2nd International Seminar on the Public Health Aspects of Non-communicable Diseases 10 – 18 August 2010 lausanne, switzerland By Dr D A Bash-Taqi Director of Postgraduate training, NCDs and Research Republic of Sierra Leone

Outline of presentation Introducing Sierra Leone NCD Situation in Sierra Leone Response to NCD interventions & approaches Challenges and Opportunities Future plans and perspectives

Introducing Sierra Leone 6 million population 37% resides in urban areas Life expectancy: 47 yrs(M), 49 yrs (F) Population below $1 a day (70%) GoSL allocation to health: 8% of GDP ($18.4 M) 4 regions, 14 districts, 149 chiefdoms Capital city is Freetown

NCD Situation in Sierra Leone Profile of NCDs Cardiovascular diseases/strokes Hypertension Diabetes Chronic respiratory diseases Cancers(breast,cervical,liver,prostrate,burkitt’s lymphoma) Mental disorders/epilepsy Sickle cell disease Injuries

NCD Situation in Sierra Leone NCD Risk factors among adult population aged25-64 years 17% current drinkers 14% males and 5% females of the population engaged in heavy episodic drinking respectively. 34% currently use tobacco( 26% smoking tobacco and 8% using smokeless tobacco) 74% and 69% of non-smokers are exposed to tobacco smoke at home and workplace respectively

NCD Situation in Sierra Leone 35% of the population have raised blood pressure with only 7% on medications Average BMI is 23 kg/m2, 22% classified as overweight and 8% obese. 91% of the population consumes less than 5 servings of fruits and/or vegetables on average per day 87% had sedentary lifestyles.

Main interventions and approaches Response to ncds Main interventions and approaches FCTC ratified (july 2010) Ban on adverts for tobacco and alcohol No smoking zones in some selected GoSL facilities Integration of NCD/MH prevention and control into PHC

Response to ncds contd NHSSP(2010-2015) developed & launched(NCD/MH) NCD Policy and strategic plan developed (2010) MH policy and strategic Plan developed & launched(May 2010) STEPS Survey on NCD RFs

Challenges and opportunities Financing, Medicines and supply system Health workforce(primary care) Affordable technologies Equity

Challenges and opportunities Referral links Integration of NCDs into PHC Information systems Political (in)stability SWAP to strengthen health systems CHALLENGES

Challenges and opportunities PRSP 2(2008-2012) and NHSSP(2009-2013) have NCDs and MH as priority objectives Existence of DPNR with a budget line within MOHS Interest of DPs in NCDs P&C Results from GYTS and STEPS surveys for advocacy Inclusion of mental health into NCDs Ratification of FCTC in 2010

Future plans and perspectives Reinforce leadership and strengthen capacity of the health system for prevention and control of NCDs.   Advocate for other relevant national policies and plans that may impact on prevention and control of NCDs Establish and strengthen an integrated NCDs surveillance and provide evidence for public health decision making. Promote healthy lifestyle and reduce risk factors using health promotion strategies.

Future plans and perspectives Promote research for the prevention and control of NCDs Strengthen partnerships and establish a network of relevant stakeholders for surveillance, prevention and management of NCDs. Establish a System for NCDs monitoring and evaluating the effectiveness of promotion, prevention and control measures.