By 2016, Member States of the World Health Organization (WHO) had developed and implemented national action plans on noncommunicable diseases in line with the Global action plan for the prevention and control of noncommunicable diseases (2013–2020). In 2018, we assessed the implementation status of the recommended best-buy noncommunicable diseases interventions in seven Asian countries: Bhutan, Cambodia, Indonesia, Philippines, Sri Lanka, Thailand and Viet Nam. We gathered data from a range of published reports and directly from health ministries. We included interventions that addressed the use of tobacco and alcohol, inadequate physical activity and high salt intake, as well as health-systems responses, and we identified gaps and proposed solutions. In 2018, progress was uneven across countries. Implementation gaps were largely due to inadequate funding; limited institutional capacity (despite designated noncommunicable diseases units); inadequate action across different sectors within and outside the health system; and a lack of standardized monitoring and evaluation mechanisms to inform policies. To address implementation gaps, governments need to invest more in effective interventions such as the WHO-recommended best-buy interventions, improve action across different sectors, and enhance capacity in monitoring and evaluation and in research. Learning from the Framework Convention on Tobacco Control, the WHO and international partners should develop a standardized, comprehensive monitoring tool on alcohol, salt and unhealthy food consumption, physical activity and health-systems response.
The objective of this study is to evaluate the perceptions of Internally Displaced Persons (IDPs) in tsunami relief camps on provision and quality of health care services, during the aftermath of the disaster. A randomly selected health administrative area in the Southern Province of Sri Lanka is selected. Two approaches using both quantitative and qualitative methods. The study assessed the perceptions of IDPs regarding on provision and quality of health care facilities, using an interviewer administered questionnaire (survey) in 200 family units. In-depth interviews were conducted with IDPs and relevant health authorities. A majority (88%) of the people was satisfied with the immediate medical assistance. However 48% of IDPs and authorities felt that frequency of visits paid by medical teams have decreased over time. Fifty-three percent were dissatisfied with the toilet facilities provided. A majority was satisfied with health education (82%) and supply of drinking water (80%). Tsunami survivors felt that health services provided during the intermediate phase was unsatisfactory compared to the immediate phase. We recommend attention to ensuring ongoing access to health care and to improving the sanitary facilities in the camps.
Chronic kidney disease (CKD) where etiology cannot be attributed to any known etiology is named CKD of uncertain etiology (CKDu). The main aims of this study were to assess the prevalence of diabetes mellitus (DM), treatment coverage, and glycemic control and its effect on renal function of patients with DM in a rural community affected by CKDu in Sri Lanka. A cross-sectional representative household survey (n = 4803) was conducted in Anuradhapura district. A random blood sugar (RBS), blood pressure, bio-impedance measurements, and renal profile were measured using standard instruments and protocols. Prevalence of DM based on self-reports verified by records was 7.9% (95% confidence interval [CI]: 7.1–8.7). Among the 4425 who did not give a history of being diagnosed ever as having DM, 2.1% (95% CI: 1.7–2.5) were classified as “possible diabetes” (RBS of more than 200 mg/dl with no history of DM). Although 76.2% were on treatment, glycemic control was poor in 40.2% (95% CI: 34.9–45.0). The presence of DM was associated with poor renal function. One in ten individuals in the rural district of Anuradhapura has possible DM. DM poses a significant burden to CKD even in populations affected by CKDu. Hence, public health initiatives should be implemented to control both CKDu and DM in these rural communities.
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