1. NCD Situation in Botswana
Ministry of Health
Department of Public Health
Disease Control Division
Non-communicable Diseases Program By
Bame Punah Shatera

2. Presentation Layout Introduction Situation of NCDs
Strategies/Response to NCDs
Successes and difficulties
Next steps

3. Switzerland
Botswana

4. Introduction cont. Demography
Relatively small population estimated in 2008 at 2million
Population density of 3 persons per sq km
34% of the population is under the age of 15years
6% are over the age of 65 years.
27% of the total population are women of child-bearing age
12% children under five years
Annual population growth rate 2.4 % and the total fertility rate is 3.17.

5. Introduction Health System
Ministry of Health runs the health care system in the country
It runs the hospitals and provides primary care through network of clinics, health posts, mobile stops as well as community based preventive and promotive services
Ministry of Health currently has 5 Departments
Prevention of HIV/AIDS;
Corporate Services;
Policy Planning and Monitoring and Evaluation;
Clinical Services and Care and
Public health, where NCD Programme falls.

6. The role of NCD Programme:
Introduction cont.
The role of NCD Programme:
Develop and maintain an effective disease
surveillance system
Carry out preventive and promotive
activities
Coordinate and monitor NCD activities

7. Introduction cont. At the moment NCD focuses on selected diseases
Cancer
Diabetes
Hypertension
Cardiovascular diseases

8. Situation of NCDs Number of cases and deaths due to NCDs (CSO-HEALTH STATISTICS REPORT 2001-2005)
2002
2003
2004
2005
Cases
Deaths DM
1.042 73
1.189 74
1.417 81
4.523 88
5.388
107
CVD
13.325 -
10.758 55
12.676
105
3.495
305
528
316
Hypertension
1.082
135
6.729 13
42.172
150
47.949
279
Neoplasm
2.143
442
1.198
415
3.109
437
8.939
410
2.879
486

9. Situation of NCDs cont. The WHO STEPS survey, Botswana, 2007 revealed
that risk factors identified were:
Tobacco use
currently smoking 32%males,7.8% females
Alcohol consumption
54.l% males 51.8% males(binge drinking)
Inadequate fruits and vegetable intake
96% of all respondents ate less than 5 servings of fruits and or vegetables on average per day
Physical inactivity
27% males, 42% females
Raised Blood Pressure
29% in males, 37% females.
Obesity/overweight
22% males, 53% females

10. Situation of NCDs cont.
Global Youth Tobacco Survey (2008)

11. Strategies/Responses
The NCD program in the Ministry of Health
The National Health Policy revised in 2009 to include Non-Communicable Diseases
A multisectoral and multidisciplinary team set to draft national policy and strategic plan on NCD(end 2009)
BNCR(population based)
Identified risk factors are addressed in the following ways:
Tobacco use
Control of Smoking Amendment Act Cap 2004
Protection from second hand smoking
Prohibition of marketing, promotion and advertising of tobacco products
Health education campaigns on harmful use of tobacco
Age restriction

12. Strategies/Response 2.Harmful use of alcohol
Alcohol policy now finalized and ready
Introduction of Levy Fund
Educational campaigns financed from the levy fund to target youths and the community.
Reduction of selling hours
Age restriction
Home brews

13. Strategies/Response 3.Nutrition 4. School Health Program
Breast feeding 1st 6months(SRH)
School Feeding programs
National action plan on nutrition
4. School Health Program
The National School Health Policy and Procedure Manual revised in 2010 to provide:
Physical examination for primary school pupils from STD 1-7 which includes:
BMI-To isolate obesity
Oral health
Eye examination
Mental Health

14. Strategies/Response to NCDs
5. Physical Activity
Inclusion of safe walk and bicycle lanes in major cities and towns
School Health Policy (revised 2010) which has a provision of safe and sanitary school environment such as:
Playgrounds and large rooms for indoor activities in every school
Adequate sports facilities and equipment in schools
A variety of other recreational activities in schools
Private Sector and NGO
Other Ministries
CAB
DAB
Private hospitals

15. Strategies/Response to NCDs
Wellness programmes
Wellness programmes in all government sectors and most of the private sectors

16. Screening and mgnt programs
Screening for High BP routine
Screening program for cancer of the cervix is run by Sexual Reproductive Health division
Management of High BP and diabetes is integrated in the health care system

17. Successes Completion of draft Strategic Plan and on NCD. BNCR
Inclusion of NCDs in the NHP
Completion of draft Strategic Plan and on NCD.
BNCR
Continued advocacy on NCD
Data on risk factors

18. Challenges Inadequate trained personnel
Lack of standard management guidelines
Inadequate advocacy
Poor surveillance system

19. Next steps Develop communication strategy Strengthen partnership
Widen scope of public education
Pilot the WHO package for integrating Essential NCD interventions into Primary Care(WHO-PEN)