The role of CNCD Commissions in tackling chronic diseases – The Barbados Experience Dominica National Commission on CNCDs Capacity Building Workshop, 19 January 2010 Professor Trevor A. Hassell, Chairman Commission for CNCDs, Barbados
The burden of the CNCDs - Barbados � Quarter of men and more than a third of women live with one or more CNCD � Five leading causes of death are CNCDs � Heart disease and stroke rank among leading causes of H t di d t k k l di f death � 22% of Barbadian adults are hypertensive and 17.5% are diabetic � Diabetes and hypertension account for 20% of primary care consultations � Overweight/obesity: 60% of women and 1/3 rd men
“ Three primary risk factors ( tobacco, poor diet and physical inactivity ) and three intermediate risk factors (hypertension, obesity and diabetes ) lead to three diseases (heart disease, lung disease and cancer) all resulting in some 50% of all deaths. ”
Complementary Complementary approaches to approaches to Individual responsibility chronic disease chronic disease prevention prevention Changes to the "toxic" environment HEALTH CARE AND POLICY ENACTMENT DOCTOR COMMUNITY AND CIVIL SOCIETY 4
Support for the CNCD Commission - local � The Barbados Strategic Plan for Health, 2002- 2012 � Strategy for the prevention and control of CNCD & Cabinet Note (2005) 26/MH.03, Ministry of Health Barbados (2004); Health, Barbados (2004); � International Consultation on a Strategy for the Prevention and Control of CNCD for Barbados; Ministry of Health, Barbados (2005) � “Healthy Hearts for life”. Report of the Task Force on the Development of Cardiovascular Services (Jan. 2007); Ministry of Health, Barbados
Support for the CNCD Commission - regional � Heads of Government of CARICOM Summit and Declaration against CNCDs, 2007 � Healthy Caribbean 2008 Chronic Disease Conference: a wellness revolution event
CARICOM Heads of Government Summit on Chronic Non-Communicable Diseases (CNCDs), 15 September 2007 adopted a fourteen-point declaration committing the region to collective action to stop the epidemic of CNCDs � **Infrastructure: Secretariat / CCH3 / Regional � **Infrastructure: Secretariat / CCH3 / Regional Plans, M & E; � **National Commission, NCD Focal Point in MOH � **Advocacy, Communications, Social marketing � **Sustainable Financing � **Surveillance, including Gender dimensions
Priorities of the Summit � Tobacco (FCTC) � Healthy Eating (DPAS): – Trans Fat, Trade, Labeling � Active Living (DPAS) – Population-wide activities – Schools/workplaces etc. – 2nd Saturday in Sept: “Caribbean Wellness Day” � Screening and integrated management
Purpose � To bring together a wide spectrum of partners from throughout the CARICOM countries countries – civil society, the business civil society the business community, educators and researchers, policy makers to plan civil society’s response to the CNCD pandemic
Participants � � Anguilla Agriculture 3 � Business 5 � Antigua � Education 3 � Aruba � Faith Based 4 � Bahamas � Finance 7 � Barbados � Food Industry 2 � Belize � Gov./Policy 13 � BVI � H C Providers 11 � � � Cayman islands Health Finance Health Finance 3 3 C i l d � Labour 5 � Dominica � Legal 1 � Grenada � Media 9 � Guyana � NGO/CNCD 35 � Jamaica � Pharma 3 � Montserrat � Reg./Pol 6 � � St. Lucia Service Clubs 3 � Sports/PA 3 � Trinidad and Tobago � Urban Dev. 3 � St. Kitts � Youth 3
Outcomes � Active Caribbean Workshop � Caribbean Civil Society Declaration on CNCDs � Caribbean Civil Society Action Plan for tackling CNCDs, � Conference Report produced as a Technical Report of the Chronic Disease Research Centre UWI Chronic Disease Research Centre, UWI � Creation of a Caribbean civil society coalition for tackling CNCDs - Healthy Caribbean Coalition � Website: www.healthycaribbean.org. � Co-sponsorship of upcoming University Diabetes Outreach Conference, Jamaica, 2010 � CNCD media campaign for Barbados and the OECS
Summary of the Declaration � 10 point preamble and 12 point declaration � Preamble recognizes the contribution of the CNCDs both to ill health & disease and excessive financial burden, but appreciates that much can be done � Declares inter alia: � Declares inter alia: � Support for Heads of Government of CARICOM Declaration on CNCDs � Need to establish a Caribbean Civil society CNCD coalition � Stresses the need for increased advocacy � Promotion of healthy lifestyles � Public education and media campaigns � Seeks to hold Governments accountable
