Dr. Shelanee Gunarathne
Currently, chronic non-communicable disease (NCDs) are overtaking communicable diseases as the dominant health problem, and are now the leading causes of mortality, morbidity, and disability. It has led to an increase in use of health resources. Aging of the population, urbanization and lifestyle changes are the key factors behind this epidemiological transition.
1.1 current situation of chronic NCDs in Sri Lanka
The following major chronic NCDs have a significant disease burden in Sri Lanka; cardiovascular diseases(including coronary heart diseases [CHD], cerebrovascular diseases [CVD] and hypertension), diabetes mellitus, chronic respiratory diseases, chronic renal diseases and cancers.
In 2001 chronic NCDs accounted for 71% of all deaths in Sri Lanka, compared with 18% due to injuries, and 11% due to communicable diseases, and maternal and perinatal conditions.
1.2 Major risk factors for chronic NCDs
There are few risk factors shared among all major chronic NCDs, namely smoking, unhealthy diet, physical inactivity and harmful alcohol use. Prevalence of these risk factors at population level has a major influence on morbidity and mortality due to NCDs.
The prevalence of (current) smokers among adult male is 22.8% while among female is less than 1% (Ministry of Health, 2008)
Unhealthy food could be defined as foods that contain high-salt content, high-sugar content, high trans-fatty acids and saturated fat. High consumption of fruits and vegetable is strongly associated with better health outcomes.
Moderate level physical activity is a protective factor against many NCDs.
Percentage of current drinkers is significantly higher in males (26.0%) compared to females (1.2%). However, less than five percent of male population take alcohol more than 4 days per week.
Other risk factors-
Air pollution – Air pollutants consist of gaseous pollutants, odours and suspended particulate matter.
The government of Sri Lanka acknowledge that the prevention and control of chronic NCDs is a priority issue in the national health agenda and the National Health Master Plan 2007 – 2016 as these lower the quality of life, impair the economic growth of the country and place a heavy and rising demand on families and national budgets.
2 Policy Vision
A country that is not burdened with chronic non- communicable diseases (NCDs), deaths and disabilities.
3 Policy Goal
The overall goal of the National NCD Policy of Sri Lanka is to reduce the burden due to chronic NCDs by promoting healthy lifestyles, reducing the prevalence of common risk factors, and providing integrated evidence-based treatment options for diagnosed NCD patients.
4. Key Strategies
- Implement a cost-effective NCD screening program at community level with special emphasis on cardiovascular diseases
- empower the community for promotion of healthy lifestyle for NCD prevention and control
- Enhance human resource development to facilitate NCD prevention and care
5. NCD Screening programme
Primary health care facilities at the door step of the community has been strengthened by establishing sustainable screening programme through Healthy Lifestyle Centers (HLCs) and initiating availability of essential generic drugs and technologies to manage NCDs and other NCD related risk factors.
NCD screening programme implemented through the NCD unit consists of 3 strategies.
- To screen people in HLCs
- To conduct workplace screening
- To conduct mobile screening
Ministry of Health has taken an initiative to establish HLCs throughout the island to screen normal people. The target group to screen at Healthy Lifestyle Centers are people who are between 40 to 65 years. Main aim of screening is to identify both behavioural and intermediate risk factors early in view of preventing pre mature deaths due to NCDs.
HLCs have been mainly established in health institutions. Wherever there is no health institution to establish HLC, approval has been given to establish HLCs in MOH office and field clinics. There are 71 Healthy Lifestyle Centers in Gampaha district.
Information about Healthy Lifestyle Centers in Gampaha district
RDHS Office Gampaha 2018
|Attanagalla||Base Hospital Wathupitiwala||Tuesday||08.00 am – 12.00 pm||0332280261/2|
|PMCU Thihariya||Thursday||08.00 am – 12.00 pm||–|
|PMCU Bemmulla||Thursday||08.00 am – 12.00 pm||–|
|PMCU Veyangoda||Wednesday||08.00 am – 12.00 pm||–|
|PMCU Alawala||Friday||08.00 am – 12.00 pm||0335678287|
|PMCU Urapola||Monday||08.00 am – 12.00 pm||–|
|Biyagama||Divisional Hospital Biyagama||Monday||08.00 am – 12.00 pm||0112487524|
|MOH Office Biyagama||Saturday||08.00 am – 12.00 pm|
