高血压英文PPT精品课件Public Health Challenges in the .ppt

1、Pan American Health Organization,2006,Public Health Challenges in the Caribbean,Mirta Roses Periago Director PAHO/WHO Nassau, Bahamas 28 February 2007,Pan American Health Organization,2006,Disability Adjusted Life Years (Dailys) 2001,Caribbean Commission on Health and Development (CCHD),Pan American

2、 Health Organization,2006,CRUDE MORTALITY RATES FOR SELECT DISEASES BY YEAR:,CAREC MEMBER COUNTRIES,Heart Disease,Cerebro Disease,Cancers,Diabetes Mellitus,Hypertensive Disease,Accidents,ARIs,HIV/AIDS,0,20,40,60,80,100,120,85,90,95,2000,YEAR,RATES,Pan American Health Organization,2006,Caribbean Comm

3、ission on Health and Development (CCHD),Arising from WHO Commission on Macroeconomics and Health; Investigation of relationships between health, economic development, and poverty; CARICOM/PAHO collaboration;Chaired by former PAHO Director, report submitted to CARICOM.,Pan American Health Organizatio

4、n,2006,Main messages (1),Recognize and promote the thesis that health is a productive asset and encourage further research in this field; The Caribbean must re-examine seriously the business case for development of health services targeted to foreign consumers; Intentional violence and injuries repr

5、esent a huge burden to the health services;The lack of systems for regular collection of data, such as the SLS in Jamaica is a major hindrance to research on Caribbean problems.,Caribbean Commission on Health and Development (CCHD),Pan American Health Organization,2006,The Caribbean as a whole must

6、face squarely the enormous problem of obesity and its co-morbidities of the non-communicable diseases.This will involve major policy changes to effect prevention through attention toa) food securityb) increasing physical activity of the population(These changes are spelled out in the Report),Caribbe

7、an Commission on Health and Development (CCHD),Main messages (2),Pan American Health Organization,2006,The Caribbean must continue and intensify the actions to control the epidemic of HIV/AIDS with special attention to: battling stigma and discrimination legislation especially as regard labor laws s

8、caling up treatment devoting a higher percentage of funding to prevention measures ensuring that funds already available are spent,Caribbean Commission on Health and Development (CCHD),Main messages (3),Pan American Health Organization,2006,Strengthen health systems infrastructure, paying special at

9、tention to;improving the management and maintenance of the physicalfacilitiesplanning in the health sectorstrengthening surveillance systems fora) communicable diseasesb) risk factors for the non-communicable diseasesStrengthen public health infrastructure, specifically:ensuring the monitoring of th

10、e essential public health functionsmandating training to advanced levels in public healthby the University of the West Indies,Caribbean Commission on Health and Development (CCHD),Main messages (4),Pan American Health Organization,2006,Address the issue of the export of nursing services as a regiona

11、l problem:- modify the program of managed migration as endorsed by the Ministers of Health, by includingthe potential for trade in nursing services as an aspect of Mode 4 form of supply. The two forms of migration to be seen will be:a) permanent migrationb) managed temporary migration(NB Countries a

12、re already encouraging FDI for nursing training),Caribbean Commission on Health and Development (CCHD),Main messages (5),Pan American Health Organization,2006,Health financingThe practice of charging user fees should be discouraged, especially for public health and preventive services. It is regress

13、ive and bears heavily on the poor. However, when employed, it should be carefully targeted.Countries should aim at a health expenditure of at least 6% GDPThe Caribbean should begin to examine the feasibility of a region wide health insurance,Caribbean Commission on Health and Development (CCHD),Main

14、 messages (6),Pan American Health Organization,2006,Specific policy recommendations to the Heads of GovernmentCombat tobacco usetax tobacco productsban smoking in public placesTarget childrenmake physical education compulsoryensure healthy school mealsrestrict advertising that promotes unhealthy die

15、tsMake regulations and standardsensure marketed foods show calorie & fat content regulate importation of fats (consult RNM),Pan American Health Organization,2006,The Report of the CCHD emphasized that the major health /disease problems that the Caribbean would have to face in the immediate future ar

16、e:Non Communicable DiseasesHIV/AIDSInjuries and violence,Pan American Health Organization,2006,Causes of death ( Rank order) Bahamas,1996 2000HIV disease ( AIDS) 1 1 Ischemic heart disease 5 2 Hypertensive disease 2 3 Diabetes mellitus 3 4 Cerebrovascular disease 4 5(*Source CMO Report 2002),Pan Ame

