Post on 15-Aug-2015
Dr Susie PereraDirector Organization Development
And Policy Analysis, Ministry of Health
Bishops College 31st October 2013
Outline of presentation
NCD problem in the country Common risk factors and lifestyle
change Social marketing tool- Super Eight lifestyle change within the School
Why? Hypertension Ischemic Heart Diseases Diabetes Stroke Chronic Respiratory Diseases Cancer
70% of deaths in Sri Lanka due to
NCDs!
In Sri LankaThere are
350 Deaths per day
250Deaths due to NCD per day
100Deaths per day due to Heart Disease
40Deaths due to Stroke
Prevalence of chronic NCD
• Prevalence of hypertension 20-25% (wijewardana et al 2005 , risk factor study 2006)
One in FIVE
• Prevalence of diabetes –( age over 20 ) around 10% (katulanda et al 2006)
One in TEN
Lifestyle change
• Occupation • Transportation • Day to day work at home• Housing and limitation in
space • Dietary pattern • Smoking / alcohol • Leisure time activities
Prevalence of NCD risk factors among adult population (18-65 Years)
22.80% 26.00%
81.40%
18% 20%
0.30% 1.20%
83.30%
31.90% 30.40%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
Current smokers Alcohol users Unhealthy diet Physical inactivity Over weight and Obese
Per
cen
tag
e
Present situation on major risk factors
Male
Female
In Sri Lanka - rise in NCD burden is due to
Aging population
AND Increase prevalence of NCD risk factors
(Changes in lifestyle )
How figure conscious are you?
Your BMI is a good predictor of Health risk!
It is a net result of your lifestyleWhat you eat!Drink – including alcohol!How much physical activity you engage in!
Adding Salt to the rice pot?
An average Sri Lankan consumes more than twice the daily recommended amount of salt.
1. Spreads on bread 2. Sauces with rice 3. Several rice pullers [lunudehi, chillipaste,karawala jadi]
4. Added salt at the table
Are you in the habit of using...
Milo pack – 3 tsp Sprite (buddy bottle) – 4.2tsp EGB (buddy) – 5 tsp Smack mix fruit pkt – 5.2 tsp Pepsi (buddy) – 5.2 tsp Fanta (buddy) – 5.4 tsp Elephant House Cream Soda (buddy) – 6.0tsp Elephant House Necto (buddy) – 6.3 tsp Mirinda (buddy) – 6.8 tsp Coca-cola (buddy) – 9.5 tsp
(see poster for further information)
Do you know that popular beverages contain high sugar levels?
Common myths about sugar intake• I am not a diabetic, you can add some more sugar to
my tea. • We do not have diabetics in our family, so I can enjoy
more sugar. • Drinking any amount of “no-added sugar drinks” is
okay!
Trans fats are formed…….• High heat for stir frying• Repeated use of the same oil for frying
Even if sunflower oil, corn oil and olive oil are used.
Trans fats are also found in…….• Cakes, Biscuits, Pastries (worse is flaky and
puff pastry!)• Some Salad dressings (eg. mayonnaise) • READ FOOD Labels!
Health Planners point of view : The Need for a Population wide strategy – WHY ? Increasing NCDs in rapidly aging population
Increasing NCDs even at a younger age Significant level of unhealthy practicesSame cardiovascular risk factors are
determinants of several common chronic NCDs in Sri Lanka
Low level of awareness on modifiable risk factorsLesser Emphasis on synergy of several
modifiable risk factors – often awareness programs mention one at a time
A strategy is needed to address DEMAND and SUPPLY towards healthier lifestyles
The Need for Majority to adopt good practices Lifestyle change is needed across
board for all START early! – changes
take place over a long time All risk factors need to be addressed in a collective
manner
The message for collectiveness is important
Super eight formulated
Scientific evidence based approach to identify Eight health targets
Social marketing principles were used to identify the eight health targets in a branded form
– Super eight: A simple way for a better life
1 level tea spoon of salt per person per day
A 400 g pack of salt should be sufficient for a family of 4 for 20 days
Target
TargetLimit food with Trans Fats found in some commercially baked and fried food such as short eats, pastries, cakes and re-heated oil
TargetConsume 5 servings of Fruit & Vegetables per day (the recommended amount is 400 gms of Fruit and Vegetables per person per day). Remember variety is good.