|Dompe||District Hospital Dompe||Saturday||08.00 am – 12.00 pm||0112409544|
|Divisional Hospital Radawana||Monday||08.00 am – 12.00 pm||0332267261|
|PMCU Mithirigala||Wednesday||08.00 am – 12.00 pm||0332267161|
|PMCU Mandawala||Wednesday||08.00 am – 12.00 pm||–|
|PMCU Malwana||Thursday||08.00 am – 12.00 pm||–|
|PMCU Pugoda||Thursday||08.00 am – 12.00 pm||0112405262|
|PMCU Anuragoda||Thursday||08.00 am – 12.00 pm||–|
|Divulapitiya||District Hospital Divulapitiya||Monday||08.00 am – 12.00 pm||0312246261|
|Divisional Hospital Akaragama||Friday||08.00 am – 12.00 pm||0312269261|
|PMCU Halpe Katana||Friday||08.00 am – 12.00 pm||–|
|PMCU Kotadeniyawa||Monday||08.00 am – 12.00 pm||0312246262|
|PMCU Dunagaha||Thursday||08.00 am – 12.00 pm||0312246262|
|PMCU Wekada||Friday||08.00 am – 12.00 pm|
|PMCU Halpe Mirigama||Daily||08.00 am – 12.00 pm|
|PMCU Badalgama||Daily (except Sunday )||08.00 am – 12.00 pm||–|
|Gampaha||District General Hospital Gampaha||Daily (except Sunday )||08.00 am – 12.00 pm||0332222261|
|PMCU Weliweriya||Monday||08.00 am – 12.00 pm||–|
|PMCU Ganemulla||Thursday||08.00 am – 12.00 pm||–|
|MCH Clinic Makevita||3rd Saturday||08.00 am – 12.00 pm||–|
|PMCU Kalagedihena||Wednesday||08.00 am – 12.00 pm||–|
|Jaela||District Hospital Jaela||Monday||08.00 am – 12.00 pm||–|
|MCH Clinic clinic Gallawatta (Ekala)||4th Tuesday||08.00 am – 12.00 pm|
|MCH Clinic clinic Kandana||2nd Saturday|
|08.00 am – 12.00 pm|
|Katana||PMCU Andiambalama||Monday , Thursday||08.00 am – 12.00 pm||–|
|PMCU Kandawala Katana||Tuesday||08.00 am – 12.00 pm||–|
|Katunayaka||PMCU Katunayaka||Daily (except Sunday )||08.00 am – 12.00 pm||–|
|Kelaniya||Base Hospital Kiribathgoda||Wednesday||08.00 am – 12.00 pm||0112911493|
|PMCU Sinharamulla||Tuesday||08.00 am – 12.00 pm||–|
|PMCU Peliyagoda||Saturday, Monday||08.00 am – 12.00 pm||–|
|PMCU Hunupitiya||Thursday||08.00 am – 12.00 pm||–|
|Mahara||Divisional Hospital Udupila||Monday||08.00 am – 12.00 pm||–|
|PMCU Kadawatha||Thursday||08.00 am – 12.00 pm||–|
|Divisional Hospital Malwathuhiripitiya||Saturday||08.00 am – 12.00 pm||0332279261|
|Mirigama||Base Hospital Mirigama||Saturday||08.00 am – 12.00 pm||0332273261|
|PMCU Kaleliya||Wednesday||08.00 am – 12.00 pm|
|PMCU Ambepussa||Friday||08.00 am – 12.00 pm||–|
|PMCU Muddaragama||Wednesday||08.00 am – 12.00 pm||–|
|PMCU Pasyala||Wednesday||08.00 am – 12.00 pm||0332285780|
|PMCU Bokalagama||Wednesday||08.00 am – 12.00 pm||0332270283|
|PMCU Weweldeniya||Wednesday||08.00 am – 12.00 pm||–|
|PMCU Maligathenna||Thursday||08.00 am – 12.00 pm||–|
|PMCU Maladeniya||Tuesday||08.00 am – 12.00 pm||–|
|PMCU Nambuluwawa||Wednesday||08.00 am – 12.00 pm||0332285794|
|PMCU Pallewela||Monday||08.00 am – 12.00 pm||–|
|PMCU Halpe Mirigama||Every week days||08.00 am – 12.00 pm||–|
|Minuwangoda||District Hospital Minuwangoda||Tuesday||08.00 am – 12.00 pm||0112295261|
|PMCU Korasa||Friday||08.00 am – 12.00 pm||0332290542|
|PMCU Dewalapola||Tuesday||08.00 am – 12.00 pm||–|
|PMCU Madelgamuwa||Wednesday||08.00 am – 12.00 pm||–|
|Negombo||District General Hospital Negombo||Daily (except Sunday )||08.00 am – 12.00 pm||0332222261|
|PMCU Thalahena||Monday||08.00 am – 12.00 pm||0312233176|
|PMCU Kochchikade||Wednesday||08.00 am – 12.00 pm||–|
|Ragama||MCH Clinic Kurukulawa||4th Wednesday||08.00 am – 12.00 pm|
|MCH Clinic Batuwatta||3rd Saturday||08.00 am – 12.00 pm|
|Seeduwa||PMCU Seeduwa||Tuesday||08.00 am – 12.00 pm||–|
|Vijaya Kumarathunga Memorial Hospital Seeduwa||Tuesday||08.00 am – 12.00 pm||–|
|PMCU Raddolugama||Tuesday||08.00 am – 12.00 pm||–|
|PMCU Madawala Minuwangoda||Thursday||08.00 am – 12.00 pm||–|
|Wattala||Divisional Hospital Pamunugama||Friday||08.00 am – 12.00 pm||0112236622|
|PMCU Uswetakeiyawa||Wednesday||08.00 am – 12.00 pm||–|
|PMCU Hendala||Friday||08.00 am – 12.00 pm||0112933212|
6. Monitoring and evaluation of the NCD programme
- District level review meetings
- Quarterly review meetings
- NCD steering committee meetings
- Safe community meetings
- Field level
- Supervisory visits to HLCs by District MO NCD
The focal point for injury prevention in the Ministry of Health is the Non Communicable Disease (NCD) unit. It involves in planning programmes, developing guidelines and polices in preventing almost all types of injuries which could occur during one’s lifetime from the date of birth to the death covering all ages from infancy to the adulthood.
NCD unit is working in collaboration with other stakeholders in view of integrating injury prevention in to everyday life of people across homes, schools, working places and roads in Sri Lanka.
NCD unit has established an injury surveillance system recently.