17、rican Health Organization,2006,Pan American Health Organization,2006,Prevalence of Obesity (% of age group),Males FemalesBahamas (15-64) 13.9 28.0Jamaica (25-74) 7.2 31.5Barbados (25-74) 10.0 31.0(*Source IOTF. Obesity as BMI 30+ ),Pan American Health Organization,2006,Trends in Diabetes mortality,P

18、an American Health Organization,2006,Atlas of Heart Disease & Stroke , WHO 2004,Pan American Health Organization,2006,0,2,4,6,8,10,12,14,16,18,20,22,20,22,24,26,28,30,32,Body mass index,Prevalence of Diabetes,Men,Women,West Africa,West Africa,Caribbean,Caribbean,US,US,UK,UK,Pan American Health Organ

19、ization,2006,Costs (US $ Million) for treatment of all diabetes and hypertension,Pan American Health Organization,2006,AIDS cases in CAREC Member Countries,Pan American Health Organization,2006,Pan American Health Organization,2006,Pan American Health Organization,2006,Pan American Health Organizati

20、on,2006,With respect to HIV/AIDS“Several recent developments in the Caribbean region (in Bahamas, Barbados, Bermuda, Dominican Republic and Haiti) give cause for guarded optimism -with some HIV prevalence declines evident among pregnant women, signs of increased condom use among sex workers and expa

21、nsion of voluntary testing and counseling”.(UNAIDS, 2005),Pan American Health Organization,2006,Obesity - The policy options,Focus on childrenProtect children against marketingSchool-based actions- foods sold in schools- nutrition education- physical activity Food availabilityGovernment food and agr

22、icultural policyFood labelingTaxes and subsidies,Pan American Health Organization,2006,Diet and the Environment,Our domestic agriculture policy lacks adequate incentives for the production of fruits and vegetables Our food imports encourage the consumption of high energy dense, manufactured foods Ma

23、ny school canteens and vendors promote high energy dense foods with little nutrient value Our local and cable networks advertise fast foods heavily, especially on childrens programs,Pan American Health Organization,2006,Physical Activity and the Environment,We build communities with insufficient par

24、ks and recreation centers which are safe and attractive;Our school policies have allowed the drastic reduction of physical education;Few employers/worksites have a policy to increase PA and wellness;Our transportation policies have favored the use of personal cars which discourage physical activity.

25、,Pan American Health Organization,2006,The “3 keys” to efficient management and prevention of chronic disease:1) Clinical management in Primary Care2) Population based interventions-inform,educate, facilitate pro-health choices3) Macro-economic policies that go beyondone sectoral ministry,Pan Americ

26、an Health Organization,2006,Issues involving regional action,Health tourism; A Caribbean - wide approach to the problem of obesity; HIV/AIDS - continuing and expanding the effort as indicated; Strengthening the public health infrastructure; A policy on export of human resources-especially and urgent

27、ly for nursing services; A Caribbean - wide health insurance; Strengthen existing mechanisms e.g. CCH; Dissemination of the Report.,Caribbean Commission on Health and Development (CCHD),Pan American Health Organization,2006,Caribbean Cooperation in Health,The CCH mechanism was developed for Member S

28、tates to:Collectively focus action and resources towards the achievement of agreed objectives in priority health areas of common concern; andTo identify approaches and activities for joint action and/or technical cooperation among countries in support of capacity-building for the achievement of the

29、objectives.,Pan American Health Organization,2006,Since 1993 CCH phases I and II have been completed and evaluated.CCH phase III is now being developed by Caribbean Member States, and includes each of the key priorities of the Caribbean Commission Report.CCH III also includes the critical issues of

30、importance to the Caribbean that are reflected in the Global Health Agenda and the Health Agenda of the Americas (global commitments and agreements),Caribbean Cooperation in Health,Pan American Health Organization,2006,Guiding Principles for CCH phase III,Equity in access to prevention and treatment

31、 for all; Focus on the poor; Development of a subregional integrated resource mobilization strategy; Allocation of the required resources at the national level to facilitate the effectiveness of the subregional support: Caribbean Commission on Health and Development recommends a minimum of 6% of Gro

32、ss Domestic Product (GDP) for government expenditure on health; Implementation of an international and regional agreements/policies: MDGs/WHO policy on diet and physical activity; Ratification of the FCTC; PAHO Guidelines for Essential Public Health Functions,Caribbean Cooperation in Health,Pan Amer

