Community

NON-COMMUNICABLE
Health
DISEASE CONTROL Nursing
 WHAT IS A NON-COMMUNICABLE
DISEASE?

◼Cannot be transferred from person to person;

non-infectious
◼Chronic diseases that are progressive
◼ Usually related to lifestyle
◼ May lead to disabilities, poor quality of life, or premature
death
 WORLD SITUATION

◼ NCDs kill more than 36 M people each year

◼ Nearly 80% of deaths occur in low to middle
income countries, with 90% of the 9 million
premature deaths occurring in the same
countries
 THE PHILIPPINE
SITUATION

Double burden of disease

◼ In 2008, of the total deaths 57% are d/t the fatal 4
◼ A significant portion of Filipino adults are exposed to
the risk factors
▪ Obesity (27%)
▪ HTN (25%)
▪ High blood sugar (5%)
▪ High cholesterol (10%)
▪ Smoking (31%)
▪ Alcohol (25%)
▪ Sedentary lifestyle (75%)
THE PHILIPPINE
SITUATION
 “THE FATAL 4”

1. Cardiovascular
diseases (HTN, CAD,
MI, stroke)
2. Cancer
3. Respiratory
Diseases (COPD)
4. Diabetes
BEHAVIOURAL RISK FACTORS

1. Tobacco smoking
2. Lack of physical
activity
3. Unhealthy diet
4. Alcohol drinking
PHYSIOLOGIC RISK FACTORS

1. High Blood Pressure

2. Overweight/obesity
3. Increased blood sugar
4. High level of fat in the blood
 PREVENTION & CONTROL OF NCDS

◼ Promote interventions to prevent & control NCDs

▪ Lessen the risk factors by means of low-cost solution
▪ High impact essential interventions for early detection &
timely treatment
▪ Creation of healthy public policies that promote & prevent
NCD
▪ Re-orient health systems to address needs of people with
such diseases
◼ Reduce the risk associated with NCDs
 WHAT IS THE WHO RESPONSE?

◼ 2008-2013 Action Plan (Global strategy for the

prevention & control of NCD)
◼ Provision of measures to lessen the risk factors
associated with NCDs
▪ Anti-tobacco campaign
▪ Global strategy on diet, physical activity & health
▪ Development of comprehensive global monitoring framework
for the prevention & control of NCDs
▪ Development of Global NCD Action Plan 2013-2010
◼ It provides the MINIMUM STANDARD for NCD
Interventions
◼ Integrated multifactorial risk management
◼ Ensures evidenced-based interventions maybe
done at the primary level
 THE PHILIPPINE
ACTIONS IN THE PHILIPPINES
ACTIONS

◼ Including NCD in the as a priority thrust under

“Kalusugan Pangkalahatan”
◼ Intensifying health promotion through Pilipinas
Go4Health Campaign
CONTINUATION..

◼ Promoting healthy food through mandatory labelling &

voluntary certification of healthier food options
◼ Implementing tobacco control initiatives: smoke-free
places , increase tax of tobacco & alcohol (RA 9211),
(House Bill 5727)
◼ Developing & implementing service delivery package of
essential NCD interventions at the primary level
◼ Enhancing NCD surveillance
 CARDIOVASCULAR (HYPERTENSION)

CATEGORY SYSTOLIC DIASTOLIC

Normal <120 <80
Pre-Hyperten 120-139 80-89
sion
Hypertension
Stage 1 140-159 90-99
Stage 2 160-179 100-109
Stage 3 >/180 >/110
RECOMMENDATIONS FOR FOLLOW UP

INITIAL BLOOD
PRESSURE

Systolic Diastolic FOLLOW-UP RECOMMENDED

<130 <85 Recheck in 2 years
130-139 85-89 Recheck in 1 year
140-159 90-99 Confirm within 2 months
160-179 100-109 Evaluate or refer to source of care
within 1 month
>/180 >/110 Evaluate or refer to source of care
immediately or within 1 week
depending on clinical situation
CVD RISK
STRATIFICATION
❑ Men > 55 years
❑ Women > 65 years
❑ Smoking
❑ Dyslipidemia
❑ Family History of premature
CVD
❑ Abdominal obesity > 120 cm,
>88 cm
❑ C-reactive protein >1 mg/dL
 STRATIFICATION OF RISK

RF Grade 1 Grade 2 Grade 3

No other RFs Low Moderate High
1-2 RFs Moderate Very High
>3 RFs or High Very High
target organ
damage or DM
Associated Very high
Clinical
Conditions
 CANCER
Type Prevention Detection
Lung Do not smoke None
Uterine Cervix Have one sexual partner, safe sex Regular pap smear every 1-3
years
Liver Vaccination, minimal alcohol None
intake and avoid moldy food
Colon and Rectum Prudent diet of variety of foods also Regular medical check-up
with high fiber and low fat intake after 40 years, yearly occult
blood tests, digital rectal
exam, sigmoidoscopy
Mouth Avoid smoking tobacco, modify
consumption of alcohol, cavity and
dental hygiene
Breast No conclusive evidence Monthly exam
Skin Avoid excessive sun exposure
Prostate No conclusive evidence
DIABETES Risk Factors
❑ Family History
❑ Obesity
❑ >45 y/o
❑ HTN
❑ High
HDL/Cholesterol
❑ History of
delivery of babies
>9 lbs
CRITERIA FOR DIAGNOSIS

❑ Symptoms + plasma
glucose >200 mg/dL
❑ Fasting plasma
glucose > 126
mg/dL
❑2 hours post
glucose load > 200
mg/dL (OGTT)
 REFERENCES

◼ WHO. (2010). WHO Package of Essential Non Communicable

Disease Interventions for Primary Health Care. Retrieved from
http://whqlibdoc.who.int/publications/2010/9789241598996_eng
.pdf
◼ http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_
phl_en.pdf
◼ http://whqlibdoc.who.int/publications/2011/9789241502283_eng.
pdf
◼ http://www.go4health.ph/pilipinas-go4health
◼ http://www.doh.gov.ph/sites/default/files/3%20Chapter1.pdf
END ☺