Discusses the role of primary health care to prevent NCDs and lessons from CARMEN initiatives and North Karelia Project

1. 140th APHA Annual Meeting
Monday, October 31, 2012
Chronic
Title PageDiseases in
Non-communicable
Latin America:The Role of PHC
Dr. Elvira Beracochea
MIDEGO, Inc.
President
elvira@midego.com

2. Disclosure
• Dr. Elvira Beracochea has nothing to
disclose.

3. Up to 80% of the NCD mortality, mainly
due to cancer, diabetes, chronic lung
disease and cardiovascular disease,
can be prevented by improved
individual care and public health
programs.

4. Objectives
1. Discuss the role of primary health
care to prevent NCDs
2. Discuss lessons from the CARMEN
initiative and North Karelia Project

5. CNCD are
Preventable
Reversible
Curable

6. North Karelia, Finland
•1972
• After the first 25 years, the project
demonstrated to have achieved
changes in smoking, BP and diet
–CVD mortality reduced by 68%
–CHD mortality reduced by 73%
–All causes mortality reduced by 49%

7. North Karelia: Interventions
•PHC providers involved in all aspects of the
program
•Involvement of community organizations and
residents
•Training and Media Communication
•Environmental changes
•Partnerships with food industry

8. CARMEN
Conjunto de Acciones para la
Reducción Multifactorial de
Enfermedades No transmisibles
Concerted actions to reduce
multifactorial non- transmissible
or non-communicable diseases

9. PAHO: Country-Wide Actions
1. National Plan of Action
2. Policies
3. Community-based actions
4. Health service reorganization
5. Integrated promotion and prevention actions
6. Health equity focus
7. Baseline and surveillance adapted to measure
progress: Observatory

10. Observatory
• Goal: support policy advocacy,
development, monitoring and impact
measurement
• Canada, Brazil, and Costa Rica
• Chile, Uruguay, Guatemala and Cuba
and other Caribbean Countries (25+)
• Benchmarks
• Improve Surveillance

11. Effective Interventions
• Tobacco taxes, smoking free areas and
smoking cessation treatments
• Transfat free America (Rio 2008)
• Healthy meals in schools
• Reduction of salt in diet
• Increase physical activity
• Community-based promotion
• Improvement of PHC and referral services

12. Advocacy
• “Program Dose” matters
• Sustained efforts also matter
• Integrated community based
programs do work:
– Health education
– PHC services
– Community involvement and
participation
• Not Surprised!

13. Visit us at www.midego.com
Remember to Download the
“Global Health Starter Program”
to start making a bigger impact right away!
Thank you!
Copyright ©2010 MIDEGO