0
IMRAN AGUS NURALI

Tackling the Non Communicable
Diseases (NCD) Burden using
Sports and Activities’.
OUTLINE PRESENTATION
Introduction
Prevalence NCD’s and Risk factors
Physical Activity and Sports approach
FITT of Physical...
Deaths attributed to 19 leading factors,
by country income level, 2004

WHO Global health Risks report, 2004.
Percentage of deaths, by cause, South-East Asia Region, 2008
Percentage of deaths, by cause, Indonesia
NBHS 2007

26.9

31.1

Stroke
Hypertension
Diabetes
12.3

9.3

10.2

10.2

Cance...
4 major of NCD’s in Indonesia
NBHS 2007

NBHS 2013

 Cardiovascular disease
- CHD : 0.9%

 Cardiovascular disease
- CHD ...
POPULATION AGED +10 YEARS OF PHYSICAL INACTIVITY
by PROVINCE, NBHS 2013
Interventions

The NCDs Iceberg

Prevention of
premature deaths and
disability
Management of stroke,
coronary heart diseas...
10
LEVEL OF PHYSICAL CONDITION
PEAK
PERFORMANCE
PRODUCTIVITY

FITNESS

HEALTHY
12
PHYSICAL ACTIVITY

EXERCISE

SPORT

Good, Right, Measure and Regular
CONTINUUM PERIOD OF PHYSICAL ACTIVITY

Pregnancy
and
Postpartum

Children

Adolescents

ATHLETEs

Older
Adults

Adults

PI...
IMPLEMENTATION PROGRAM SPORTS HEALTH
of MoH-Indonesia based on :

1. Guidelines of exercise during pregnancy and
post deli...
Benefit of Regular physical activity:
TO REDUCE :

•
•
•
•

the risk of dying prematurely
the risk of dying from heart dis...
Regular Physical Activity at The Correct Intensity






Reduces the risk of death by 40%
Lowers the risk of stroke b...
Mechanism for Cancer Reduction with Exercise
• Physical activity lowers levels of biologically available sex
hormones
– De...
3/4/2014

19
SITE PLACE OF
PHYSICAL ACTIVITY
1. AT HOME
2. DURING TRAVEL
3. WORKSITE PLACE
4. AT SCHOOL
5. PUBLIC PLACE
INTERVENTION :
1.
2.
3.
4.
5.

INDIVIDUALLY BEHAVIOUR PROGRAM
SCHOOL BASED PHYSICAL EDUCATION
ENVIRONMENTAL APPROACHES
COM...
PRESCRIPTION OF EXERCISE :
1.
2.
3.
4.

FREQUENCY
INTENSITY
TEMPO
TYPE
PRINCIPLES OF EXERCISE

1. OVERLOAD
2. PROGRESSIF
3. INDIVIDUAL
Promote Partnerships for The
Prevention and Control of NCD’s
1. Promote agreement between the government and other
relevan...
NATIONAL
POLICY
•
• Food availability
and access
•
• Improved
quality of food
consumption

•

• Improve d
physical activit...
Linkage between Components of Diet and Physical Activity

ECONOMY AND
GLOBALIZATION

MEDIA
ADVERTICEMENT
AND SOCIAL
NETWOR...
Stakeholders of National Network
of NCD’s Control
1. Bappenas (National Development
Planning Agency)
2. Home Affairs
3. Th...
PHYSICAL ACTIVITY OF SCHOOL AGE

8/29/2013
IAN 2012
PHYSICAL FITNESS TEST AT WORKPLACE
EXERCISE FOR PILGRIMS
CITY PARK
CONCLUSION

Physical inactivity is part of the problem
Physical activity is part of the solution
Intervention
to increasin...
THANK YOU
Next Step 2014 presentation by Imran Agus Nurali from Ministry of Health of Indonesia
Next Step 2014 presentation by Imran Agus Nurali from Ministry of Health of Indonesia
Next Step 2014 presentation by Imran Agus Nurali from Ministry of Health of Indonesia
Next Step 2014 presentation by Imran Agus Nurali from Ministry of Health of Indonesia
Next Step 2014 presentation by Imran Agus Nurali from Ministry of Health of Indonesia
Next Step 2014 presentation by Imran Agus Nurali from Ministry of Health of Indonesia
Next Step 2014 presentation by Imran Agus Nurali from Ministry of Health of Indonesia
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Transcript of "Next Step 2014 presentation by Imran Agus Nurali from Ministry of Health of Indonesia"

