailand (excluding Bangkok)
2001-2004 (Source: Bureau of Policy and Strategy)
 Since
the NCD and injury prevention and control programmes
emphasise public health and primary care approaches
(rather than secondary and tertiary treatment), effective multi-sectoral collaboration is required. Clearly, traffic
injury prevention and tobacco and alcohol control programmes
cannot be implemented by the health sector alone. The Thai government has
demonstrated a strong commitment to the control of tobacco use and alcohol
consumption by drafting legislations, particularly in the area of
advertisement. However, the major challenge ahead remains how to effectively
reduce risk behaviour (smoking and alcohol
consumption) and increase regular exercise and healthy diet. The Department
of Mental Health, Ministry of Public Health (MoPH),
is in the process of developing the National Strategies on Mental Health,
based on the Tenth National Health Development Plan. To ensure the success of
implementation, advocacy and multi-sectoral
collaboration are required to address the root of social problems that are
considered to be the major causes of mental illness.
|
|
Activities supported during Biennium 2006-2007
|
|
 Establishing and strengthening NCD sub-networks: cancer prevention
& control
Establishing
networking mechanism for resources and social support for chronic disease
management in communities
Training of
regional and provincial staff in integrated NCD prevention and control
Development of
model for training of primary care unit staff in NCD prevention and care
Development of
guidelines for planning, implementation and evaluation of community-based NCD
intervention projects or programmes
Development of
strategic guidelines for community-based prevention and care of diabetes and
hypertension DM & HT in north-eastern Thailand
Development of guidelines
for strategic planning, implementation and evaluation of community-based
traffic accident prevention
Pilot project
on NCD prevention and care among
youth scouts in urban communities
Establishment of
integrated NCD surveillance system for provincial health offices, contracted
units of primary care (CUPs) and primary care units
(PCUs)
GIS (Geographical
Information System) intervention for prevention and surveillance of road
traffic accident at provincial level
|
|
Key Event
|
|
 Chronic non-communicable diseases (NCDs) are
assuming alarming proportions in the South-East Asia (SEA)
Region. Almost half of the 89 million NCD-related deaths projected in the
region during the next 10 years will occur prematurely, thus hindering social
and economic development of member countries.
There is strong evidence that
significant reduction in NCDs can be achieved by
the introduction of simple public health interventions addressing major NCD
risk factors and their socio-economic determinants at population, community
and individual levels. Member countries of the SEA
Region are in the process of strengthening their public health response to
ongoing epidemics of NCDs by initiating national
policies, plans and programmes for prevention and control of NCDs. To this end a SEANET-NCD meeting was held in Phuket, Thailand, 22-26 October 2007 in
an effort to scale up prevention and control of non-communicable diseases.
1. To review progress in prevention and control of NCDs
in SEAR;
2. To review the status of oral health programmes
and advise on their integration with NCD prevention and control, and
3. To provide inputs towards development of regional and global plan of
action for integrated prevention and control of NCDs
for 2008-2013.
77 participants
included NCD focal points of WHO Headquarter, Regional (SEARO), Country
Offices (WRO), and national agencies (MoH) from 11
Member Countries including Bangladesh, Bhutan, Democratic People’s Republic
of Korea, India,
Indonesia, Maldives, Myanmar,
Nepal, Sri Lanka, Thailand.
1. Review of national policies, plans and programmes
for prevention and control of NCDs
2. Regional capacity for NCD prevention and control
3. Scaling up oral health programmes in SEAR
4. Legislation for NCD prevention and control
5. Community based interventions
6. Progress in NCD Surveillance
7. Formulating global and regional plan of action on NCD prevention and
control
|
|
Conclusions
|
|
1. There is increasing
commitment in all the Member Countries of the region for prevention and
control of NCDs. This commitment, however, has not
been fully translated into programmes and actions.
2. The partnership
between different stakeholders is sub-optimal, especially, those outside the
health sector and international partners.
