prevention and control of non communicable diseases in Iraq

NONCOMMUNICABLE DISEASES A Recent Public Health Concern in Iraq NCDs form a major public health problem in Iraq Iraq is passing through a transitional epidemiological period with increasing burden of Non communicable diseases NCDs and their contributory risk factors.

Current Situation of Noncommunicable Diseases Mortality Attributed to Noncommunicable Diseases: Five -six of the ten leading causes of mortality are attributed to NCDs. Mostly, cardiovascular diseases Every year 22000 people die with cardiovascular diseases, 7000 with cancer, 4000 with diabetes and 1500 with chronic respiratory diseases/asthma. Morbidity Imposed by Non communicable Diseases: Public Clinics: Hypertension 20,000/,Diabetes: 16,000,Ischemic heart diseases: 7,000,Asthma 4,500/ Year. Hospital record: Ischemic heart diseases leading cause of hospitalization. Iraqi cancer registry: more than 14,000 new cases of cancer are recorded yearly. Breast cancer first ranked among the top 10 cancers in Iraq followed by lung cancer then Leukemia.

Non Communicable Diseases Risk Factors Among Adults (25-65 yrs), Iraq 2006 Female Male Both Behavioural risk factors * Tobacco consumption 6.9 41.5 21.9 Less than 5 servings of fruit and/or vegetable/ day 91.5 Physical inactivity 52.7 61.8 56.7 Biological factors       Overweight 31.4 37.4 34 Obesity 38.2 26.2 33 Raised blood pressure 38.3 43.1 40.4 Hyperglycaemia 9.9 10.9 10.4 Hypercholesterolemia 36.5 37.5

Integration of NCD Care into Primary Health Care Services Screening and comprehensive care for hypertension and diabetes Early detection of breast cancer Primary care for asthma Development of National evidence based guidelines Introduction of essential drugs and laboratory tests and diagnostic procedures for major NCDs into PHCcs. Services for prevention and control of avoidable blindness with a focus on primary eye care.

Challenges/requirements: Active Multi-sectoral participation to support addressing social determinants,Globalization ,Social norms ,Legislations Sustained resources especially for health promotion campaigns and intervention on social determinants. Access to target population .Availability of resources for national surveys Updating information and upgrading skills.

Tobacco Control . monitor tobacco use and tobacco-prevention policies protect people from tobacco smokee in public places and workplaces offer help to people who want to stop using tobacco warn people about the dangers of tobacco enforce bans on tobacco advertising, promotion and sponsorship raise tobacco taxes and prices Challenges/requirements(Tobbaco control) Maintenance of the Multi sectoral commitment at the decision making level Sustainability of funding source for intervention and tobacco control campaigns. Technical cooperation with national sectors and international organizations

Promotion of healthy diet, physical activity and health Screening and primary care for obesity for school children Promotion of physical activity addressing a variety of age spectrum with emphasis on school children School based nutrition education program Production of guidelines Public awareness approaching different target group in collaboration with the media and other governmental and nongovernmental sectors.

Annual review of NCD programs preventing department of DOH , DOHUK ,2010

PHCs included in NCD programs (2009-2010)

NCD Activities 2010 No. Activity 19 Training course 245 Participant 18 seminar 5 Celebration 40(1:cervical ca.,28: DM&HTand11:Mental health PHCs newly Included in NCD programs 45 Monitoring visit

Community eye health center (bahdinan) statistics 2009-2010

Primary mental health program 2009 2010 12 worker/ 11unit 22 worker/ 21unit

screeningD.M,HT

Breast ca.

Breast cancer program Breast cancer screening Program for 2010 Total no. of women Attending the breast cancer clinic2009:1292 Total no. of women Attending the breast cancer clinic 2010:1962

Breast cancer 2010

Breast cancer 2010 No. of female examind on ( 58): PHCs 53574 No. of female refered to the breast cancer clininc from PHCs 1234 No. of female refuse refering to the breast cancer clininc 85 Referal cases from PHCs reach the breast cancer clinic 903

Diabetes center The total number of patients during the year 2010 : 17122 Male 6288 Female 10834 Number of files done at year 2010 : 1546 Male 572 Female 974

DOHUK,IRAQ Thank You for Listening