Summary of the Action Plan � Action lines: � Establishment of Caribbean CNCD coalition � Advocacy � Support for Caribbean Wellness Day � Support for Caribbean Wellness Day � Development of a communication strategy � Public education programme � Risk factor reduction � Support for country level activities
The National Commission for CNCDs, Barbados � Established January 2007 � Inter-sectoral body � 14 members and 4 ex-officio members � Volunteers paid small stipend � Meetings held monthly � Professional, administrative and secretarial support provided by staff of the Health Promotion Unit � No budget allocated to the Commission at start up
The Commission’s mandate � Advise Minister of Health on CNCD policies and legislation � Broker involvement of all sectors in program implementation � Assist in mobilisation of resources to facilitate implementation of programs � Recommend relevant research � Promote collaborations and partnerships � Monitor regional and international trends � Facilitate commissioning of audits /evaluation of CNCD programs � Recommend to Minister of Health framework that encourages and promotes behaviour change to prevent CNCDs
Membership of NCCNCD, Barbados • Professor Trevor Hassell MD., Chairman • Professor Henry Fraser MD., Dean Faculty of Medical Sciences • Mr. David Neiland , Businessman, the private sector • Mr Orlando Scott, trade union movement • Mr Wilfred Beckles, Barbados Association of Retired Persons • Mr. Michael Gaskin, teacher, physical education • Mr Adrian Randall , CEO, Heart & Stroke Foundation of Barbados • Dr Elliott Douglin MD., Representing Faith based organisations • Mrs. Sophia Cambridge, Advertising and media • Ms Candace Waldron, Youth Representative • Ms Zonia Phillips, Food and Nutrition advocate • Mr Barton Clarke Chief Agricultural Officer, Ministry of Agriculture • Mrs Wendy Griffith-Watson, Chief Education Officer • Mrs. Ena Harvey, IICA
Strategic Plan: Objectives � Internal action : � Improved management of NCCNCD � Improved CNCD data management � External action : E t l ti � Health promotion � Reduction of CNCD risk factors � Quality CNCD treatment and care
Strategic Plan: Vision, mission and values � Vision: to be a leader in all major national developments related to CNCDs in order to achieve reduction in CNCDs � Mission: Advises on facilitates and promotes � Mission: Advises on, facilitates and promotes evidence based best practices in Prevention and Control of CNCDs � Values: Transparency, inclusiveness, respect for all views, adoption of evidence based practices, accountability, and collaboration
Strategic plan: key strategies � Strategic management issues � Epidemiological data, Health Information S System and research d h � Measures to support reduction of risk factors � Health promotion � Quality treatment and care
Strategic management issues � Advisory body guiding and assisting a highly motivated group of operational partners � Driving CNCD interventions in collaboration with: with: � Public and private sector � Government and NGOs � Professional and voluntary bodies � Community based organizations � Regional and international bodies
Epi- data, Health Information Systems and Research � Increasing access to data on CNCDs � Strengthening functional links with CDRC/UWI � Using the BNR as a priority data source to i f inform actions of the CNCD Commission i f h CNCD C i i � Increasing surveillance capacity of Ministry of Health � Using Health Information System
Measures to support reduction of risk factors � Declare CNCDs a national priority � Enhance the role of the commission with the public � Giving the public access to CNCD data Gi i h bli CNCD d � Inform the public of standards in treatment and care � Support on-going educational programmes targeting health care professionals
Health promotion � Integrate health promotion strategies in the planning process � Improve inter-sectoral collaboration � Lobby where necessary for high impact L bb h f hi h i � Influence legislation and regulation
Quality treatment and care � Establish standards for CNCD treatment and care
Indicators of success � Organizational and management structures 1. Budgetary funds allocated to CNCDs increased by 10% 2. Administrative staff added to MOH to support Commission 3. Secretariat established � Epi- data, HIS and research 1. Implementation of annual surveillance reporting system for CNCDs 2. Regular outputs from BNR 3. Repeat BRFS survey in 2010 4. Establishment of a web portal for CNCDs
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