Current Progress in NonCommunicable Disease Prevention in the Caribbean: Overview

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Current Progress in Non-Communicable Disease
Prevention in the Caribbean Overview
Pan American Health Organization Office of
Caribbean Program Coordination Barbados

• D. Beverley Barnett
• Chronic Diseases Health Promotion Advisor
• PAHO/WHO CPC
• November 2000

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NCDs in the English-speaking Caribbean (ESC)

• Main causes of death 1980-1990 (CAREC)
• Cardiovascular disease
• Cerebrovascular disease
• Malignant neoplasms
• Diabetes
• Hypertension
• Increase of 147 in diabetes-related deaths
  1980-1994 (Health in the Americas, 1998)

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NCDs in the ESC

• Diabetes prevalence in adults
• Barbados 17 (published 1993)
• Jamaica 18 (published 1995)
• Hypertension prevalence in adults
• Barbados 45 (published 1993)
• Obesity increasing
• Barbados overweight prevalence
• Males 1970 7 1981 19
• Females 1970 32 1981 39

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Stakeholders in NCDs in the ESC

• Ministries of Health
• Hospitals and clinics
• Diabetes Associations
• Heart Foundations
• Cancer Societies
• UWI - TMRI (TMRU, CDRC, MRC)
• Other tertiary institutions

• CARICOM
• CHRC
• PAHO/WHO - CFNI, CAREC, CPC, HPP, HCP
• International NGOs
• Others

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NCDs in the ESC

• Challenges
• To organize and systematize ongoing efforts to
  prevent and control NCDs
• To address promotion of health and prevention of
  disease as well as clinical/curative services
• To foster collaboration among the many national,
  regional and international agencies involved in
  NCD prevention and control, including NGOs

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Progress in NCDs in the ESC Framework

• Caribbean Cooperation in Health (CCH)
• Phase I 1986-1996
• Phase II 1998-2003
• Planning and information systems
• Risk factor prevention and control
• Screening
• Quality of care

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Progress in NCDs in the ESC Framework

• Caribbean Charter for Health Promotion
• Formulating Health Public Policy
• Re-orienting Health Services
• Creating Supportive Environments
• Empowering Communities
• Developing/Increasing Personal Health Skills
• Building Alliances, with Special Emphasis on the
  Media

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Progress in NCDs in the ESC Framework

• Health Sector Reform
• Provides opportunity for suggested health
  promotion and disease prevention approaches which
  address risk factors e.g. obesity
• Situation analyses
• Health Conditions in the Americas, last 1998
• Health Conditions in the Caribbean 1997
• Caribbean Regional Health Study 1996

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Progress in NCDs in the ESC PAHO/WHO CPC
Technical Cooperation

• Joint planning, programming, evaluation
• Information sharing
• Identification of roles and responsibilities
• avoid duplication, use limited resources more
  efficiently

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Progress in NCDs in the ESC PAHO/WHO CPC
Technical Cooperation

• Collaboration with government, NGOs, including
  non-health sectors
• multiple determinants of health and importance of
  non-health factors in promotion and prevention
• Use of diabetes as entry point to NCD prevention
  and control

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Progress in NCDs in the ESC Initiatives

• Sub-regional level
• Guidelines for management of diabetes (1995) and
  hypertension (1998) in 1? care - CHRC
• Guide for development of diabetes programs (1998)
  - CPC
• Model policy for diabetes prevention and control
  (1998) - CPC
• Identification of Caribbean research priorities
  (2000) - CHRC
• CINDI/CARMEN - CARBI?

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Progress in NCDs in the ESC Initiatives

• National level
• Risk factor surveys - BAR, SAV (1991)
• Health fairs - Healthy Lifestyle Extravaganza,
  Nation Publishing House, BAR, since 1995
• Continuing education for health professionals
• Protocol for Surveillance and Monitoring of
  Diabetes - BAR
• Barbados Diabetes Intervention Study (1998) -CDRC

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Progress in NCDs in the ESC Initiatives

• National level
• Drug Utilization Review in SAV re diabetes and
  hypertension (2000) - PAHO, OECS/PPS
• Draft diabetes programs that address 1?, 2? and
  3? prevention using Logical Framework Approach
• Developed over 1998-99 biennium
• Facilitated by CPC office
• ANU, ANI, BVI, GRA, GUY, MOT, SAL, SCN, SAV, SUR

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Draft Diabetes ProgramsExpected Results

• Information/education/communication programs
• Healthy lifestyle programs
• High risk screening programs
• Improved management of persons with diabetes -
  self care, continuing education for health
  professionals

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Draft Diabetes ProgramsExpected Results

• Research
• Establishment/strengthening of information
  systems, including disease registries
• Resource mobilization

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Progress in NCDs in the ESC Future Challenges

• Research to provide up to date data
• Effective strategies for long-term adoption of
  healthy lifestyles
• Implementation of guidelines
• Finalization and implementation of draft programs
• Resource mobilization

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