Communicable Diseases
Non-communicable Diseases & Mental Health
Family & Community Health
Sustainable Development & Health Environment
Health Technology & Pharmaceuticals
Evidence & Information for Policy
   

Surveillance, Prevention and Management of Non-communicable Diseases
Bangladesh has been experiencing an epidemiological transition from communicable diseases to non-communicable diseases. Tertiary level hospital data indicate that cardiovascular diseases have already appeared as one of the leading causes of mortality. However, exact situation in the country is not known because of lack of representative data and efficient surveillance system. Surveillance for a few communicable diseases is known to exist although it needs major improvement. Unfortunately there is no national surveillance system for non-communicable diseases. The Health,

Highlights
The Health, Nutrition, Population Sector Programme (HNPSP) has identified three NCDs-cancer, cardiovascular diseases and diabetes mellitus-as major public health problems

Nutrition, Population Sector Programme (HNPSP) has identified three NCDs-cancer, cardiovascular diseases and diabetes mellitus-as major public health problems. Therefore surveillance of these diseases should be started to assist in formulating country policies and programmes. They have a few common risk factors for which Bangladesh does not have representative data to be addressed for primary prevention. More...

National Institute of Cardiovascular Diseases (NICVD)
National Institute of Cancer Research and Hospital (NIC), Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), and National Heart Foundation Hospital and Research Institute (NHF) are playing important role in providing services to the patients and education of professionals on cardiovascular diseases, cancer and diabetes mellitus. Recently, Zia Heart Foundation Hospital and Research Center (ZHF), Dinajpur, started providing services to cardiovascular patients of northern outlying districts of Bangladesh where such services had been lacking. Their capacity needs to be strengthened to ensure quality management, and surveillance and prevention of major NCDs.

Rheumatic Heart Disease (RHD)
RHD still remains a public health problem of Bangladesh. Improvement of skill of doctors is necessary for its surveillance, prevention and management. The National Center for Control of Rheumatic Fever and Heart Diseases (NCCRFHD) has been working for RHD prevention but there is no surveillance mechanism for RHD.
Networking among these organisations, other research groups in the country and overseas institutes is necessary for sharing information, experience and building skills.

Tobacco
A vast majority of the tobacco users are not aware that it is an important risk factor for cardiovascular diseases, cancer and chronic obstructive pulmonary disease. Recently, the Government of Bangladesh has identified it as a modifiable risk factor for non-communicable disease prevention in Health Nutrition and Population Sector Programme (HNPSP) which indicates government's willingness to reduce the harmful effects of tobacco. On the other hand, tobacco companies are promoting their products by setting up attractive billboards, and publishing advertisements in newspapers and magazines. Some private satellite TV channels are also telecasting advertisements mainly to attract adolescents and young adults. To the contrary, there are some NGOs who are organising anti-smoking campaigns along with the government organisations (such as Health Education Bureau/BCC unit). Intensification of antismoking activities is therefore, necessary. Meanwhile, Bangladesh became the first country to sign the FCTC. However, efforts need to be taken to intensify and expedite the process of ratification of the FCTC as well as enacting an appropriate anti-tobacco legislation conforming to the provisions in the FCTC. More...

Health Promotion (Elderly)
Within a life-course perspective, the main thrust is to conduct Health Promotion in household settings where elderly people live, work and play in a creative and cost effective environment that is supportive of health and of improving health and quality of life.

The major task will be implementing intersectoral collaborative action and integrated comprehensive approaches to promote healthy life style, particularly for poor and elderly people. Advocacy of health promotion for the elderly will facilitate them to help each other in utilisation of resources available for the elderly people, especially among decision makers, so as to ensure necessary political commitment and resources.

Health Promotion (Health Education)
The World Health Report 2002 documented the public health impact of several major risks that can be reduced through health promotion, such as poor diet and nutrition, tobacco use, alcohol consumption, physical inactivity, poor hygiene, lack of safety and unsafe sex.

Risks to health are interrelated and influenced by socio-cultural determinants, such as gender, norms and spiritual beliefs. Effective policies need to be multisectoral and should draw upon a wide array of potential partners for their successful implementation

Injuries and Disabilities (Prevention)
Challenges in designing and implementing prevention programmes for disability / injury include the lack of ownership with uncertainty about who is responsible for developing solutions and as a result the duties of public health sector remain ill-defined in absence of a national plan for injury and violence prevention. More...

The response should include surveillance systems and research to understand better the magnitude of the burden and causes and prevention of violence and injuries, training for public health personnel, advocacy and better services.

Injuries and Disabilities (Blindness)
Increased life expectancy has contributed to a rise in the population of older persons leading to an increasing number of persons with disabilities. Injuries are also increasing due to violence, conflict and road traffic accident. The disabilities include blindness due to cataract, trauma, etc. Integrated programmes for prevention, control and rehabilitation in all these areas are needed. These issues were not adequately addressed and WHO support in improving the situation will be instrumental.

Mental Health and Substance Abuse
Mental disorders impose a range of consequences on the course and outcome of chronic conditions such as cancer, heart disease and diabetes. There is an expected rise in the burden of mental and neurological disorders and substance abuse primarily because of the projected increase in the number of individuals entering the age of risks for the onset of those disorders. Bangladesh is ill equipped to deal with the burden. So, it is necessary for the government to place mental health and substance abuse on the health and development agenda in order to formulate and implement cost-effective responses to mental disorders and substance abuse.


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