National Strategy for Prevention and Control of Noncommunicable

National Strategy for Prevention and Control of Noncommunicable Diseases In Iraq

Goal: To reduce morbidity and premature mortality attributed to chronic non-communicable diseases. Impact indicators: ØPremature mortality attributed to major noncommunicable Diseases. ØPrevalence of high blood pressure among adults 25 years and more. ØPrevalence of hyperglycemia among adults 25 years and more ØPrevalence of tobacco smoking among adults 25 years and more and youth 13 -15 years old ØPrevalence of obesity adults 25 years and more. ØProportion of cancers diagnosed in early stages.

Vision: Iraqi community free of preventable NCDs in which all people have access to high quality care to increase life expectancy. Mission: Multi-sectoral and multi-level response to control noncommunicable diseases and their contributory risk factors.

Scope Major Chronic Noncommunicable Diseases: Cardiovascular Diseases Diabetes Chronic Respiratory Diseases Cancers Risk factors: Tobacco consumption Unhealthy dietary habits Low physical activity Other related conditions Blindness and lmpaird vision Musculoskeletal disorders

Objectives Objective one: To raise the priority accorded to noncommunicable disease in developmental plan at national level, and to integrate prevention and control of such diseases into policies across all governmental departments. OBJECTIVE 2: TO IMPLEMENT THE NATIONAL POLICIES AND PLANS FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES. OBJECTIVE 3: TO PROMOTE INTERVENTIONS TO REDUCE THE MAIN SHARED MODIFIABLE RISK FACTORS FOR NONCOMMUNICABLE DISEASES: TOBACCO USE, UNHEALTHY DIET AND PHYSICAL INACTIVITY. OBJECTIVE 4: TO PROMOTE RESEARCH FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES OBJECTIVE 5: TO PROMOTE PARTNERSHIPS FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES. OBJECTIVE 6: TO MONITOR NONCOMMUNICABLE DISEASES AND

ITICAL AND GOVERNMENTAL SUPPORT/ LITICAL MULTI-SECTORAL RESPONSE Introduction into the National Health System Ø Developmental plan Incorporation into the poverty reduction Ø strategy Incorporation into the ministerial plans Ø through the national strategy for prevention and control of noncommunicbale diseases Ø Introduction into the National Public Health Ø. Low (draft) Adaption of global strategies, conventions Ø (FCTC, DPAS, VISION 2020…)

STRENGTHENING NCD CARE 1000 Number of PHCc Implementing Screeing 800 for Hypertension and Diabetes , Iraq (2008 -May/ 2012) 600 400 Integration of Primary NCD Care into PHC services: 200 0 2012 Screening and Comprehensive Care for Hypertension and Diabetes at PHC level Primary Care for Asthma Ø Screening/ early detection of selected cancers Ø (Breast, Ca cervicx). Guidelines for PHC physicians and paramedical staff Addition to Essential List of Drugs, Equipments and procedures for PHCs Premarrital screening/counseling –detection of Ø Thalassemia Detection and management of blood hereditary Ø diseases (hemophilia and sickle cell anemia) Ø 2011 2010 2009 2008

Prevention of Blindness and visual Impairment : Establishment of 30 community eye health units at main PHCs (Ophthalmologists and Optometrists/refractionst). Primary eye care: Ø Ø Preschool eye screening Ø School enrollment screening Ø Cases of hypertension and diabetes Ø Adoption of SAFE Strategy for prevention and control of Trachoma. Ø Elderly care: Expansion of elderly clinics at main hospitals in Iraq(18 clinic) Development of 17 elderly friendly PHCs. Ø Development of osteoporosis prevention and management Ø for PHC physicians Introduction of elderly health into Public Health Law. Ø Ø

RISK FACTORS CONTROL A. IMPLEMENTATION OF THE NATIONAL TOBACCO CONTROL PROGRAM: Ø Ø FCTC endorsed National tobacco control law endorsed Tobacco free places implemented at Ministries Tobacco cessation clinics under development

B. IMPLEMENTATION OF THE NATIONAL STRATEGY FOR DIET, PHYSICAL ACTIVITY AND HEALTH: Setting based implementation: Schools: Ø Anthropometric measurements are introduced into school enrollment screening system. Ø Early detection and primary care for obesity among school children implemented at health promoting schools PHCs: Ø Capacity building of PHC health workers on nutritional assessment and counseling Ø Development of guidelines on diet, physical activity community: Production of educational materials EIC

C. IMPLEMENTATION OF THE NATIONAL PROGRAMS FOR NATIONAL INFANT AND YOUNG CHILD FEEDING PROGRAM Ø Baby friendly hospitals improved with stepwise expansion and a number of baby friendly PHC centers developed for implementation of the National Exclusive Breast Feeding Program Ø The National Infant and Young Child Feeding IYCF program Implemented and gradually expanded at PHC centers and hospitals

SURVEILLANCE, MONITORING, EVALUATION: NCD prevention and control is introduced into the research priority list of the ministry of health in accordance with the regional and global recommendations NCDs introduced into national surveys (social determinants, family surveys) Ø Ø Incorporated into research agenda of other ministries and sectors (Academia, Arab board, Iraqi Board) based on the national priorities Production of the first national NCD report Ø Ø

National data on trends of NCDs cause specific mortality and contributory risk factor available Introduction of NCDs into HIS Ø Registration system Reinforced based on updated Ø International Classifications for Disease ICD in all health institutes Strengthening cancer registry Ø Development of the national ESRD (end stage renal disease) surveillance Ø Ø

NATIONAL AND INTERNATIONAL PARTNERSHIPS Steering committee for prevention and control of Noncommunicable Ø Diseases Steering committee for Tobacco Control Ø National committee for Prevention of blindness and visual impairment Ø Technical Committee for Diet, Physical Activity and Health Ø Central Committee on Elderly Ø National Committee on Prevention of Musculoskeletal Disorders Ø Medical Associations (Heart and Chest , Diabetes, Osteoporosis) Ø Specialized Centers and Units (Cardiovascular, Diabetes, Obesity) Ø NGOs Ø ، International Organizations: W. H. O. , CBM , USAID Ø