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Non-Communicable Diseases:
We know the answers, how
about the implementation?
Feisul Idzwan Mustapha MBBS, MPH, AM(M)
Publ...
2Source of icons: World Heart Federation Champion Advocates Programme
Global NCD
Targets
20%15%
23%15%
HED* <1.2%
35.2%...
3
National Strategic Plan for
Non-Communicable
Diseases (NSP-NCD) 2010-
2014
 Presented and approved by the Cabinet on
17...
Where should our focus be 2015
onwards?
 Biggest contributor to DALY & deaths.
 Most cost-effective interventions (based...
DALYs attributable to risk factors
5
10.8%
10.7%
9.0%
8.3%
5.2%
4.3%
3.1%
0.7%
0.1%
10.8%
0.7%
11.4%
12.1%
5.1%
0.9%
4.3%
...
19.4%
15.7%
8.5%
7.3%
7.0%
5.0%
2.3%
0.2%
0.1%
22.8%
1.2%
9.1%
8.1%
8.2%
7.1%
0.3%
0.2%
0.1%
25% 20% 15% 10% 5% 0% 5% 10% ...
Where should our focus be 2015
onwards?
1. Tobacco control and intensifying implementation of
FCTC
2. Salt reduction – hea...
Proposed Framework for NSP-NCD
2015-2020 [based on the 9 voluntary global targets]
Proposal Status Division
1. Plan of Act...
NCDs included in the 2030 Agenda for
Sustainable Development
9
NCDs included in the 2030 Agenda for
Sustainable Development
10
WHO NCD Progress Monitor 2015
11
10 Progress Monitoring Indicators
12
10 Progress Monitoring Indicators
13
NCD Progress Monitor 2015:
Malaysia
14
NCD Progress Monitor 2015:
Malaysia
15
So what is next?
 More soft policies?
 More hard policies?
 Are we clear on the causes of causes?
 Or is it the story ...
Everybody, Somebody, Anybody and
Nobody?
There was an important job to be done and Everybody
was sure that Somebody would ...
Overview of Current Interventions for
NCD in Malaysia (from womb to tomb)
Pre-
conception
First 1,000 Days
To reduce obesi...
19Source of icons: World Heart Federation Champion Advocates Programme
Global NCD
Targets
20%15%
23%15%
HED* <1.2%
35.2%...
Thank you
20
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NCD: we know the answers, how about the implementation?

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Paper presented at the 2nd Public Health Seminar: Emerging public health issues, UNIMAS, 16 November 2015

Published in: Health & Medicine
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NCD: we know the answers, how about the implementation?

