Communicable and Non-Communicable Diseases in Nigeria: …

1 HEALTH EDUCATION IN THE CONTROL AND PREVENTION OF Communicable AND NON- Communicable Diseases IN NIGERIABy Prof. Louis O. EgwariCovenant University The things we say are never new They have either been said or written What we are doing is echoing them Until they have expressionWHO FACT-FILE ON nigeria Total population: 169,000,000 Total deaths: 2,083,000 NCDs are estimated to account for 24% of total deathsThe probability of dying between ages 30 &70 yrs from the 4 main NCDs is 20% Cancers Diabetes Cardiovascular Diseases Chronic Respiratory DiseasesADULT RISK FACTORSM ales Females Total Current tobacco smoking (2011)10%6%2% Total alcohol per capital consumption, in litres of pure alcohol (2010) Raised blood pressure (2008) (%) Obesity (2008)

2 Systems response to NCDs Has an operational NCD unit/branch or department within the Ministry of Health, or equivalent No Has an operational multi-sectorialnational policy, strategy or action plan that integrates several NCDs and shared risk factors No Has an operational policy, strategy or action plan to reduce the harmful use of alcoholNoNational systems response to NCDs Has an operational policy, strategy or action plan to reduce physical inactivity and/or promote physical activity No Has an operational policy, strategy or action plan to reduce the burden of tobacco use No Has an operational policy, strategy or action plan to reduce unhealthy diet and/or promote healthy diets NoNational systems response to NCDs Has evidence-based national guidelines/protocols/standards for the management of major NCDs through a primary care approachNo Has an NCD surveillance and monitoring system in place to enable reporting against the nine global NCD targetsYes Has a national.

3 Population-based cancer registryNo * The mortality estimates for this country have a high degree of uncertainty because they are not basedon any national NCD mortality data (WHO remarks).World Health Organization -Noncommunicable Diseases (NCD) Country Profiles, 2014 The probability of dying between ages 30 and 70 years from the 4 main NCDs is20% Cardiovascular Diseases 7% Cancers 3% Chronic respiratory Diseases 1% Diabetes 2% Other NCDs 11% Communicable , maternal, perinataland nutritional conditions 66% Injuries10%The Global Burden of Chronic Diseases In 2002, Cardiovascular diseaseCancerChronic respiratory diseaseDiabetes caused 29 million deaths worldwide Despite growing evidence of epidemiological and economic impact.

4 The global response to the problem remains Stakeholders include:GovernmentsWorld Health OrganizationOther United Nations bodiesAcademic and Research groupsNongovernmental organizationsPrivate sectorImpediments to Prevention and Control Lack of financial supports for capacity development, research, treatment and control Decision makers do not have adequate up-to date evidence of the nature of disease burden in the society Strong beliefs that chronic Diseases afflict only the affluent and elderly, and arise solely from freely acquired risks Impediments Present control measures are ineffective and very costlyPOLICYLEVERS TO IMPEDIMENTS Elevate chronic Diseases on the health agenda of key policymakers Providing policymakers with better evidence about risk factor control Persuading them of the need for health systems Diseases .

5 Communicable Diseases HepatitisViralhepatitiscauses78% HIV/AIDST hemostsuccessfulprogramstofightAIDS havebeeneffortstomakeavailableantiretrov iraldrugsthatallowpeoplewithHIVtolivefor manyyearsbeforedevelopingsymptomsofAIDS InfluenzaBecauseinfluenzaaffectssomanype oplearoundtheglobeeveryyear,extensiveint ernationalcoordinationisrequiredintheare asofinfluenzasurveillance,detection,andr esponseCommunicable Diseases MalariaThefocusareasinvolvedincombatingm alariaincludepublichealthinformation,sci enceandresearch,preventionandcontrol,cas emanagement,andregulatingdiagnostictests andvaccines PolioPoliotendstoinfectchildrenunderfive causinglifelongcripplingconditions,buttw ovaccinespromisethepossibilityoferadicat ion Diseases prevention and control: WHO ASSISTED PROGRAMMES WHOhassupportedNigeriaintheprevention, (NTDs).

6 Dracunculiasis(Guineawormdisease(GWD)), HumanAfricanTrypanosomiasis(HAT), BuruliUlcer(BU), Lymphaticfilariasis(LF), Onchocerciasis, Schistosomiasisand Althoughsafeandcosteffectivemeansofpreve ntionandcontrolareavailable, Preparedness and Response: Panic Reporting and Consequences Outbreaksandepidemicsdonotrecognizenatio nalboundariesandifnotcontained,canrapidl yspreadwithinthecountryandinternationall y. Unverifiedandinaccurateinformationondise aseoutbreaksoftenelicitexcessivereaction sfromthemediaandauthorities,leadingtopan icandinappropriateresponses,whichinturnm ayresultinsignificantinterruptionoftrade ,travelsandtourism,therebyplacingfurther economicburdenonaffectedcountries.

7 Furthermore,theseoutbreaksthreatenglobal healthsecuritybecausetheyfrequentlyandun expectedlychallengenationalhealthservice sanddisruptroutinecontrolprogramme, Plan InNigeria,asinotherAfricancountries,thec hallengeistodeveloporreinforcemechanisms todetect, ,workingwithMinistries,NationalEmergency ManagementAgencyandotherstakeholderstost rengthenthenationalcommunicablediseasesu rveillanceandresponsesystemsthroughexist ingsurveillancestructuresinthestatesandL ocalGovernmentAreas(LGAs).The Paradigm ,thelatter,includingcardiovasculardiseas es(CVD), "epidemiologicaltransition"istakingplace partlybecauseof: therapidagingofthedevelopingworld'spopul ations, progressiveurbanizationandsocioeconomict ransformation.

8 Changesinnutritionalpatternsexperiencedo verthelastfewdecades, thetwentiethcenturymasshabitofcigarettes moking,and Thistrendwillcontinueandbytheyear2020,no n-communicablediseasesareexpectedtoaccou ntforsevenoutofevery10deathsinthedevelop ingregions, fever/rheumatic heart disease , fever Atthecommunitylevel, , ,however, Strategies , ,suchaswhatsortoffoodtobuy,howtopreparem eals, Considerations Provisionofinformationisnotenough, 'shealth-relatedpracticesinanycommunitya recloselyrelatedtothegeneralpracticesoft hecommunity,andtothegeneralbeliefs,norms andsocialvalues.

9 Thusitisoftendifficultfortheindividualto makemajorchangesinlifestyle,ifrespective changesdonottakeplaceinthecommunity,andm oregenerally, Considerations Therefore,successfullarge-scalepreventiv eprogrammesattempttochange,insteadofthei ndividual,thewholecommunitytogetherwithm anyofitssocialandenvironmentalfactors. Considerations Severalgovernmentdepartmentsotherthanthe ministryofhealthwillhavetobeinvolvedinah ighlycoordinatedmanner. Nongovernmentalorganizationsshouldalsobe involvedand,ultimately, Acentralroleofcarefullydesignedcommunity programmesistoformalinkbetweenbasichealt hresearch, "pilot","demonstration",or"model" ,particularlywithregardtotobaccouse, ,suchascardiovasculardiseases.