Transcript Chronic Diseases Program of Medical Relief Society

Chronic Diseases Program
of
Medical Relief Society
PMRS (UPMRC)
Heritage
• A grassroots, community- based, non-profit
Palestinian health organization
• Founded in 1979
• Our health programs emphasize prevention,
education, community participation, and the
empowerment of people
PMRS (UPMRC)
Mission
• PMRS seeks to improve the overall physical,
mental, and social wellbeing of all Palestinians
• Focuses on the needs of the poor in villages,
refugee camps, and in the urban areas.
• Focuses on the needs of women, children,
elderly, disabled, and others marginalized
groups
• Looks to provide the quality of care in 400
Palestinian communities
PMRS (UPMRC)
Vision
• PMRS follows the principles and practice
of Primary Health Care in the provision of
preventive, curative, and promotive health
services
Map of UPMRC activities in the
West Bank and Gaza Strip
The Need for this Program
• Epidemiologic and demographic transition
– Rapid aging
– Progressive urbanization
– Socioeconomic transformation
• Changes in nutritional patterns:
– Less proportion of complex carbohydrates
– More sugar
– More animal fat
• Obesity becomes more prevalent
• Less physical activity
• Increased cigarette consumption
Why chronic diseases?
• The disease burden has moved towards chronic
diseases as a result of the epidemiological
transition
• The leading causes of mortality, the leading
causes of morbidity (including disability), and
impose an enormous financial and societal
burden on the country
• Chronic diseases account for one-third of the
years of potential life lost before age 65.
• They are preventable.
NCDs of Interest..
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Heart
HTN
Diabetes
CVD
Cancer (Breast)
Dyslipidemia
Obesity ?!
Targeted Diseases
• High prevalence
• An increasing morbidity and mortality
burden
• An increasing economic, social, and
psychological burden
• Early detection improves prognosis
• Public awareness is crucial for prevention
• Comprehensive management is generally
absent
How High is the Risk ?
• After the age of 35 years:
– 1 out of six may develop diabetes
– 1 out of 3 may develop hypertension
– 1 out of 2 have dyslipidemia
– 2 out of 3 are overweight
– 2 out of 5 are obese
– 1 male out of 3 is a smoker
Leading causes of death among the
Palestinian population in – 2002
(MoH)
25
% of Total
Death
20
19.4
15
12.5
10
11.7
9
8.2
6
5
5.1
4.9
3.8
3.6
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History
Purpose
• Developing a model that focuses on prevention
methodology
• Alleviating some pressure on curative treatment
• Early detection of diseases and proper
management
• Preventing disability and loss of labor power
• Using of data collected to advocate reformation
of health care policies
• Reaching the marginaliyed people
Components
Prevention, Early Detection
And
Health Promotion
Surveillance,
Data Collection,
And
Research
Proper Management
Mobile Clinic
• More than 11,000
people screened fpr
NCDs
• 68% were women
• 7800 women were
screened for breast
abnormalities
• All of them know how
to do self breast
examination
Diagnostic Procedures
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Patient’s and family history
Blood pressure
Weight and height
Dr’s examination
Upon need:
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ECG
Echocardiography
Treadmill
Holter
• Counseling
Integration with PHC clinics
• An important goal for a successful
program
• Started with 6 villages in Ramallah area,
and will continue to cover all clinics
• The aim is to reach a common vision
towards the management of NCD
Preliminary results (%) from different locations
been screened by the mobile clinic (2003)
Location
Diabetes
Hypertensio
n
Dyslipidemia
Overweight
Abud
11.6
21
43
72
An Nabi Saleh
12.5
37
42
67
CHF (work org)
11.5
25
57
69
Deir Ghassaneh
21
44
43
68
Kobar
14.7
38
57
71
Qarawat BZ
17
31
52
74
Sinjil
18
25
54
78
Turmus Ayya
18
38
61
81
Abu Qash
17.5
33
54
75
Total Average
18
30
52
75
Data Collection
& Research
• First national data base on chronic
diseases and their risk factors
• Data are used to evaluate the burden of
diseases and the quality of medical care
• Information gathered is used in lobbying
and advocacy to raise the problem of NCD
• Call for reformation of health policy
Health Promotion
• Different methods used:
– Health education booklets (diabetes, HTN,
Heart disease, smoking, breast cancer…)
– Posters and flyers
– TV and radio spots
– Group and individual counseling
– Radio and TV programs
Comprehensive Management
• Management of NCDs is of a holistic
approach:
– Assessment of risk factors
– Early detection of the disease
– Diagnostic procedures
– Life style modification
– Pharmaceutical intervention
– Follow up of the patients
– Referrals
Training
• A well trained team in NCDs
• Team building of health professionals to
deal with NCDs
• Training of Teams including
representatives of health providers:
UPMRC, MOH, UNRWA, UHWC, and
private doctors
• The aim is to transfer the model to other
sites.
Lobbying and Advocacy
• Cooperation and consultations with other health
providers
• Using the media to raise the burden of NCDs
• Using the media to call for national efforts to
provide quality of care
• Meetings with representatives of local
communities, youth clubs, and people of
different activities to alert the issue on NCDs.
Building a model
• The comprehensive approach in
management
• Capacity building
• Transfer of knowledge and experience
• Connect the center with the periphery
• Rational use of technology
• Emphasizing the importance of prevention
in combating NCDs
A Different Approach
• A comprehensive approach in the
management of diseases:
• Prevention
– Life style modification
– Health promotion
• Early detection
• Proper treatment
• Train and support management at PHC
level
• Establish a good referral system