Malawi is a Sub-Saharan African country experiencing the epidemiological transition from predominantly infectious to noncommunicable diseases (NCDs) with dramatically increasing prevalence of lifestyle-related diseases such as obesity, hypertension, and diabetes. Malawi's 2011-2016 Health Sector Strategic Plan included NCDs, and an NCD Control Program was established with subsequent development of a National Action Plan for prevention and management of NCDs launched in 2013. The current study was designed to identify gaps in implementation of NCD control program policies and action plan strategies by describing current efforts toward prevention and management of NCDs in Malawi with emphasis on challenges and opportunities. Semistructured questionnaires were used to collect quantitative and qualitative data from Malawi Ministry of Health personnel (senior officers, service providers, health education officers, and nutritionists) in 10 health districts and 3 central hospitals. Frequencies were generated for quantitative data. Qualitative data were used to generate themes and most common responses. Results showed that current services focus on facility-based NCD screening and clinical services rather than active screening, prevention, and community awareness and outreach, although respondents emphasized the importance of prevention, lifestyle education, and community outreach. Respondents indicated inadequate resources for NCD services including financial capital, human resources, equipment and supplies, and transportation. While Malawi has begun to address NCDs, policy and practice implications include (a) better integration of services within the existing infrastructure with emphasis on capacity building; (b) greater implementation of planned NCD activities; (c) a stronger, more comprehensive data management system; and (d) innovative funding solutions.
Rose et al. 271exclusively on locally produced foods (i.e., a local food diet) for 4 weeks during the summer and fall of 2006. For this study, a local food was defined as a food produced within 100 miles of an individual's residence. Food records were used to assess each participant's compliance with the local food diet as well as the impact of following the diet on the intakes of energy, macronutrients, and fruits and vegetables. Body weight was assessed at baseline and immediately following the 4-week period. Compliance with the local food diet varied considerably, but the average intake of local foods increased from 15% of calories at baseline to 81% of calories during the local food diet. Compared to participants' baseline values, following the local food diet for 4 weeks significantly (p < 0.05) reduced reported intakes of energy and protein and increased reported intakes of dietary cholesterol, saturated fat, and servings of fruits and vegetables. Results from this pilot study suggest that individuals attempting to follow a local food diet vary in how they execute a local food diet and that following a local food diet may result in a reduction of energy intake. Future research into the impacts of following a local food diet on dietary quality is needed.
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