Tuesday, June 4, 2013
Non-Communicable Diseases Prevention & Control
By Cooh Odette Behn, Cameron Link The prevention and control of non-communicable diseases was at the centre of a one day Community of Learning Issues workshop in Yaoundé on the 30th May, 2012 how these diseases affect lactating mothers, the family and relatives. The workshop was presided by the Sub-Director for disease prevention at the ministry of public health, Dr SEPDE OUMAROU, who emphasized that the problem has become a public health issue in Cameroon. Cameroon Link led by James Achanyi-Fontem chaired the session to adopt the statute and internal regulation of a consortium of associations and put in place an administrative board to work out strategies to prevent and control non-communicable diseases in Cameroon. These common diseases which are avoidable have socio-economic and ecological impact that limits access to treatment. Early screening can act as primary preventive measures that modify common risk factors in health promotion. Non-communicable diseases are classified in four groups which include hypertension, diabetes, la chronic renal infections and cardiovascular infections in the first group. Cancer, Asthma and other respiratory problems fall in the second group. Dental, visual and ear problems are classified third, while epilepsy, neurological infections, sickle cell disorder, rheumatism and mental disorders considered to be genetic infections are in the fourth class. WHO Statistics in 2010 showed that the prevalence of hypertension in men is 39.6%, while 34.2 % of women are affected in Cameroon. In 2008, mortality rate in men is put at 39.7 and 46.1 % in women. This is even worse for aged persons before 70 years as statistics are put at 63.1% for men and 62.6% for women. The situation is worsen by the limited financial resources to take care of patients. Focusing attention on cancer, it was revealed that there are 12.000 new cases of cancer registered each year, 25.000 persons are said to be currently living with cancer. This figure may double by the year 2020 experts say. The most frequent cancers of cancers affected the breasts, uterus, prostate gland and liver. More than 80% of persons affected do the first screening test only the infection is at an advanced stage and these persons die within the 12 months that follow diagnosis. Asthma et chronic respiratory affections are on the increase and morbidity is visible in Cameroon, because of the low age of the population, the rapid demographic increase, the decrease in infectious diseases, increase in urbanisation and industrialisation and progress changes in life style. Chronic respiratory infections occupy an important place in the epidemiologic profile. No real statistics exist on the number of deaf persons in Cameroon and a study undertaken in two primary schools in Yaounde in 2002 showed a 15.5% rate. The psychologic impact leads to stigmatisation, exclusion and poor academic performance. This is also leading to an increase on spending in family health, weak socio-professional performance and academic failures. 1% of the population of Cameroon has eye problems. The national prevalence of the blind is 3%. The main causes of blindness are cataract, glaucoma, trachoma, refractive opacity of the corn and diabetic retinopathy. The fight against blindness in Cameroon is witnessing an important development due to the training of local specialists and an increase in the technical know-how. There are 50 million cases of epilepsies around the world and 30 million of the cases are located in Asia, while 10 million are in Africa. In Cameroon, we find cases of epilepsies in all regions. The areas with high prevalence are Mbam (6%) , lékié (5,9%), DS . Mbengwi, DS. Batibo, Nkam Division, and in the north, Garoua has the highest number. These rates are highest in sub Saharan Africa, especially among persons aged between 10 and 29 years of affected populations. The lack of knowledge of the origin of epilepsy, economic difficulties and limited access to treatment available contribute to the expansion of the problem. Sickle Cell Disorder is a genetic disease, which wide spread around the world and 80% of children affected die before the age of 5 years. The population is advised to do a blood cells diagnosis before engaging marriage. On the other hand, rheumatism prevalence in Cameroon is put at 9.4% with women constituting 62.31% of persons affected. 225 out 1.000 inhabitants of Cameroon are said to have mental problems according to WHO statistics in 2008. The health professionals trained in this field is very low and the rate is put at 0.33 for 100.000 inhabitants, making only 1.79 for every 1.000. The risk factors of non-communicable diseases are tobacco consumption in all its forms. The statistics available show that 10.5% of men smoke tobacco, while 1.1% of women smoke. 