  1. 1. IMRAN AGUS NURALI Tackling the Non Communicable Diseases (NCD) Burden using Sports and Activities’.
  2. 2. OUTLINE PRESENTATION Introduction Prevalence NCD’s and Risk factors Physical Activity and Sports approach FITT of Physical Activity Principle of Exercise Promote Partnership Conclusion
  3. 3. Deaths attributed to 19 leading factors, by country income level, 2004 WHO Global health Risks report, 2004.
  4. 4. Percentage of deaths, by cause, South-East Asia Region, 2008
  5. 5. Percentage of deaths, by cause, Indonesia NBHS 2007 26.9 31.1 Stroke Hypertension Diabetes 12.3 9.3 10.2 10.2 Cancer Heart D's Others
  6. 6. 4 major of NCD’s in Indonesia NBHS 2007 NBHS 2013  Cardiovascular disease - CHD : 0.9%  Cardiovascular disease - CHD : 1.5% - Decomp. Cordis : - Hypertension : 31.7% - Decomp. Cordis : 0.3% - Hypertension : 25.8%  Diabetes Mellitus 1,1%  COPD : - Asthma : 3.5%  Tumour/Cancer : 4.3‰  Diabetes Mellitus 2,1%  COPD : 3.8% ; Asthma 4.5%  Cancer : 1.4‰  Stroke 0,83%  Central Obesity 18,8%  Stroke 1,21%  Central Obesity 26,6% NBHS : National Basic Health Survey
  7. 7. POPULATION AGED +10 YEARS OF PHYSICAL INACTIVITY by PROVINCE, NBHS 2013
  8. 8. Interventions The NCDs Iceberg Prevention of premature deaths and disability Management of stroke, coronary heart disease, diabetes complications and COPD Early diagnosis Hypertension, Rx of hypertension, hyperglycemia, dyslipidemia, diabetes HOSPITAL PRIMARY HEALTH FACILITY Risk factors/diseases Chronic/life threatening conditions -Stroke -Coronary heart disease -Diabetic nephropathy - COPD Biological risk factors -Hypertension -Hyperglycemia -Dyslipidemia -Obesity Behavioral risk factors Health promotion and disease prevention Adoption of healthy lifestyle by individual, community and family -Tobacco -Physical inactivity -Lack of fruits -Lack of vegetables -Excess alcohol SOCIAL DETERMINANTS
  9. 9. 10
  10. 10. LEVEL OF PHYSICAL CONDITION PEAK PERFORMANCE PRODUCTIVITY FITNESS HEALTHY 12
  11. 11. PHYSICAL ACTIVITY EXERCISE SPORT Good, Right, Measure and Regular
  12. 12. CONTINUUM PERIOD OF PHYSICAL ACTIVITY Pregnancy and Postpartum Children Adolescents ATHLETEs Older Adults Adults PILGRIMS
  13. 13. IMPLEMENTATION PROGRAM SPORTS HEALTH of MoH-Indonesia based on : 1. Guidelines of exercise during pregnancy and post delivery in Primary Health Centre 2. Guidelines to develop physical fitness of school age through Health Promotion School (UKS) 3. Guidelines to develop physical fitness for employee at workplace 4. Guidelines to develop physical fitness for pilgrims 5. Guidelines to build physical fitness for athletes 6. Guidelines of physical activity for elderly
  14. 14. Benefit of Regular physical activity: TO REDUCE : • • • • the risk of dying prematurely the risk of dying from heart disease or stroke the risk of developing heart disease, colon cancer and type 2 diabetes the risk of developing lower back pain can help in the management of painful conditions, like back pain or knee pain HELPS TO : • • • • prevent/reduce hypertension control weight and lower the risk of becoming obese prevent/reduce osteoporosis, reducing the risk of hip fracture in women build and maintain healthy bones, muscles, and joints and makes people with chronic, disabling conditions improve their stamina • prevent or control risky behaviours, especially among children and young people, like tobacco, alcohol or other substance use, unhealthy diet or violence • promotes psychological well-being, reduces stress, anxiety and depression
  15. 15. Regular Physical Activity at The Correct Intensity      Reduces the risk of death by 40% Lowers the risk of stroke by 27% Reduces the incidence of diabetes by almost 40% Reduces the incidence of high blood pressure by almost 50% Can reduce mortality and the risk of recurrent breast cancer by almost 50%  Can lower the risk of Colon Cancer by 60%  Can reduce the risk of developing of Alzeimer’s disease by onethird  Can decrease depression as effectively as medications or behavioral therapy
  16. 16. Mechanism for Cancer Reduction with Exercise • Physical activity lowers levels of biologically available sex hormones – Decreased lifetime exposure to endogenous sex hormones -> decreased risk of hormone-related cancers • Breast, endometrial, ovaries, prostate, testes • Exercise decreases endogenous insulin production – Higher levels of circulating insulin linked with several cancers • Adiposity and Cancer Risk – Increased fat associated with increased risk of cancers of colon, kidney, esophagus, endometrium, thyroid, post-menopausal breast • Physical activity decreases colon transit time – Decreases colonic exposure to carcinogens in stool • Level of physical activity inversely related to levels of C-reative protein
