1. PROF. G.C. ONYEMELUKWE (MON)
ROLE OF MEDICAL WOMEN ASSOCIATION OF NIGERIA IN NON-COMMUNICABLE DISEASES BY
PROF. G.C. ONYEMELUKWE (MON)
CHAIRMAN, NATIONAL EXPERT COMMITTEE ON NON-COMMUNICABLE DISEASES
AREWA HOUSE KADUNA
23RD NOVEMBER 2004

2. _ _____ _ ______ ______ _____ ______ ____ ______ ____
WHAT DO WOMEN WANT?
_ _____ _ ______ ______ _____ ______ ____ ______ ____

3. LIST OF NON COMMUNICABLE DISEASES
10. Coronary heart disease
11. Cerebrovascular disease (stroke)
12 Heart Disease
a. Cardiomyopathies
b. Endomyocardial fibrosis
c. Peripartum Cardiac
failure (PPCF)
13. Cancers
a. Hepatoma
b. Prostate
c. Cervix
d. Breast
Hypertension
Diabetes Mellitus
Sickle Cell Disease
Mental ILL Health & drug abuse
Asthma
Violence (Road traffic accident, domestic, conflict
Blindness
Oral Health
Rheumatic fever/rheumatic heart disease

4. Road traffic Accidents 14.25% 2. Infections and Septicaemia 10.80% 3.
MORTALITY STATISTICS ( ) ABUTH, ZARIA (Source: Community Medicine) 1.
Road traffic Accidents
14.25% 2.
Infections and Septicaemia
10.80% 3.
Hypertension
9.32% 4.
Protein calorie malnutrition
8.53% 5.
Tuberculosis
5.09% 6.
HIV/AIDS
4.75% 7.
Cancers
4.07% 8.
Mellitus
3.29% 9.
Cerebrovascular Accidents (Stroke)
2.35%
*44% of deaths are due to NCDs

5. *2003 SURVEILLANCE DATA LAGOS (SW ZONE)
BP systolic =>140mmHg
BP diastolic =>90mmHg
Female : 22.6%
Male : 22.1%
Female: %
Male : 30%
Rural (all) : 13.7%
Urban (all): 28.7%
Rural : %
Urban : %
* Risk of CVS damage doubles for every 10 point increase in diastolic and 20 point systolic increase. * ¼ to 1/3 of women in rural and urban areas are hypertensive.

6. NATIONAL MENTAL HEALTH SURVEY
DEPRESSION SYMPTOMS HIGH (Female>male)
ANXIETY SYMPTOMS HIGH
NB: Severe depression can lead to violence and suicide

7. BURDEN OF NON COMMUNICABLE DISEASE (DALYs) %DISTRIBUTION IN SUB SAHARAN AFRICA

8. WHAT IS RISK FACTOR?
A risk factor is a condition that places an individual at risk of developing a health related problem.
A risk factor can be genetic or acquired. It may be identified as a single measurement (e.g. a physical feature such as weight), a disease (e.g. Hypertension) or a lifestyle characteristics (e.g. smoking)

9. WHAT IS RISK FACTOR? Cont.
In order to be considered a risk factor for a disease, the condition must be associated with that disease in a manner which is beyond chance alone.
A casual link is therefore implied
A risk factor will however not necessarily lead to the development of the disease
Risk factors/habits begin in youth/in womb.

10. RISK FACTORS IN NCD’s I √ Physical inactivity Alcohol Excess
Hypertension
Diabetes
Mellitus
Strokes
Cancer
CAD
Mental
Illness
Violence
Heart Disease/ PPCF
Physical inactivity √
Alcohol Excess
Drug Abuse/Use
Tobacco Use/Smoking
Salt Excess X
Unhealthy Diets
Obesity
Abnormal Blood Lipids
Psychological Stress
Low Economic Status
Unsafe Sex
Age
Family History/Heredity
Gender

11. RISK FACTORS IN NCD’s II
Asthma/COPD
Sickle Cell Disease
Blindness
Oral Health
Osteoporosis/
Nutrition
Physical inactivity √ X
Alcohol Excess
Drug Abuse/Use
Tobacco Use/Smoking
Salt Excess
Unhealthy Diets
Obesity
Abnormal Blood Lipids
Psychological Stress
Low Economic Status
Unsafe Sex
Age
Family History/Heredity
Gender

12. REASONS FOR EXPLOSION OF NCDs
1. Western Lifestyle Leading to
INSULIN RESISTANCE
2. ROLE OF INFECTIONS
Cancer Liver HBV, HBC (25-40% CARRIERS)
Cervix – Papilloma/Herpes genitalis
Bladder – Schistosomiasis
Coronary artey disease – Chlamydia
Rheumatic heart disease – streptococci
Blindness – filaria/chlamydia.

