National prevention and control of non communicable diseases programme annual report 2014
Non-communicable diseases (NCDs) present an urgent and growing health emergency in countries around the world with evidence showing an ever growing increase in number of deaths due to NCDs coming from middle-income countries.
Swaziland recognized an upsurge of diabetes cases, national diabetes prevention and control unit was established in 1999, but due to other emerging non-communicable diseases, this unit gave birth to a National Prevention and Control of Non Communicable Diseases Programme.
Currently surveillance data for NCDs is managed through the Health Management Information System (HMIS), which covers largely the data from health facilities. Population level data is collected through surveys.
Service delivery interventions are mainly focused on the following conditions; Cardiovascular diseases
CVDs, Diabetes mellitus, Cancer, Chronic obstructive pulmonary diseases, Violence trauma and injuries, Mental health, Epilepsy, Ear and eye health, Oral health and Other related conditions.
In 2014, out of 1431 deaths recorded in the Health Management Information System (HMIS); a total of 406 (28%) was as a result of NCDs. Hypertensive diseases accounted for 10 percent of all deaths in 2014. The health data shows that more women are dying due to NCDs as compared to males; however males are more likely to die of communicable diseases.
Of the top 10 leading causes of admission in 2014, NCDs account for 33% of all inpatient admissions. Of the 33% of in-patients admitted to health facilities in 2014, the majority were there as a result of fractures, accounting for 15%, whilst cancer and hypertensive disease both accounted for 7% of all admissions.
The highest number cases among the top ten leading conditions in the out-patient department between
2012 and 2014 was due to Upper respiratory infections.
Globally, CVD is the leading NCD, contributing to 17 million deaths (48% of NCD deaths). The data from the country indicates that cardio-vascular diseases account for seven percent of all deaths in health facilities.
Cancer presents one of the top NCDs leading to mortality amongst the admissions attended in 2012 to 2014. There is an increase in the number of recorded deaths due to cancer for both males and females. Data from 2014 indicates that 3 major cancers that account for 60 percent of all deaths due to cancer in the country; malignant neoplasm of cervix oteri, malignant neoplasm of liver and bile duct, and malignant neoplasm of the prostate.
Six percent of the diabetes admissions in 2014 died. Of the 56 who died in 2014, 53 percent were females and 47 were males, one was unknown. In Swaziland a total of 71 deaths were recorded as related to COPD in the period 2010 – 2014. In 2010, there were more female deaths, however the trend has reversed in 2012 with more males dying from COPD related diseases.
The program has made achievements in promoting a healthy lifestyle at community level, particularly the work of Diabetes Swaziland and other stakeholders. Community involvement is crucial in addressing the primary intervention model of NCD program, particularly in promoting health seeking behaviour.
Another achievement has been the development of key structures and policies that aide the coordination of the multi-faceted program. The NCD program has a function technical working group, and draft strategy and policy. Plans are also underway towards the completion of the national STEPS survey.