33、ican Health Organization,2006,Subregional Program Areas,Subregional Program AreasChronic Diseases, Mental Health, Communicable Diseases, Strengthening Health Information Systems, Human Resource Management, Food and Nutrition, Environmental Health, Family and Community Health Services, MatrixHIV/AIDS

34、 Integrating HIV/AIDS with Sexual and Reproductive Health Programs (critical to the achievement of a number of the MDGs Indicators to capture mobile population within the context of the CSME,Pan American Health Organization,2006,Priority Areas:HIV/AIDS Chronic Diseases Mental Health Crosscutting Are

35、as:Information Systems Human Resource Management Health Promotion,Priority Areas and Crosscutting Areas of CCH III,Pan American Health Organization,2006,What is the DCPP?,DCPP is an alliance of organizations/partners designed to review, generate and disseminate information on how to improve populati

36、on health in developing countries.,Fogarty International CenterWorld BankWorld Health OrganizationBill & Melinda Gates FoundationPopulation Reference Bureau,Partners,Pan American Health Organization,2006,Objectives of DCPP (1),Inform health sector decision-making in developing countries to decrease

37、illness, disability, death, and economic burden by:Developing an evidence base to inform decision-making by: Providing estimates of the cost-effectiveness and impact of single interventions and packages Collaborating in defining disease burdens globally and regionally Summarizing implementation expe

38、rience in different regions and globally,Pan American Health Organization,2006,Communicating major findings Suggesting the “best buys” and the “worst buys” in any given setting Disseminating the results widely to multiple audiences Stimulating national priority setting and program implementation,Obj

39、ectives of DCPP (2),Pan American Health Organization,2006,Combat Tobacco Use,Tobacco-related diseases are the fastest-growing cause of disease and disability in developing countries.,Tax tobacco products to increase consumers costs by at least 33% to curb smoking. Restrict smoking in public places a

40、nd workplaces. Provide nicotine replacement therapy and other cessation tools. Ban tobacco advertising.,DCPP,Pan American Health Organization,2006,Reduce fatal and disabling injuries,Injuries and violence caused more than 5 million deaths in 2001, with an especially heavy toll on young men.,Promote

41、use of seatbelts. Install speed bumps at dangerous intersections.,DCPP,Pan American Health Organization,2006,Ensure equal access to high-quality health care,When women lack access to health care, the health of the whole family suffers.,Encourage providers to treat the most common causes of bad healt

42、h. Help providers choose the most cost-effective interventions.,DCPP,Pan American Health Organization,2006,What is it? An expression of the shared vision of the countries of the Americas for 10 years to make concrete improvements in health Proposed new long-term planning instrument that sets strateg

43、ic goals to address health-sector needs in the Americas What is its purpose? To provide a collective framework for subregional and national planning & resource mobilizationTo maintain coherence among international players in the health sector To provide goals on a time-horizon that will allow for ac

44、hievement of measurable impact, as well as frame PASBs own Strategic Plan,Health Agenda for the Americas 2008-2017,Pan American Health Organization,2006,Principles and values,Human rights, universality, access, and inclusion.Pan American solidarity.Equity in health.Social participation,Health Agenda

45、 for the Americas 2008-2017 (HHA),Pan American Health Organization,2006,Areas of action,Strengthening the National Health Authority Tackling Health Determinants Harnessing Knowledge, Science, and Technology Strengthening Solidarity and Health Security Diminishing Health Inequities among and within C

46、ountries Reducing the Risk and Burden of Disease Increasing Social Protection and Access to Quality Health Services Strengthening the Management and Development of People Working for Health,Health Agenda for the Americas 2008-2017 (HHA),Pan American Health Organization,2006,Caribbean Cooperation in

47、Health CCH 1994 Health Systems Human Resources Noncommunicable Disease Communicable Disease Family and Reproductive Health Food and Nutrition Mental Health Environmental Health,Nassau Declaration 2001 HIV/AIDS Noncommunicable Disease Mental Health Caribbean Commission for Health and Development (CCH

48、D) 2005HIV/AIDS Obesity and Co-morbidities Violence and injuries Financing the health system Social statistics and HIS,How can we achieve Success,Pan American Health Organization,2006,How can we achieve Success,Establish monitoring and evaluation mechanismAgreement on the Caribbean Health priority A

49、gendaConsensus on regional goals, targets and indicators with particular reference to national implementation and circumstancesAssign and/or secure resources for both administration and implementationEstablish timeframe and reporting mechanisms Assign/delegate responsibility for monitoring and evaluation (possibly to PAHO and CARICOM ),