NCD Unit

District MO NCD duty list

1 Background

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.

Smoking

The prevalence of (current) smokers among adult male is 22.8% while among female is less than 1% (Ministry of Health, 2008)

Unhealthy diet

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.

Physical inactivity

Moderate level physical activity is a protective factor against many NCDs.

Alcohol consumption

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-

Stress

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

1. Implement a cost-effective NCD screening program at community level with special emphasis on cardiovascular diseases
2. empower the community for promotion of healthy lifestyle for NCD prevention and control
3. 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.

1. To screen people in HLCs
2. To conduct workplace screening
3. 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.

Guideline for the establishment of HLC 1

Guideline for the establishment of HLCs in healthcare institutions 2

Guideline for the establishment of HLCs in healthcare institutions 3

6. Monitoring and evaluation of the NCD programme

1. District level review meetings

• Quarterly review meetings
• NCD steering committee meetings
• Safe community meetings 

Multisectoral approaches for prevention and control of NCD

National Multisectoral Action Plan

2. Field level

• Supervisory visits to HLCs by District MO NCD

Supervisory check list

ISH Risk Prediction Chart

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.

Acute NCD

NCD Guidelines

Guidelines for management of overweight and obesity

Management of DM

National salt reduction strategy 2018 – 2022

Guidelines for cardiovascular risk management