13. REASONS FOR EXPLOSION OF NCDs Cont.
3. CULTURAL
Large body image “pot” belly/ “cash madam”
Cultural pre-matual fattening
“Kunu Kanwa” heating postpartum heart failure
“Mai – Shanu” consumption lipidemia
Traditional African cooking vitamins antioxidants destroyed
4. INTRAUTERINE LOW BIRTH WEIGHT
(BAKER’S HYPOTHESIS – Stress, infection, under-nutrition, smoking.
5. NUTRITIONAL TRANSITION
CHILD STUNTING; REFEEDING – SHORT OBESE ADULT

14. CHILDHOOD UNDER NUTRITION
ENVIRONMENT
GENES
PHYSICO-CHEMICAL-MICROBIAL ENVIRONMENT
PSYCHOSOCIAL ENVIRONMENT
INTRAUTERINE ENVIRONMENT VS
HIGH STRESS
LACK OF EXERCISE
HIGH FAT
SMOKING
HIGH RISK
BEHAVIOUR
HIGH SALT
ALCOHOL
UNSAFE SEX
DRUG ABUSE
FETAL UNDER NUTRITION
OBESITY, HYPERTENSION, DIABETES,
ASTHMA, CANCERS, MENTAL ILL-HEALTH,
CORONARY ARTERY DISEASE
OSTEOPOROSIS ETC
CHILDHOOD UNDER NUTRITION

15. TEN COMMAND CIVIC DUTIES OF ALL NIGERIANS
S/N
DUTIES
BENEFITS 1.
Exercise daily (including walks)
Prevention of hypertension, diabetes, obesity, mental ILL health, cancers etc. 2.
Know blood pressure from age 30 and above (annually/six monthly)
Detect hypertension early (blood pressure increases with age) 3.
Know blood sugar from age 40 years
Detect diabetes mellitus (blood sugar increases with age) 4.
Know sickle cell genotype of all family
For counseling of family 5.
Monthly breast self examination by females from age 17
To detect lumps and early breast cancer 6.
Know presence of hepatitis B surface antigen in blood of family members
Prevent liver cancer and other diseases. 7.
Know prostate specific antigen (PSA) blood level (men 50 years)
To detect prostate cancer 8.
Women screen cervical smear (PAP Smear) every 2 – 3 years
To prevent, detect early cervical cancer. 9.
Know blood cholesterol by obese or overweight people from age 40 years
Prevent coronary heart disease
10.
Know body mass index (BMI) (weight in kg
Height x height (mtrs)
To watch nutritional excess or deficiency
Issued by NCD Expert Committee on Non-Communicable Disease Note: BMI >30kg/mtr2 is Obesity BMI >25kg/mtr2 is overweight BMI <18.5kg/mtr2 shows under-nutrition

16. POLITICAL WILL – Lack IN STATES of NCDs, SILENT KILLERS CARING/COMPASSIONATE SOCIETY
FIRM VOICE; FIRM AGENDA BY (WOMEN)
STRATEGIC GATES OF WOMEN AND CONSEQUENCES
1. Gate to stomach
2. Gate into world (womb – intrauterine)
3. Gate to Child/Family Destiny – Children risk factors
4. Gate to Domestic Finance

17. CONCLUSION ROLES: INFORMATION, EDUCATION, COMMUNICATION – RADIO TALKS
SCREENING
LIFESTYLE RISK FACTOR MODIFICATION (MULTIFACTOR APPROACH)
RESEARCH IN WOMEN HEALTH – BRITISH WOMEN/USA DONE
NATIONAL ACTION ON TOBACCO CESSATION
HEPATITIS B VACCINATION OF CHILDREN

18. MAY GOD’S PUPPOSE
FOR NIGERIA BE
PERFORMED