The increasing burden of Non Communicable
Diseases (NCD), particularly in developing countries, threatens to overwhelm
already-stretched health services. The factors underlying the major NCDs (heart disease, stroke, diabetes, cancer and chronic
respiratory conditions) are well documented. Primary prevention based on
comprehensive population-based programme is the most cost-effective approach
to contain this emerging epidemic.
unique opportunity that exists to formulate and implement an effective
strategy for substantially reduce deaths and disease burden worldwide by
improving diet and promoting physical activity, WHO has adopted, in May 2004,
the "Global Strategy on Diet, Physical Activity and Health". The overall goal of the strategy is to
promote and protect health through healthy eating and physical activity.
2007, progress report to the Assembly describes non communicable disease activities in advocacy, surveillance
and population-based prevention since the year 2000. A resolution urges
Member States to strengthen national efforts in non communicable disease
(NCD) prevention and control and also calls for an action plan for the
prevention and control of NCDs to be presented to
the 61st WHA in 2008. The Assembly held lengthy discussions on public-health
problems caused by the harmful use of alcohol.
An NCD policy and
strategies has been drafted and NCD RF survey conducted in 2004-2005, in
2006-2007 with a good coordination of WCO Nepal, SEARO and support from HQ
Nepal has been able to follow up with interventions at district level,
launching of the global report, improving country’s capacity on NCD RF data
analysis and planning for the nationally representative data of the NCD risk
Objective of the evaluation
Present the results
and future options of GON - WHO collaborative program
Specific objective Identify investments to improve
v Health System
v Equitable access to health
v Global health security
v Determinants of health and accountability
Outputs of 2006-07
As part of supporting implementation of the
national policies and strategic plans for NCDs
following exercises were conducted to meet the following expected results.
NCD surveillance system initiated and
linked to the HMIS, in keeping with the National NCD surveillance strategic
v Utilizing the NCD RF data of 2004-05 NCD
intervention plan in 3 districts have been developed. A dissemination meeting
of NCD RF 2005 was carried out, a district plan of action for NCD awareness
program agreed upon, and a screening camp for early detection of breast and
cervical cancer, hypertension and Diabetes mellitus was carried out.
v Two officials were trained in planning and
implementation of NCD InfoBase to develop NCD InfoBase network in three
hospitals. Beginning by developing guidelines and instrument for data
collection at hospital level, a training guideline was developed.
v An Inter country workshop on NCD RF data
management analysis and reporting was carried out in Kathmandu from 18-22 July 2006 supported by
experts from SEARO and trainers from HQ. At the event there were also a
launching program of World NCD report by Ministry of Health and Population.
v A screening camp was carried out in Lalitpur, Ilam and Tanahun. About 1000 local people were screened for major NCDs,
early detected cases were referred for further follow up at the district
v 7 hospitals have been supported for National
cancer registry. A new reporting tools has been
Human resource for integrated
NCD prevention and control strengthened
v Policy makers and NCD program managers have been
briefed on evidence based prevention and control of NCD’s
during which the policy draft was reviewed and proposed for revision.
v Oral health issues was advocated and
disseminated among health stakeholders, government as well as external
development partners. Oral health training materials were reviewed and
necessary changes have been recommended. ToT in
Oral health management conducted and refresher training for 24 health workers
on basic oral health package was carried out for health worker in line with
the second long term health plan 1997-2017.
Dr Praveen Mishra,
Oral Health Focal Point and Mr Gyan Bdr Basnet participated in the
international conference in China.
Technical input provided by participating in Diet Physical activity and
Myanmar 2006, Cervical cancer
prevention, Bangkok, Thailand 2007, Monitoring and supervision of NCD RF
survey result dissemination, screening camp for major NCD, and awareness
program follow up.
Community and hospital based interventions on major NCDs operational in selected demonstration area
v Awareness program for diet and physical activity
was conducted in three districts. Support has been provided to create
awareness program on NCD at community level by local NGO.
v Regional Statistical Support Group provided
support in finalizing the proposal for the national NCD RF survey 2007. The
NCD Regional Adviser was supporting the whole process not only technically
but also helping Nepal
to get funds for NCD survey implementation. At present Nepal NCD Risk Factor
Survey 2007 is being initiated.
hospital teams together with central NCD team carried out the screening for
major NCD at the three districts (Lalitpur, Ilam and Tanahun). An NGO,
teachers’ association developed a training manual for school age youth in and
out of school, to increase awareness of primary prevention for NCD. At
present the draft is in field trial.
policy and strategies reviewed and waiting for government endorsement. The
regional and HQ support for NCD was
profound, and there is significant awareness improvement about primary
prevention for NCD. After the NCD RF survey 2007 Nepal can refine the policy and
strategies draft, design an intervention policy to reduce risk and promoting
v Nepal NCD intervention is the country responsibility as a follow
of member countries’ commitment in the WHA. The global strategy has four main
objectives: Reduce risk factors for chronic diseases, increase awareness and
understanding of DPAS, develop strengthen and implement global, regional,
national policies and action plans and monitor science and promote research
on diet and physical activity. Bringing about changes in the dietary habits
and patterns of physical activity will require the combined efforts of many
stakeholders, public and private, over several decades. A combination of
sound and effective actions is needed at global, regional, national and local
levels, with close monitoring and evaluation of their impact.
link to the health education program could be developed and supported by the