NCD in Saudi Arabia Dr Ahmed Al madani Director of Crown Health Project NCD, MOH,KSA

1. NCD in Saudi Arabia Dr Ahmed Al madani Director of Crown Health Project NCD, MOH,KSA

3. Saudi Arabia-Background Area: 2,250,000 Km2 ( 20 Health Districts ) Population: 24,802,273 (2008) 80 % Saudi (50,1 % male & 49,9 % female Population Growth: 2.23% 85% urban #12% villages # 3% Bedwins MOH Financial Resources(GDP): 6.00 % of total Budget MOH Per Capita Health expenditure: 257 US$/year PHC centers accommodate more than 85% of MOH health facilities attendants . (1986 centers )

4. Demographic Indicators

5. Health Status Indicators

7. PHC Visits ,MOH ,2007

8. Hospital Emergencies ,MOH,2007

9. MOH Hospitals Clinics visits,2007

10. CAUSES OF Saudi Deaths in MOH,2007

11. Introduction • General Directorate of Non-communicable diseases established in 2004 • Responsible for planning strategies & policies of NCD • Cooperation and Coordination with other (NGO+ National committees for various NCD programs for developing national guidelines & protocols. • Conducting screening & surveillance of NCD.

12. Programs

13. Step wise - surveillance forNCDs 2005

14. Diabetes prevention program Problem magnitude: The rising prevalence of Diabetes in Kingdom : -According to age group (15-64 years) 18%. -increasing by age to reach 24% at age more than 30 years. High prevalence of risk factors causes diabetes: -obesity and overweight(66.5%). -lack of physical activity .

15. Diabetes prevention program Achievements: Formulation of the national executive plan derived its elements from the Arab Gulf plan(2010 – 2020). Creating and updating Saudi manuals on Diabetes prevention(operational manuals, manual on nutritional instructions). Adapted the national strategy about the food, physical activity of health DPAS (in light of the WHO strategy.

16. Diabetes prevention program Achievements: Create a registry for (Type 1&2) DM connected to the central computer network. Establishing training educational programs in diabetic care, and the risk factors for all health professionals in cooperation with Diabetes national center and Saudi Diabetes society.

17. Diabetes prevention program Establishing the national committee on diabetes control and prevention which includes 14 specialists and consultants. Nominating a diabetes coordinator in each province and region with definite tasks and responsibilities. Accomplishing campaigns for raising awareness about diabetes and its early detection.

18. Diabetes prevention program • Finalizing the field work on Saudi Risk Score Validation and work is underway for data entry and analysis. • - Establishing training package for primary health care providers according to the unified national clinical guideline.

19. National Premarital Screening program Premarital screening program is a primary prevention program where a number of genetic and infectious diseases are screened by premarital examination to avoid or reduce the high risk marriages.

20. National Premarital Screening program • Diseases were discovered by the program arechronic in nature and require continuous and usually expensive health care support & lead to a dreadful economic and psychosocial burdens on the family and community.

21. The Saudi premarital screening program started actually on (2004) which made premarital screening obligatory for all those couples who plan to marry . • This procedure is a prerequisite for writing down the marriage contract. The choice of completing the marriage is given to two spouses regardless of the test result whether positive or negative”.

22. No. of Incompatible reports

23. % of couples complied to screening results

25. Neonatal Screening Program • A National Program for Neonatal Screening have been introduced for a number of metabolic, endocrine and hereditary diseases (16). • Program was started August 2005 , 24 hospital in 1st stage, May 2009, screened 295,885 babies and were diagnose 364 cases, 1.23 / 1000 delivers.

26. Cancer Control Program • In Saudi Arabia, the total number of cancers incidence reported to the SCR in 2005 was 10.513 affected 50.5% males and 49.5% females,7761 cases(73.8 %) were reported among Saudies. • The crude incidence rate (CIR) of all cancers among Saudi population was 44.6 / 100,000 and the over all age standardized incidence rate (ASR) was 74.3 / 100,000 and the median age at diagnosis was 59 years for men and 49 years for women.

27. Top ten most common cancers among Saudis 2005 (all ages).

28. Crown Health Project

30. Crown Health Project • National community based project, aims to prevent NCDs through focusing on health education to reduce risk factors for NCDs and, comprehensive approach with all partners (governmental and private). • Improving community awareness about healthy life style, and health promotion

31. Cont - Crown Health Project • Capacity building in public health services, esp on PHC level ,surveillance of NCDs and its risk factors • The project will emphasize its efforts in Al-Jouf district as a sentinel site, and then can be generalized in the whole kingdom

32. Objective of Crown Health Project • TO Improve health awareness about risk factors of NCDs • To Reduce exposure to risk factors (physical inactivity, unhealthy diet, tobacco used, hypertension, . . . . ). • To Early detect of NCDs and risk factors • To Reduce NCDs and its complication

33. Steps of the Project • Situation analysis • Designing preventive intervention programs • Training health workers on community health services • Encouraging community participation • Mobilize national support • Implementation of the project in the sentinel site (Al-jouf) • Implementation of the project in the whole kingdom 

34. Conclusion High prevalence of NCDs and its risk factors in Saudi community There is urgent need for active and comprehensive control program for risk factors of NCDs Integrate control program in PHC centers and community through CROWN HEALTH PROJECT

35. The rate of participation in the NCD survey in Aljouf, Saudi Arabia, 2007 (n=1170)

36. Gender distribution, NCD survey in Aljouf, Saudi Arabia, 2007 (n=1022)

37. Age distribution, the NCD survey in Aljouf, Saudi Arabia, 2004. (n= 1022)

38. Age distribution, the NCD survey in Aljouf, Saudi Arabia, 2004. (n= 1022)

39. Smoking practices, the NCD survey in Aljouf, Saudi Arabia, 2007 (n=1024)

40. Physical activity, the NCD survey in Aljouf, Saudi Arabia, 2004. (n= 1022)

41. Body Mass Index (BMI), the NCD survey in Aljouf, Saudi Arabia, 2007 (n=1008)

42. Prevalence of Hypertension, the national survey of NCD, Saudi Arabia, 2004 (n=4616)

43. Prevalence of Hyperglycemia, the NCD survey in Aljouf, Saudi Arabia, 2007 (n=918)

44. Prevalence of Hyperglycemia in each age group, the NCD survey in Aljouf, Saudi Arabia, 2007 (n= 918)

45. Prevalence of Hyperglycemia in each sex, the NCD survey in Aljouf, Saudi Arabia, 2007 (n= 918

46. Prevalence of Hyperglycemia, the NCD survey in Aljouf, Saudi Arabia, 2007 (n=918)

47. Prevalence of Hypercholesterolemia, the NCD survey in Aljouf, Saudi Arabia, 2007 (n=919)

48. Conclusion • NCDs and their risk factors are highly prevalent among Saudis • NCDs Control Programs are needed

49. Thank you