3. SEANET-NCD provides
a good forum for sharing information and networking between different
partners in the area of NCD prevention and control.
4. Information and
communication technology (website for SEANET-NCD and NCD InfoBase) could be
used for dissemination of evidence and networking.
5. Tobacco control serves
as a good example in the area of legislation and inter-sectoral
action.
6. Currently, the NCDs and their risk factors are not being addressed
adequately in the primary health care systems.
7. Progress has been
made in achieving the targets of NCD Surveillance strategy in the region.
8. Oral health
problems pose a significant burden on the population in the region. Oral
health issues are getting adequate priority and attention among the policy
makers and programme managers.
9. There are
opportunities for integration of oral health issues into NCD surveillance,
prevention and control as well as health promotion.
|
|
Recommendations
|
|
1. Develop, review and
revise national public health oriented policies, plans, programmes
for NCD prevention and control.
2. Establish and
sustain appropriate infrastructure and funding mechanisms for management of
national NCD prevention and control programmes
including oral health.
3. Create, support and
sustain a multi-sectoral forum for addressing all
aspects of NCD prevention and control and oral health.
4. Support development
of legal and other appropriate instruments for modifying different risk
factors.
5. Align and
strengthen primary health care systems to address NCDs
and their risk factors and mainstream NCD prevention and control into the
primary health care system.
6. Monitor, evaluate
document and disseminate report on NCD programmes
and activities regularly.
7. Promote capacity
strengthening and public health education at all levels for NCD prevention
and control and oral health.
8. Develop national
Oral Health policy and strategies.
9. Consider
identifying a national focal point for oral health (Chief Oral Health
Officer).
10. Form country and
inter-country network forum to facilitate action in the area of ORH.
WHO should:
1. Facilitate the
process of bringing together all concerned stakeholders at all levels and
actively involve them in the NCD prevention and control activities, including
oral health promotion in the region.
2. Produce appropriate
advocacy documents for different stakeholders as relevant for the region.
3. Facilitate the
development of appropriate legislative and regulatory frameworks for alcohol,
diet and physical activity.
4. Strengthen
SEANET-NCD, including experts and national programme
managers of oral health, through regional and sub-regional mechanisms
including the SEANET website.
5. Facilitate
development of guidelines, norms, and standards for integrated management of NCDs at primary health care level.
6. Provide support and
coordinate NCD InfoBase through WHO collaborating centres.
7. Provide technical
assistance/support
in capacity building to develop appropriate guidelines for oral
health promotion.
8. Assist Member
countries in strengthening capacity for NCD surveillance prevention and
control.
9. Support a regional
workshop on oral health for strategy development.
10. Establish an oral
health focal point to coordinate oral health programmes
at the Regional Office.
|
|
Issues for Support
during Biennium 2008-2009
|
|
Political, financial and
technical supports provided for developing and implementing national programmes for prevention and control of chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and
disabilities.
Political, financial and
technical support provided for developing and implementing national programmes for prevention and control of chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and
disabilities.
Improved surveillance and
related information systems established at the national level for planning,
monitoring and assessing impact of national programmes
for prevention and control of chronic noncommunicable
diseases, mental disorders, and violence.
Evidence-based cost-effective
interventions to address chronic noncommunicable
conditions, violence and injuries and disabilities disseminated to relevant
agencies for implementation.
Enhanced capacity of relevant
agencies to initiate and implement multisectoral,
population-wide programmes to prevent mental and behavioural disorders, violence and injuries, together
with hearing and visual impairment, including blindness.
Enhanced capacity of national
health and other relevant sectors by means of institutionalised
training to prevent and manage chronic noncommunicable
conditions, mental and behavioural disorders,
violence, injuries and disabilities.
|
|
Related Issues
|
|
Cardiovascular diseases, click here.
Cancer, click here.
Diabetes, click here.
Noncommunicable Disease Surveillance, click here.
Violence and Injury Prevention, click here.
Mental health, click here.
Nutrition for Health and Development, click here.
|
|
|
|
|
