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140th APHA Annual Meeting
               Monday, October 31, 2012



                      Chronic
         Title PageDiseases in
Non-communicable
Latin America:The Role of PHC

                       Dr. Elvira Beracochea
                                MIDEGO, Inc.
                                    President
                        elvira@midego.com
Disclosure

• Dr. Elvira Beracochea has nothing to
  disclose.
Up to 80% of the NCD mortality, mainly
due to cancer, diabetes, chronic lung
disease and cardiovascular disease,
can be prevented by improved
individual care and public health
programs.
Objectives

1. Discuss the role of primary health
   care to prevent NCDs
2. Discuss lessons from the CARMEN
   initiative and North Karelia Project
CNCD are

Preventable
Reversible
  Curable
North Karelia, Finland
•1972
• After the first 25 years, the project
demonstrated to have achieved
changes in smoking, BP and diet
–CVD mortality reduced by 68%
–CHD mortality reduced by 73%
–All causes mortality reduced by 49%
North Karelia: Interventions

•PHC providers involved in all aspects of the
 program
•Involvement of community organizations and
 residents
•Training and Media Communication
•Environmental changes
•Partnerships with food industry
CARMEN
Conjunto de Acciones para la
Reducción Multifactorial de
Enfermedades No transmisibles

Concerted actions to reduce
multifactorial non- transmissible
or non-communicable diseases
PAHO: Country-Wide Actions

1.   National Plan of Action
2.   Policies
3.   Community-based actions
4.   Health service reorganization
5.   Integrated promotion and prevention actions
6.   Health equity focus
7.   Baseline and surveillance adapted to measure
     progress: Observatory
Observatory
• Goal: support policy advocacy,
  development, monitoring and impact
  measurement
• Canada, Brazil, and Costa Rica
• Chile, Uruguay, Guatemala and Cuba
  and other Caribbean Countries (25+)
• Benchmarks
• Improve Surveillance
Effective Interventions
• Tobacco taxes, smoking free areas and
  smoking cessation treatments
• Transfat free America (Rio 2008)
• Healthy meals in schools
• Reduction of salt in diet
• Increase physical activity
• Community-based promotion
• Improvement of PHC and referral services
Advocacy
• “Program Dose” matters
• Sustained efforts also matter
• Integrated community based
  programs do work:
  – Health education
  – PHC services
  – Community involvement and
    participation
• Not Surprised!
Visit us at www.midego.com


                Remember to Download the
              “Global Health Starter Program”
        to start making a bigger impact right away!


                         Thank you!




Copyright ©2010 MIDEGO

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Chronic Non-communicable Diseases in Latin America: The Role of Primary Health Care (PHC)

  • 1. 140th APHA Annual Meeting Monday, October 31, 2012 Chronic Title PageDiseases in Non-communicable Latin America:The Role of PHC Dr. Elvira Beracochea MIDEGO, Inc. President elvira@midego.com
  • 2. Disclosure • Dr. Elvira Beracochea has nothing to disclose.
  • 3. Up to 80% of the NCD mortality, mainly due to cancer, diabetes, chronic lung disease and cardiovascular disease, can be prevented by improved individual care and public health programs.
  • 4. Objectives 1. Discuss the role of primary health care to prevent NCDs 2. Discuss lessons from the CARMEN initiative and North Karelia Project
  • 6. North Karelia, Finland •1972 • After the first 25 years, the project demonstrated to have achieved changes in smoking, BP and diet –CVD mortality reduced by 68% –CHD mortality reduced by 73% –All causes mortality reduced by 49%
  • 7. North Karelia: Interventions •PHC providers involved in all aspects of the program •Involvement of community organizations and residents •Training and Media Communication •Environmental changes •Partnerships with food industry
  • 8. CARMEN Conjunto de Acciones para la Reducción Multifactorial de Enfermedades No transmisibles Concerted actions to reduce multifactorial non- transmissible or non-communicable diseases
  • 9. PAHO: Country-Wide Actions 1. National Plan of Action 2. Policies 3. Community-based actions 4. Health service reorganization 5. Integrated promotion and prevention actions 6. Health equity focus 7. Baseline and surveillance adapted to measure progress: Observatory
  • 10. Observatory • Goal: support policy advocacy, development, monitoring and impact measurement • Canada, Brazil, and Costa Rica • Chile, Uruguay, Guatemala and Cuba and other Caribbean Countries (25+) • Benchmarks • Improve Surveillance
  • 11. Effective Interventions • Tobacco taxes, smoking free areas and smoking cessation treatments • Transfat free America (Rio 2008) • Healthy meals in schools • Reduction of salt in diet • Increase physical activity • Community-based promotion • Improvement of PHC and referral services
  • 12. Advocacy • “Program Dose” matters • Sustained efforts also matter • Integrated community based programs do work: – Health education – PHC services – Community involvement and participation • Not Surprised!
  • 13. Visit us at www.midego.com Remember to Download the “Global Health Starter Program” to start making a bigger impact right away! Thank you! Copyright ©2010 MIDEGO