Non-communicable diseases (NCDs) are the leading cause of death globally, responsible for 35 million deaths per year including 18 million women. NCDs disproportionately impact women in developing countries and are increasingly affecting women during their prime productive years. Key risk factors like tobacco use, unhealthy diets, physical inactivity, and harmful alcohol use must be addressed at both the individual and population levels. An integrated approach is needed that combines NCD prevention and control into existing health systems with a focus on women's education, empowerment, and involvement in developing solutions. Coordinated action from families, communities, healthcare providers, and governments is required to prioritize women's health and make NCDs a development priority.

1. Call to action on NCDs:
Challenges and Way Forward
for Maternal and Child Health
Dr. Niloufer Sultan Ali
Professor, Family Medicine
Aga Khan University, Karachi
1

2. ‘Each year, millions of
women & children die
from preventable causes.
These are not mere statistics.
They are people with names & faces.
Their suffering is unacceptable in the
21st century’,
Ban Ki-moon,
United Nations Secretary-General
2

3. A neglected dimension of
women’s health
NCDs are the world’s number one killer
• 35 million people die every year
18 million are women
NCDs represent the biggest threat to women’s
health worldwide
3

4. WHO report 2008
4

5. Total deaths
around the world:
58 million
Deaths from NCDs:
35 million
Deaths from NCDs
in developing
countries:
28 million
Countdown to 2015, Maternal Child and Newborn survival, the 2012 report
5

6. NCDs are no longer diseases of the rich and
elderly
Increasingly impacting on women in developing
countries during the prime of their life
Urgent priority for women’s
health
6

7. Source: WHO Chronic Disease Report, 2005
7

8. 0
1
2
3
4
5
6
7
8
9
10
1990
2000
2010
2020
1990
2000
2010
2020
1990
2000
2010
2020
1990
2000
2010
2020
Ratio
India
China Other Asia-Pacific
Latin America
& Carribean
Ratio of Non-Communicable/ Communicable Deaths,
India, China, Other Asia-Pacific, 1990-2020
Source: WHO Chronic Disease Report, 2005
Deaths due to NCDs are 3 times more as compared to
communicable diseases in Asia Pacific
8

9. NCD Diseases
4 Diseases, 4 Modifiable Shared Risk Factors
Tobacco
Use
Unhealthy
diets
Physical
Inactivity
Harmful
Use of
Alcohol
Cardio-
vascular
Diabetes
Cancer
Chronic
Respiratory
Source: WHO Chronic Disease Report, 2005
9

10. NCD in Pakistan
WHO report 2008
10

11. NCD in Pakistan…Cont
WHO report 2008
11

12. 2006-2015 (cumulative)
2005
Lost national income from
premature deaths due to
heart disease, stroke and
diabetes
Lost national income
(billions)
Lost national income
(billions)
Countries
49
3
Brazil
558
18
China
237
9
India
8
0.4
Nigeria
31
1
Pakistan
303
11
Russian Federation
3
0.1
Tanzania
Source: WHO Chronic Disease Report, 2005
IMPACT OF NCD
NCDs macro-economic impact
Lost National Income
12

13. Women & Diabetes
• Currently,143 million women are suffering from
diabetes
• By 2030, this number is expected to rise to 222
million
• Diabetes is the ninth leading cause of death in women
globally
• Gestational diabetes develops in one in 25
pregnancies worldwide.
Source: WHO Chronic Disease Report, 2005
13
Source: Countdown to 2015, Maternal Child and Newborn survival, the 2012 report

14. Women & Cancer
• Over 3 million women die of cancer each year
• Breast & lung cancers are the most common cancer
killers of women
• An estimated 1.7 million women will be diagnosed
with breast cancer in 2020—a 26% increase from
current levels—mostly in the developing world
Source: WHO Chronic Disease Report, 2005
14

15. Women & CVD
Source: WHO Chronic Disease Report, 2005
• CVD is the number one killer of women worldwide
• Causes 9.1 million deaths among women annually
• In 2008, CVD killed 1.2 million women aged
between (20-59 years) the most productive years of
life
• Developing countries are more affected
15

16. Offspring CVD Risk by Parental CVD
Status: Framingham Study
0
0.5
1
1.5
2
2.5
MEN WOMEN
NONE
MATERNAL
PATERNAL
Risk Ratio
2.5
2
1.5
1
0.5
0
Male offspring Female offspring
1.0
1.7
2.2
1.0
1.7 1.7
Parental CVD
<55 men, <65 Women
Source: International Society of Hypertension
16

17. NCDs in women compromises
child health
NCDs not only affect the health of women but also the
health of their children
• Being born to a malnourished mother increases the
chances of the infant suffering from under-nutrition,
late physical and cognitive development and NCDs in
adulthood
17

18. Childhood Obesity
• 43 million children under five years are overweight
• Girls are more likely to be overweight
> Restrained from regular physical activity
and sport
>Lack of safe and supportive environments
18

19. Source: The Growth Assessment and Surveillance Unit, Department of Nutrition
for Health and Development, World Health Organization, Geneva, Switzerland.
19

20. Current Challenges & Barriers
to Women’s Health
20

21. Socio-cultural Barriers
Women Education & Empowerment
– Young women & girls are unable to make
decisions about care for themselves or for their
children without the permission of their husbands
– Higher rates of illiteracy among women results in
less access to information about NCD risk factors,
prevention & treatment
21

22. Health System Barriers
• Women are less likely to seek medical care from male
health providers due to cultural taboos
• Shortage of female health care providers
• Lack of NCD component in existing health systems
22

23. Health System In Pakistan
Source: WHO, country profile 2008
23

24. A Way Forward
24

25. Fight for NCDs
Reduce modifiable risk factors among
individuals & populations
•Tobacco use
• Unhealthy diet
• Physical inactivity
• Harmful use of alcohol
25

26. A CALL FOR ACTION
We need to move away from the fragmented
approach to health and move towards taking a
holistic view of the health of girls and women
26

27. A call for Action…Cont
• Enhance women education and empowerment
• NCD component to be integrated into existing health
systems
• Link information of NCDs to reproductive health
programs
• Involvement of women in identifying problems,
solutions & implementing policies in the fight against
NCDs
27

28. We can act
TOGETHER, LET’S MAKE NCDs
A
PRIORITY FOR WOMEN’S
HEALTH
AND DEVELOPMENT
28

29. Act now on NCDs
for girls,
women
and
future
generations
29

30. We all have a role to play
Everyone has a critical role to play in improving
the health of women and children
30

31. Role of Family Physicians
• Promote healthy lifestyle
• Provide opportunistic care
• Share information regarding NCDs
• Address modifiable risk factors
• Conduct public awareness sessions
• Emphasize on regular check-ups
31

32. Thank You