Non-Communicable Diseases Non-Communicable Diseases in Saudi Arabiain Saudi Arabia

Dr. Mohamad SaeediDr. Mohamad SaeediDirector General NCDDirector General NCD

MOHMOH

IntroductionIntroduction

NCDsNCDs Major health problem, challenging globally and Major health problem, challenging globally and

nationally nationally

As a factAs a fact

General Directorate of Non-communicable diseases General Directorate of Non-communicable diseases established in 2004, under the Asst. Deputy Minister established in 2004, under the Asst. Deputy Minister for Preventive Medicinefor Preventive Medicine

NCDs International OverviewNCDs International Overview

NCDs Strategic NCDs Strategic Objectives Objectives &Responsibilities&Responsibilities

Primary and Secondary Prevention of NCDsPrimary and Secondary Prevention of NCDs Planning NCDs policies and control measuresPlanning NCDs policies and control measures Stakeholders CollaborationStakeholders Collaboration Patient Empowerment ProgramsPatient Empowerment Programs Capacity building for health professionalsCapacity building for health professionals Surveillance of NCDsSurveillance of NCDs Research and Information systemsResearch and Information systems Health Promotion: Enhancement of community Health Promotion: Enhancement of community

participationparticipation

Prioritization of NCDs programsPrioritization of NCDs programs

Most prevalent diseases that poses a public health Most prevalent diseases that poses a public health problemproblem Diabetes (14.1% age: 15-64, 28% age: >30y Diabetes (14.1% age: 15-64, 28% age: >30y ‘Robaian 2008’‘Robaian 2008’) ) Cardiovascular Diseases (42% of total mortality 2010 Cardiovascular Diseases (42% of total mortality 2010 ‘WHO’‘WHO’))

Cost effectivenessCost effectiveness Preventable diseases with proved measures in other Preventable diseases with proved measures in other

countriescountries Curable diseases by early detectionCurable diseases by early detection

KSA NCDs Status:KSA NCDs Status:Step wise - surveillance for NCDs 2005Step wise - surveillance for NCDs 2005

prevalenceMen (%)

Women(%)

Total (%)

hypertension24.118.321.1

diabetes19,216.617.9

hyperlipedeamia18.719.919.3

obesity28.643.336.1

Central obesity2731.929.4

smoking24.71.412.9

Physical inactivity

34.433.233.8

According to MOH / WHO step-wise surveillance will be repeated on 2012 - 2013

KSA NCDs Mortality 2010KSA NCDs Mortality 2010**

WHO – World Fact book 2012

NCDs programs in KSANCDs programs in KSA

1.1. Diabetes control and Prevention program.Diabetes control and Prevention program.2.2. Cancer Prevention Program.Cancer Prevention Program.3.3. Food and Physical Activity program.Food and Physical Activity program.4.4. Cardiovascular Diseases Prevention Program.Cardiovascular Diseases Prevention Program.5.5. The Healthy Marriage Program. The Healthy Marriage Program. 6.6. Early Screening Program for the New-born.Early Screening Program for the New-born.7.7. The Crown’s Health Prevention Program. The Crown’s Health Prevention Program. 8.8. The Prevention of Accidents and Injuries. The Prevention of Accidents and Injuries. 9.9. Prevention of chronic respiratory diseases.Prevention of chronic respiratory diseases.10.10. Osteoporosis ProgramOsteoporosis Program11.11. Blindness Prevention ProgramBlindness Prevention Program

Diabetes Diabetes prevention & control programprevention & control program

National diabetic guidelinesNational diabetic guidelinesHealth promotion Health promotion Screening programs for high risk groupsScreening programs for high risk groupsElectronic national registry for DM Electronic national registry for DM (Phase I)(Phase I)Integration of health services in PHCsIntegration of health services in PHCsEstablishment of specialized diabetic centers, and Establishment of specialized diabetic centers, and diabetic units in hospital (20 referral centers for C/O)diabetic units in hospital (20 referral centers for C/O)Continuous capacity buildingContinuous capacity building

Prevention of cardiovascular diseasesPrevention of cardiovascular diseases

Guidelines for Primary Prevention at PHC level Guidelines for Primary Prevention at PHC level (endorsed)(endorsed)

Guidelines for Secondary Prevention (started)Guidelines for Secondary Prevention (started) National health education campaign about risk National health education campaign about risk

factors and prevention (healthy life style)factors and prevention (healthy life style) Pilot Research for Scoring System for local Pilot Research for Scoring System for local

adaptationadaptation Electronic national registry Electronic national registry

Prevention of cancerPrevention of cancer

National cancer registry National cancer registry (1992)(1992)Health education campaignHealth education campaignTraining for health Training for health professionals professionals (local Training (local Training Manuals with case studies)Manuals with case studies)

