Africa-Press – Malawi. Non-communicable diseases (NCDs), also known as chronic diseases, are medical conditions that are not passed on from person to person and have a long duration and slow progression, or that can result in sudden death.
Some of the most common NCDs are cardiovascular disease (heart disease and stroke), diabetes, chronic respiratory disease, mental disorders, neurological disorders and cancer.
The growing burden of NCDs is of particular concern worldwide. In Malawi, there is a significant unmet need for NCD care, which already accounts for 32 percent of all deaths, 10 percent of which are due to cardiovascular disease.
Diabetes was not a major public health problem in the 1960s and 1970s, when the prevalence was one percent or less. However, according to population-based national NCD surveys, 32 percent of Malawians have hypertension and six percent have diabetes.
Furthermore, a 2018 population-based study in rural and urban Malawi showed that 41 percent of people with diabetes were undiagnosed, meaning that the true burden may be significantly higher.
Risk factors for NCDs include physical inactivity, tobacco use, alcohol abuse and high-fat, low-fibre, high-sugar diets and low fruit and vegetable intake. Early diagnosis is critical in ensuring that patients receive the right treatment and continue to live in good health.
Monitoring disease progression with diagnostic tools can help many people with these debilitating disorders manage their health better and enjoy their lives to the full as they age.
However, Malawi’s limited resources and weak health-care systems mean that ensuring the prevention, early diagnosis and appropriate management of NCDs is extremely challenging.
Access to NCD care in the country has been limited, particularly in primary care which serves as the initial point of contact for those living in rural areas.
Constraints on resources, time and training inevitably mean that the ability of rural healthcare professionals to handle chronic diseases and complicated situations is compromised and people suffering from these disorders are usually referred to higher levels of care rather than being treated in the community.
The limited availability of diabetes treatment at health centres forces patients to travel long distances each month to receive care. According to a Ministry of Health evaluation, 70 percent of cases in tertiary care (central hospitals) could have been managed at primary care or district hospitals.
Since a recent study found that NCDs consume almost 22 percent of monthly per capita household expenditure in rural Malawi, improving care at rural hospitals is critical.
To meet the World Health Assembly’s target of a 25 percent reduction in preventable deaths from NCDs by 2025, the Ministry of Health formally added NCD screening and treatment to its Essential Health Package in 2011.
This demonstrated the government’s commitment to addressing N C D s , though the implementation and scaling up of these services remain limited. Despite mounting evidence of the health and economic effects of NCDs in the country, efforts to prevent and control them have been inadequate.
Problems such as inadequate funding, health system challenges, competing interests from industry actors (such as the salt, tobacco, and alcohol industries), as well as low levels of awareness, continue to be important hurdles in efforts to combat NCDs.
Progress in adopting preventative strategies such as tobacco taxation, strengthening health systems and restricting the marketing of unhealthy food and drink products to children is alarmingly slow.
Despite studies showing that small investments in implementing cost-effective NCD interventions in Malawi could result in significant reductions in NCD mortality and consequent economic benefits, the government has not taken advantage of such chances.
People’s perceptions and understanding of the risks of NCDs strongly influence their lifestyle and health behaviour. Campaigns to increase awareness and promote healthy lifestyles, early detection of disease and prompt treatment all have a vital role in preventing and controlling these major killers and improving public health. The author is a medical laboratory scientist specialised in medical biochemistry
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