8% of men smoke cigarettes, while 0.6 % women smoke cigarettes in Cameroon. This leads to overweight in 30.2 % in men and 40.5% in women. The obesity rate is 6.4% for men and 14.1% for women. The lack of participation in physical exercises and excessive intake of alcohol are also considered to have negative impact on the body. To find a solution these problems, an inter-sectorial Synergy has been put in place in Cameroon within the context of the health sector strategy 2001 – 2015 as recommended by the World Health Organisation. Civli society organisations and the community need to be strongly involved for the promotion information, education and communication action for behaviour change. According to WHO records, diabetes, hypertension of high blood pressure, heart attack, cancer, and chronic respiratory problems represent 31% of the causes of deaths in Cameroon and women are the most vulnerable group, though it affects without discrimination all other groups in the society. This comes to increase the health problems already caused by persistent transmissible infections. Within the framework of the community of learning initiative, it was agreed that a very serious action plan should be designed to tackles the difficult incidences that make the rural populations poorer as they spend their little resources for health consultations and treatment. Participants agreed that the situation constitutes an infringement to the socio-economic development of the population and a menace to the emergence of Cameroon. The determinants of most of the diseases are the social, cultural, environmental, attitudes, economic and health policies by the government. The development of health offers do not correspond to the increasing popular demands. The achieve positive results, a multi-sectored action plan is needed. The health strategic orientations need to reflect appropriate policy in the execution and delivery of services. This resides on consideration of the determining elements of the sectorial problems already registered. The actors must translate policies for the amelioration of transparency, competence, sharing of national resources and responsibilities in the management of public affairs. Health system decentralisation must be reinforced and partnership between the different actors should be developed. The community which is considered the beneficiary of the policies must be involved during planning and decision making process including organisation and management. The information system needs reinforcement in the management of resources, coordination and regulation of the control of activities. New approaches to health policy need to be defined which include the integration of economic opportunities and new technologies through promotion of partnerships to compliment public services. Three commissions were put in place as follows: Media, Public Relations and Sponsorship Commission in charge press coverage and the elaboration of media strategies and the road map for the expansion of activities. It is composed of : 1.Norbert ELOUNDOU ENGAMA 2.Mr. Anselme Ndopata (Yaoundé) 3.Mr Roger Mamoun (Yaoundé) 4.Mr Bebe Roger (Douala) 5.Mr Parfait SIKI 6.Mr Donchieu Fabien (Douala) 7.Mme Bikai Emilie Hortense (Douala) 8.Mr ALemju Funtu (Kumba) 9.Mr James Achanyi Fontem (Douala) The logistic commission is in charge of putting in place the functional modalities of the consortium and the organisation of materials and protocol services. This commission was constituted of: 1.MATANGA Philippe (Yaoundé) 2.M.MABEE Jean Marie (Douala) 3.M.DINGONG Francis 4.Mme BANDA NOMBOL Judith 5.Mme Mballa Pancrace Ep Songo (Douala) 6. Nlend Paul (Douala) 7. Mme Ngo Bindoo Hanna Ep Billè (Douala) 8.Mr. Irené Gaping Tchongo (Yaoundé) 9.Mlle Ndolo Bep Christine (Yaoundé) The third commission is in charge of planning, follow up, monitoring and evaluation. It is expected to set the base of the working groups and their priority interventions, which will be integrated in the road map of activities of the consortium. The member are: 1.Dr DISSONGO Jean II 2.Dr NNOMZO’O ETIENNE (YAOUNDE) 3.M. NDAYA ANDRE DEMAISON (YAOUNDE) 4.M. ZOMBOUDEM ZOMBOUDEM 5.M. KUEDA Zacharie. 6.M. MBONJO Martin Martial 7.M. SIME EWONDE Coordinating the discussions of reports by the commissions, James Achanyi-Fontem, the chairman, emphasized that participants should always consider the fact the consortium aims at federating energies for the mobilisation of human and financial resources. Advocacy action should tackle the actors of the public and private sectors. Women, youths, professionals, traditiona and religious authorities should be involved for action.