TargetAt least 30 minutes of moderate physical activity per day for at least 5 days a week
brisk walk, aerobic exercises, cycling
Totality !Those who are exercise fanatics also get heart
attacks!!Those who never smoke also get heart attacks!!!Those who are pure vegetarians ……Those who claim that they never had a sweet
tooth…….
The Combination of Risk factors need to be addressed
Common risks that address the range of NCDs
• BMI ( over weight or obese) • Unhealthy diet( salt, sugar, tans fat,
low intake of fruit and vegetables)• Physical inactivity• Smoking & alcohol
From Health Sector – The Way forward to empower people and institutionalize Super Eight
• Training all MOOHs in the country
• creating greater Community awareness through MOOHs
• Institutionalizing Super Eight through government and private sector
• Taking Super eight to pre schools , schools and youth groups
• Creating super eight conducive market - catering to new demands of
people who want to change lifestyle
• Promoting home gardens to increase fruit and vegetable consumption
Super Eight Reach
Government institutions (166) Universities (11) Hospitals (43) Nurse training schools ( government ) (17) Authorities and Commissions (27) Ministries (60) Other 08)
- Central Bank- Foreign Employment bureau
- Bandaranayaka International Airport
- National Chamber of Commerce- NIHS
Non governmental organizations (09)Private sector (71)Provincial Governors (09)Provincial Health Departments (09)Regional Health departments(24) Hotels (35)Restaurants (11) Schools (14)Tea Factories/ business enterprises (20)
CONT...
List of tools that are developed on SUPER 8
Posters/ leaflets : 1. Super 8 health targets [8 posters in a set]2. Sugar Analysis 3. Jigsaw Poster 4. Myths 5. Super 8 health targets [in Sinhala, English and Tamil]
Guidelines:A. Guideline for Institutionalizing Super Eight- to be used by lead agencies attempting to introduce Super
eight to institutionsB. Check list to be used by Head of Institution to mainstream 'Super eight' health targets within the organizationC. Guidelines for provincial/ district health managers for institutionalizing Super eight and empowering
Communities with Super eightD. Guidelines for institutionalizing Super Eight in School settingsE. Guide for a Healthy cafeteria settingF. Quick guide for healthier menu planning- business meetings
Presentations: 1. Slideshow2. PPT for Healthcare Workers3. PPT for Government officials/ other institutions4. PPT for Armed forces5. PPT for youth/ schools
How can the school setting promote healthier lifestyle? YOU Be aware – understand what this means
to you Get to know the Super 8 health targets Assess where you are with your family Discuss how you and your family need
to change
How can the school setting promote healthier lifestyle?Your School Key decision makers must want to take
this change Prefects body, old girls associations,
School development societies, School health clubs, Interactors can get together to discuss how you want to change to create healthier options
How can healthier practices be fostered through school setting? 1. Peer lead activity– Super 8, read food labels, to
make your choice known 2. BMI checks 3. exercise - happy face days 4. healthier options in school canteen display of health targets at school canteen, 5. extending knowledge from school to parents, families
and well wishers – days to check BMI and BP, healthier food festivals,
6. opportunity to demonstrate about their experiences in adopting super eight at school assembly, essay competitions, poster and drama competitions
How can healthier practices be fostered through school setting? Super eight messages in school
newsletters or as foot notes in common letters that are widely circulated
School functions serving healthier options – give a choice
Talk about good practices and commend such practices
2. Avoid excess Salt
Limit salt consumption to one teaspoon of salt per person per day.A 400g pack of salt should be sufficient for a family of four, for 20 days.
3. Avoid food with trans fats.
Found in some commercially prepared fried food, short eats, pastries, cakes and re-heated oil.
4. At least 30 minutes of Moderate Physical Activity
Do brisk walking, aerobic exercises, cycling, swimming for at least 30 minutes per day for 5 days a week.
6.Consume 5 servings of fruits and vegetables per day.
Recommended amount is 400 gms of fruits and vegetables per person per day.
Remember variety is good.