  1. 1. Non-Communicable Diseases: We know the answers, how about the implementation? Feisul Idzwan Mustapha MBBS, MPH, AM(M) Public Health Physician 2nd Public Health Seminar 2015, UNIMAS 16 November 2015 Kota Samarahan, Sarawak
  2. 2. 2Source of icons: World Heart Federation Champion Advocates Programme Global NCD Targets 20%15% 23%15% HED* <1.2% 35.2%30.0% 8.76.0gm 32.2%24.0% <15.0% Targets for Malaysia * Heavy episodic drinking
  3. 3. 3 National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010- 2014  Presented and approved by the Cabinet on 17 December 2010.  Provides the framework for strengthening NCD prevention & control program in Malaysia.  Adopts the “whole-of-government” and “whole-of-society approach”.  Diabetes & obesity are used as the entry points. Seven Strategies: 1. Prevention and Promotion 2. Clinical Management 3. Increasing Patient Compliance 4. Action with NGOs, Professional Bodies & Other Stakeholders 5. Monitoring, Research and Surveillance 6. Capacity Building 7. Policy and Regulatory interventions
  4. 4. Where should our focus be 2015 onwards?  Biggest contributor to DALY & deaths.  Most cost-effective interventions (based on WHO recommendations) 4
  5. 5. DALYs attributable to risk factors 5 10.8% 10.7% 9.0% 8.3% 5.2% 4.3% 3.1% 0.7% 0.1% 10.8% 0.7% 11.4% 12.1% 5.1% 0.9% 4.3% 0.7% 0.1% 15.0% 10.0% 5.0% 0.0% 5.0% 10.0% 15.0% High BP Tobacco Diabetes Mellitus High BMI High Cholesterol Alcohol Physical Inactivity Underweight Poor Water & Sanitation Male Female Burden of Disease Study Malaysia 2008, slide courtesy of Dr Mohd. Azahadi Omar, Institute for Public Health
  6. 6. 19.4% 15.7% 8.5% 7.3% 7.0% 5.0% 2.3% 0.2% 0.1% 22.8% 1.2% 9.1% 8.1% 8.2% 7.1% 0.3% 0.2% 0.1% 25% 20% 15% 10% 5% 0% 5% 10% 15% 20% 25% High BP Tobacco Diabetes Mellitus High Cholesterol High BMI Physical Inactivity Alcohol Underweight Poor Water & Sanitation Male Female Deaths attributable to risk factors Burden of Disease Study Malaysia 2008, slide courtesy of Dr Mohd. Azahadi Omar, Institute for Public Health 6
  7. 7. Where should our focus be 2015 onwards? 1. Tobacco control and intensifying implementation of FCTC 2. Salt reduction – health promotion  NCD must take a leadership role in the multi-sectoral effort 3. Focus on community empowerment: using the KOSPEN platform 4. Focus on the quality of management for hypertension  However, not to introduce another program in silo 7
  8. 8. Proposed Framework for NSP-NCD 2015-2020 [based on the 9 voluntary global targets] Proposal Status Division 1. Plan of Action for Prioritising Interventions to fight Obesity in Malaysia 2015-2020 Work in progress Nutrition 2. Salt reduction strategy for Malaysia 2015- 2020 Work in progress Disease Control 3. National Strategic Plan for Tobacco Control Adopted Disease Control 4. Malaysia’s Alcohol Action Plan (MAAP) 2013-2020 Adopted Disease Control 5. National Action Plan for Physical Activity Work in progress Health Education 6. Prioritising action for strengthening Chronic Disease Management in Malaysia Proposed Family Health Development 7. National Plan of Action for Nutrition Malaysia (NPANM) III 2016-2025 Work in progress Nutrition 8. National Cancer Blueprint Adopted Disease Control 8 The Overarching Framework for Prevention and Control of NCD in Malaysia will be the proposed NSP-NCD 2015-2020 under which…
  9. 9. NCDs included in the 2030 Agenda for Sustainable Development 9
  10. 10. NCDs included in the 2030 Agenda for Sustainable Development 10
  11. 11. WHO NCD Progress Monitor 2015 11
  12. 12. 10 Progress Monitoring Indicators 12
  13. 13. 10 Progress Monitoring Indicators 13
  14. 14. NCD Progress Monitor 2015: Malaysia 14
  15. 15. NCD Progress Monitor 2015: Malaysia 15
  16. 16. So what is next?  More soft policies?  More hard policies?  Are we clear on the causes of causes?  Or is it the story of four people named Everybody, Somebody, Anybody and Nobody? 16
  17. 17. Everybody, Somebody, Anybody and Nobody? There was an important job to be done and Everybody was sure that Somebody would do it. Anybody could have done it, but Nobody did. Somebody got angry about that, because it was Everybody’s job. Everybody thought Anybody could do it, but Nobody realized that Everybody wouldn’t do it. It ended up that Everybody blamed Somebody when Nobody did what Anybody could have. 17
  18. 18. Overview of Current Interventions for NCD in Malaysia (from womb to tomb) Pre- conception First 1,000 Days To reduce obesity and NCDs-birth weight Lifestyle during pregnancy – fetal health Intervention Package for young couples at pre- conception Pregnancy Infant/ Toddler Pre- School School- going Age Guideline on Marketing of unhealthy food & drinks to Children Guideline on Enforcement of ban on sale of unhealthy food & drinks outside of school perimeters Higher Education Adults Elderly Komuniti Sihat, Perkasa Negara (KOSPEN) Healthy Workplace for a Healthy Workforce • School Canteen Guidelines • BMI measurement twice per year & reporting to parents • Involvement of PIBG / PTA JOM MAMA Initiative MyBFF@school • Healthy menu during meetings • Healthy Cafeterias • Healthy vending machine policies MyBFF@work MyBFF@home Kelab Doktor Muda Program Siswa Sihat (PROSIS)
  19. 19. 19Source of icons: World Heart Federation Champion Advocates Programme Global NCD Targets 20%15% 23%15% HED* <1.2% 35.2%30.0% 8.76.0gm 32.2%24.0% <15.0% Targets for Malaysia * Heavy episodic drinking
  20. 20. Thank you 20

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