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Discusses the role of primary health care to prevent NCDs and lessons from CARMEN initiatives and North Karelia Project
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Title PageChronic
Non-communicable Diseases in Latin America:The Role of PHC
Dr. Elvira BeracocheaMIDEGO, Inc.
Presidentelvira@midego.com
140th APHA Annual Meeting Monday, October 31, 2012
Disclosure
• Dr. Elvira Beracochea has nothing to disclose.
Up to 80% of the NCD mortality, mainly due to cancer, diabetes, chronic lung disease and cardiovascular disease, can be prevented by improved individual care and public health programs.
Objectives
1. Discuss the role of primary health care to prevent NCDs
2. Discuss lessons from the CARMEN initiative and North Karelia Project
CNCD are
Preventable
Reversible
Curable
North Karelia, Finland
•1972
• After the first 25 years, the project demonstrated to have achieved changes in smoking, BP and diet
–CVD mortality reduced by 68%
–CHD mortality reduced by 73%
–All causes mortality reduced by 49%
North Karelia: Interventions
•PHC providers involved in all aspects of the program•Involvement of community organizations and residents•Training and Media Communication•Environmental changes•Partnerships with food industry
CARMEN
Conjunto de Acciones para la Reducción Multifactorial de Enfermedades No transmisibles
Concerted actions to reduce multifactorial non- transmissible or non-communicable diseases
PAHO: Country-Wide Actions
1. National Plan of Action
2. Policies
3. Community-based actions
4. Health service reorganization
5. Integrated promotion and prevention actions
6. Health equity focus
7. Baseline and surveillance adapted to measure progress: Observatory
Observatory
• Goal: support policy advocacy, development, monitoring and impact measurement
• Canada, Brazil, and Costa Rica• Chile, Uruguay, Guatemala and Cuba
and other Caribbean Countries (25+)• Benchmarks• Improve Surveillance
Effective Interventions
• Tobacco taxes, smoking free areas and smoking cessation treatments
• Transfat free America (Rio 2008)• Healthy meals in schools• Reduction of salt in diet• Increase physical activity• Community-based promotion• Improvement of PHC and referral services
Advocacy
• “Program Dose” matters
• Sustained efforts also matter
• Integrated community based programs do work:– Health education– PHC services– Community involvement and participation
• Not Surprised!
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