National Strategy for Prevention and Control of Noncommunicable Diseases In Iraq

1. National Strategy for Prevention and Control of Noncommunicable Diseases In Iraq

4. Goal: • To reduce morbidity and premature mortality attributed to chronic non-communicable diseases. • Impact indicators: • Premature mortality attributed to major noncommunicable • Diseases. • Prevalence of high blood pressure among adults 25 years and • more. • Prevalence of hyperglycemia among adults 25 years and more • Prevalence of tobacco smoking among adults 25 years and more • and youth 13-15 years old • Prevalence of obesity adults 25 years and more. • Proportion of cancers diagnosed in early stages.

5. Vision: Iraqi community free of preventable NCDs in which all people have access to high quality care to increase life expectancy. Mission: Multi-sectoral and multi-level response to control noncommunicable diseases and their contributory risk factors.

6. Scope Major Chronic Noncommunicable Diseases: • Cardiovascular Diseases • Diabetes • Chronic Respiratory Diseases • Cancers Risk factors: • Tobacco consumption • Unhealthy dietary habits • Low physical activity Other related conditions • Blindness and lmpaird vision • Musculoskeletal disorders

8. Political and Governmental support/ Multi-sectoral response • Introduction into the National Health System Developmental plan • Incorporation into the poverty reduction strategy • Incorporation into the ministerial plans through the national strategy for prevention and control of noncommunicbale diseases • Introduction into the National Public Health Low (draft). • Adaption of global strategies, conventions (FCTC, DPAS, VISION2020…)

9. Strengthening NCD Care Integration of Primary NCD Care into PHC services: • Screening and Comprehensive Care for Hypertension and Diabetes at PHC level • Primary Care for Asthma • Screening/ early detection of selected cancers (Breast, Ca cervicx). Guidelines for PHC physicians and paramedical staff Addition to Essential List of Drugs, Equipments and procedures for PHCs • Premarrital screening/counseling –detection of Thalassemia • Detection and management of blood hereditary diseases (hemophilia and sickle cell anemia)

10. Prevention of Blindness and visual Impairment : • Establishment of 30 community eye health units at main PHCs (Ophthalmologists and Optometrists/refractionst). • Primary eye care: • Preschool eye screening • School enrollment screening • Cases of hypertension and diabetes • Adoption of SAFE Strategy for prevention and control of Trachoma. Elderly care: • Expansion of elderly clinics at main hospitals in Iraq(18 clinic) • Development of 17 elderly friendly PHCs. • Development of osteoporosis prevention and management for PHC physicians • Introduction of elderly health into Public Health Law.

11. Risk Factors Control A. Implementation of the National Tobacco Control Program: • FCTC endorsed • National tobacco control law endorsed • Tobacco free places implemented at Ministries • Tobacco cessation clinics under development

12. B. Implementation of the National Strategy for Diet, Physical Activity and Health: Setting based implementation: Schools: • Anthropometric measurements are introduced into school enrollment screening system. • Early detection and primary care for obesity among school children implemented at health promoting schools PHCs: • Capacity building of PHC health workers on nutritional assessment and counseling • Development of guidelines on diet, physical activity community: Production of educational materials EIC

13. C. Implementation of the National Programs for National Infant and Young Child Feeding Program • Baby friendly hospitals improved with stepwise expansion and a number of baby friendly PHC centers developed for implementation of the National Exclusive Breast Feeding Program • The National Infant and Young Child Feeding IYCF program Implemented and gradually expanded at PHC centers and hospitals

14. Surveillance, Monitoring, Evaluation: • NCD prevention and control is introduced into the research priority list of the ministry of health in accordance with the regional and global recommendations • NCDs introduced into national surveys (social determinants, family surveys) • Incorporated into research agenda of other ministries and sectors (Academia, Arab board, Iraqi Board) based on the national priorities • Production of the first national NCD report

15. National data on trends of NCDs cause specific mortality and contributory risk factor available • Introduction of NCDs into HIS • Registration system Reinforced based on updated International Classifications for Disease ICD in all health institutes • Strengthening cancer registry • Development of the national ESRD (end stage renal disease) surveillance

16. National and International partnerships • Steering committee for prevention and control of Noncommunicable Diseases • Steering committee for Tobacco Control • National committee for Prevention of blindness and visual impairment • Technical Committee for Diet, Physical Activity and Health • Central Committee on Elderly • National Committee on Prevention of Musculoskeletal Disorders • Medical Associations (Heart and Chest , Diabetes, Osteoporosis) • Specialized Centers and Units (Cardiovascular, Diabetes, Obesity) • NGOs • International Organizations: W.H.O., CBM ,USAID ،

17. Thank You for Listening