Mammogram screening Mammogram screening (Phase I)(Phase I)

Type of cancerOccurrence

frequency (%)

Breast 12.4

Colo-rectal 9.7

Non-Hodgkin lymphoma 7.3

Thyroid 6.7

Leukemia 6.3

Liver5.2

Skin4.1

Lung3.9

Hodgkin diseases3.6

Stomach 3.4

Diet and Physical activityDiet and Physical activity

BurdenBurden High prevalence of overweight and obesity (67 %)High prevalence of overweight and obesity (67 %) Low physical activity Low physical activity Unhealthy diet habitsUnhealthy diet habits

Achievement:Achievement: Adoption of DPASAdoption of DPAS National health education campaignNational health education campaign Guidelines for healthy life styleGuidelines for healthy life style Cooperation & coordination with other concerned sectorsCooperation & coordination with other concerned sectors

Premarital screeningPremarital screening

Compulsory screening started 2004, for couples to Compulsory screening started 2004, for couples to detect some hereditary and infectious diseases detect some hereditary and infectious diseases (Thalassemia, Sickle cell disease, Hepatitis B, C, and HIV)(Thalassemia, Sickle cell disease, Hepatitis B, C, and HIV)

Incompatible couples will receive counseling Incompatible couples will receive counseling session and it is their right to marry or not session and it is their right to marry or not

In 2004 out of incompatible couples (90%) continue In 2004 out of incompatible couples (90%) continue marriage, while in 2010 only (50 %) continuemarriage, while in 2010 only (50 %) continue

>2.2 Million were tested>2.2 Million were tested

Newborn screeningNewborn screening

Neonatal screening for (16) different metabolic and Neonatal screening for (16) different metabolic and hormonal syndromes, for the purpose of early detection hormonal syndromes, for the purpose of early detection and treatmentand treatment

Started in 2005 in some main maternity and child Started in 2005 in some main maternity and child hospitals, and to be expanded to cover all hospitals by hospitals, and to be expanded to cover all hospitals by year 2020year 2020

Till now, 630,000 newborns were screened & 620 positive Till now, 630,000 newborns were screened & 620 positive case s were diagnosed, properly managed & monitoredcase s were diagnosed, properly managed & monitored

Prevention of injuries and road traffic accidentsPrevention of injuries and road traffic accidents

Saudi Arabia ranking as one of the highest road Saudi Arabia ranking as one of the highest road traffic accident globally traffic accident globally (15% of annual Mortality)(15% of annual Mortality)

Ministry of Health is part of the national committee Ministry of Health is part of the national committee for road traffic accidentfor road traffic accident

Responsibility of MOH: Responsibility of MOH: Providing medical emergency services Providing medical emergency services Registry Registry Educational campaign Educational campaign

Control of osteoporosisControl of osteoporosis

National health education campaign targeting National health education campaign targeting postmenopausal females, and old peoplepostmenopausal females, and old people

Screening for high risk populationScreening for high risk population

The Crown’s Health Prevention ProgramThe Crown’s Health Prevention Program

An integration of all NCD programsAn integration of all NCD programs

Started the Pilot in Al Jawf regionStarted the Pilot in Al Jawf region

Integrated NCDs ClinicsIntegrated NCDs Clinics

Enhanced Stakeholders CollaborationEnhanced Stakeholders Collaboration

Health Promotion at the Community Level Health Promotion at the Community Level (Successful inclusion of religious and community (Successful inclusion of religious and community leaders)leaders)

Prevention of chronic respiratory Prevention of chronic respiratory diseasesdiseases

WHO / World bank estimated 4 millions WHO / World bank estimated 4 millions deaths in 2005deaths in 2005

4.09% of KSA annual Mortality (2010)4.09% of KSA annual Mortality (2010)

27.1% of KSA occupational health 27.1% of KSA occupational health diseasesdiseases

Established Asthma program Established Asthma program (National (National Asthma Management Guidelines)Asthma Management Guidelines)

•Stepwise 2012 - 2013

•DPAS (integration of stakeholders collaboration)

•Implementation of related legislations (Prohibition of Smoking in closed areas)•Improving early detection of NCDs by national screening programs (diabetes, cancer, osteoporosis, . . )•Integrated Electronic Information System for NCDs

Dr. Mohammad Y. SaeediDr. Mohammad Y. Saeedi