  17. 17. 3/4/2014 19
  18. 18. SITE PLACE OF PHYSICAL ACTIVITY 1. AT HOME 2. DURING TRAVEL 3. WORKSITE PLACE 4. AT SCHOOL 5. PUBLIC PLACE
  19. 19. INTERVENTION : 1. 2. 3. 4. 5. INDIVIDUALLY BEHAVIOUR PROGRAM SCHOOL BASED PHYSICAL EDUCATION ENVIRONMENTAL APPROACHES COMMUNITY CAMPAIGNS SOCIAL SUPPORT INTERVENTIONS IN COMMUNITY 6. POLICY APPROACHES
  20. 20. PRESCRIPTION OF EXERCISE : 1. 2. 3. 4. FREQUENCY INTENSITY TEMPO TYPE
  21. 21. PRINCIPLES OF EXERCISE 1. OVERLOAD 2. PROGRESSIF 3. INDIVIDUAL
  22. 22. Promote Partnerships for The Prevention and Control of NCD’s 1. Promote agreement between the government and other relevant partners in the implementation of national strategy of diet and physical activity for NCD’s prevention 2. Reorient the role and existence of a national network of NCD’s control 3. Strengthen the role of existing networking in province and district of NCD’s control 4. Develop national action plan for implementation of diet and physical actiivty for NCD’s prevention
  23. 23. NATIONAL POLICY • • Food availability and access • • Improved quality of food consumption • • Improve d physical activity • • Public Health and Community Nutrition • • • • • • • • PROGRAM IMPLEMENTATION Strengthen regulation of low salt, low sugar and low saturated fat of food products Strengthen the role of networking in province and district on NCDs control Increase budget allocation and the means to support the activities Integrate activities to control risk factors of NCDs related to diet and physical activity into Social Security System Adopt community-based interventions adaptive to local social and culture wisdom Conduct research on the impact of behavior changes in consumption of sugar, salt, fat and physical activity on NCDs prevalence reduction INPUT & PROCESS INDICATOR • Regulation of low salt, low sugar and low saturated fat of food products • Effective NCDs control networking • Budget allocation for program implementation • NCDs control of vulnerable group incl. the poor • Community-based interventions adaptive to local social and culture wisdom • Research on the impact of behavior changes in consumption of sugar, salt, fat and physical activity on NCDs prevalence reduction OUTPUT INDICATOR Increased percentage of family with healthy life style behavior of low sugar, salt, fat consumption and regular and adequate physical activity NATIONAL STRATEGY Strengthen legislation on healthy diet and physical activity. Multi-sector and stakeholders partnerships include strengthen National Networking of NCDs Control. Resource development for the implementation of activities /actions. Address equity and equality and eliminating disparities among social groups. Increase the effective evidence-based interventions by place settings (households, schools, public places, workplaces and health care facilities) Conduct operational research and development of policy and long-term strategy for sustainable NCDs community-based prevention. REDUCTION OF NCDs PREVALENCE
  24. 24. Linkage between Components of Diet and Physical Activity ECONOMY AND GLOBALIZATION MEDIA ADVERTICEMENT AND SOCIAL NETWORK DIET AND PHYSICAL ACTIVITY LEGISLATION, BUDGET AND CONTROL ENVIRONMENT AND INFRA STRUCTURE FOOD AND NUTRITION SOCIOCULTURE, TOURISM AND LOKAL WISDOM KNOWLEDGE, GENDER & LIFESTYLE
  25. 25. Stakeholders of National Network of NCD’s Control 1. Bappenas (National Development Planning Agency) 2. Home Affairs 3. The House of People Representatives 4. Province and District Government 5. Health 6. Agency For Drugs and Food 7. Education 8. Religious Affairs 9. Youth and Sports 10.Agriculture 11.Marine and Fisheries 12.Labor 13.Trade 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. Industry Tourism Fiscal Industrialist and Businessman Woman empowerment and Child Protection Social and Human Rights Non Government Organization Mass Media Professional Organizations Universities UN Agencies and International Develeopment Partners
  26. 26. PHYSICAL ACTIVITY OF SCHOOL AGE 8/29/2013
  27. 27. IAN 2012
  28. 28. PHYSICAL FITNESS TEST AT WORKPLACE
  29. 29. EXERCISE FOR PILGRIMS
  30. 30. CITY PARK
  31. 31. CONCLUSION Physical inactivity is part of the problem Physical activity is part of the solution Intervention to increasing physical activity
  32. 32. THANK YOU
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