Kingdom of Bahrain Ministry of Health Public Health

Kingdom of Bahrain Ministry of Health Public Health Directorate Diseases Control Section Noncommunicable diseases NCD Dr. Naeema Isa Al Sabaeei 2014

overall structure and organization involved in prevention services and resources available Ø The National Committee develop a comprehensive national plan for the Kingdom of Bahrain, this national plan was formed in concordance to the Gulf plan issued in the document of Manama, which was adopted by the Supreme Council of the GCC in December 2011. Ø The Council of Ministers adopted the national plan to combat noncommunicable diseases, this comes as a confirmation of the Kingdom of Bahrain's commitment to the resolutions adopted by the United Nations and the World Health Organization and the decisions of the Supreme Council of the GCC. Ø The update includes all of the (Vision and Mission) commensurate with the current stage and cope with the future direction of regional and global ambitions of the Gulf. As well as identification (main objective of long-term) of the Plan, was adopted so that the names of the strategic goals (seven) as contained in the previous plan adopted. It also has been updated by adding each strategic objective targets and indicators adopted by the World Health Organization (May 2013). As well as a comprehensive review of each application strategies and mechanisms and indicators of enforcement mechanisms (the addition, modification or deletion) commensurate with the goals and new indicators).

overall structure and organization involved in prevention services and resources available Ø The main objective long-term Achieve a relative decrease by 25% in the overall rate of premature deaths caused by cardiovascular disease and cancer and diabetes and chronic respiratory diseases among adults (age 30 -70 years) during the next 15 years. Ø The ministry of health is the main provider of health care in Bahrain services through : Ø 26 primary health centers Ø public hospitals as: Ø collector's Salmaniya medical. Ø psychiatric hospital. Ø hospital elderly. Ø three maternity hospitals. Ø the Bahrain Defense Force Hospital serves the health of members of the Bahrain Defence Force and their families , and provides emergency services and the treatment of heart to the entire population , in addition to that has recently been the opening of the King Hamad University Hospital to enhance health services in the Kingdom. Ø as the private sector provides health services through 13 hospitals and many private clinics run by individuals or a group of doctors as well as medical centers

main achievements in your country in tackling NCDs and their risk factors NCD Clinics Indicators By Patients

Diabetic indicators in NCD Clinics (2009 -2013) 2009 -2011 85. 2%86. 4% 64. 9% 2012 2013 85. 8%87. 2% 59. 3% 11. 1%10. 9%8. 4% Percentage of people with type 2 diabetes receiving formal diabetes education about physical activity in one year. Percentage of people with type 2 diabetes receiving type 2 diabetes who smoke. formal diabetes education about healthy diet in one year.

Diabetic indicators in NCD Clinic (2009 -2013) 2009 -2011 2012 2013 88. 0% 84. 1% 87. 5% 87. 4% 84. 9% 81. 8% Percentage of people with type 2 diabetes having an eye examination in the past year. Percentage of people with type 2 diabetes having at least one foot examination in the past year.

Diabetic indicators in NCD Clinic (2009 -2013 Percentage of people with type 2 diabetes with Serum Lipid Measurement (Cholesterol) during past year. 100% 90. 4% 88. 9% 78. 4% 80% 60% 40% 20% 0% 2009 -2011 2012 2013

Diabetic indicators in NCD Clinic (2009 -2013 LDL Cholesterol 27. 3% Percentage of people with type 2 diabetes with LDL cholesterol ≥ 3. 0 mmol/l (115 mg/dl) 29. 3% 21. 6% Percentage of people with type 2 diabetes with LDL cholesterol ≥ 3. 0 mmol/l (115 mg/dl) not treated with lipid lowering medications. 37. 5% 32. 7% 30. 0% 2009 -2011 2012 2013

Percentage of smokers, obese, and controlled Hypertensive among patients attended NCD clinic for Visit 1, 4, and 7 (2009 -2013) 100% 80% 60. 6% 50. 1% 62. 6% 47. 6% 49. 5% 43. 1% 40% 20% 0% 10. 8% Hypertension BP<140/90 BMI Visit 1 Visit 4 9. 0% 7. 3% Smoker Visit 7

Rates of improvement in the indicators of risk factors after the implementation of early detection of risk factors for non-communicable diseases clinics Random sample was selected (32) of those who were transferred Clinic chronic diseases and ratios are as follows improvement in their indicators abnormal after 4 months of the first visit

Rates of improvement in the indicators of risk factors after the implementation of early detection of risk factors for noncommunicable diseases clinics Random sample was selected (50) of those who were transferred to the clinic with chronic diseases and ratios are as follows improvement in their indicators abnormal after 4 -6 months of the first visit:

Regular meeting with different level

Activates for care and educate

campaign (protect your heart )

main lessons learnt over the last 5 yrs Ø no national system and database for monitoring and follow-up and evaluation of advanced based on quality standards for noncommunicable diseases Ø no national responsibility with non-governmental organizations, the private sector and civil society to counter non-communicable diseases Ø no Involvement of people with noncommunicable diseases and their families to bear the responsibilities of the treatment and prevention of complications Ø No an epidemiological surveillance system and national noncommunicable diseases. Ø The absence of a culture of clinical audit, review and evidence based practice. Ø The separate steams of activity in the Ministry of Health absence of a Knowledge sharing culture.

National plan for the prevention of diseases, non-clinical and control 2014 -2019 (next 5 years ) Ø Raise awareness about the health risk factors for noncommunicable diseases. Ø Early detection of non-communicable diseases and risk factors between the groups with high-risk Ø Improve the quality of health services provided by the three levels of patients with non-communicable diseases and their complications Ø Create an epidemiological surveillance system and national noncommunicable diseases. Ø Involvement of people with noncommunicable diseases and their families to bear the responsibilities of the treatment and prevention of complications Ø Activating the partnership with government institutions and nongovernmental organizations, the private sector and civil society to bear national responsibility to counter non-communicable diseases Ø Study of the environmental and health reasons for asthma in the Kingdom of Bahrain at the end of 2016 Ø The existence of a national system and database for monitoring and follow-up and evaluation of advanced based on quality standards for non-communicable diseases

Thank you