A health promotion approach to mainstreaming Non-communicable Diseases (NCD) Control and Prevention Partnerships in sub-Saharan Africa

by Gabriel Oguda and Jared Odhiambo Owuor

On 16th May 2011, the 64th World Health Assembly began in Geneva, Switzerland. It came hot on the heels of the just-released Global Status Report on Non-communicable Diseases, commissioned by the World Health Organization (WHO). In her opening address, the WHO Director-General, Dr. Margaret Chan reminded health officials to “Never forget the people” and asked them to translate their talk into action:

“…let us be frank. Health clearly speaks with a louder voice, but still carries a small stick when it comes to shaping the way this world works. This will have to change, especially if we want to reverse the growing burden of non-communicable diseases.” (1)

Dr. Chan made explicit reference to Non-communicable diseases (NCDs) because NCDs – principally cardiovascular diseases, diabetes, cancers and chronic respiratory diseases- are the leading causes of death globally, killing more people each year than all other causes combined (2). According to recent research, nearly 80% of NCD deaths occur in low-and middle-income countries (3).  In Africa, this situation is compounded by the double-disease burden – the prevalence of both communicable and non-communicable diseases.  

To nip this growth in the bud, a group of African researchers, academicians and practitioners have come together under the umbrella of the Consortium for Non-Communicable Diseases Prevention and Control in sub-Saharan Africa (CNCD-Africa). The mission is to harness partnerships with NCD actors in the region and globally in order to spearhead a reduction in NCD risk factors through health promotion, disease prevention, and improved management of NCDs by synergizing the capacity of the various existing organizations and main players within and out of the sub-Saharan African region.

CNCD-Africa Countries (shown in yellow)

CNCD-Africa: The Interview

To learn more about CNCD-Africa, Gabriel Oguda interviewed Jared Odhiambo Owuor, the current Executive Secretary of CNCD-Africa:

1. Can you give us a brief history of CNCD-Africa?

Recognizing the increasing burden of lifestyle-related diseases in sub-Saharan Africa, CNCD-Africa was formed to initiate and facilitate a process of supporting countries in the region to help advocate for and maximize their efforts towards NCD prevention and control.

The first NCD Prevention and Health Promotion Advocacy Meeting was held in 2008 in Bagamoyo, Tanzania with support from the IUHPE. The meeting brought together NCD experts from different countries to deliberate on the priorities for NCD control, prevention and management in the African region. During this meeting, two groups, the Expert Group and the Partner Forum, were formed. The Expert Group was composed of researchers, academicians and practitioners of NCDs in Africa. The Partner Forum consisted of organizations with special interest in NCDs, as well as interest in overall health in the sub-Saharan African Region.

NCD Partner and Expert Group, Entebbe 2009

 

The two groups reconvened in 2009, where they formed a Consortium to encompass national, regional and global associations as well as individuals working on NCDs in the region. Their overarching vision was to improve health and quality of life of people in sub-Saharan Africa through tackling NCDs comprehensively, competently and sustainably. They aimed to do this through harnessing partnerships with NCD actors to spearhead a reduction in NCD risk factors through health promotion and other strategies relevant to the sub-Saharan African region.

2. What progress has CNCD-Africa made so far?

Our progress has incorporated a conscientious alliance-building, awareness- raising and creation of a framework for dialog:

a. Establishment of NCD Expert and Partner Groups and the coordination of NCD Partner Forum through the CNCD-Africa platform;

b. Establishment of the Consortium’s Secretariat in Nairobi and the official launch during the 20th IUHPE conference on health promotion (July 2010);

c. Establishment and coordination of the Kenya National NCD Stakeholders’ Forum (July 2010) which brings together arms of the government and non-governmental organizations working towards NCD prevention, control and treatment. The forum has been formalised as the Kenya National NCD Alliance (KNCD-Alliance);

d. CNCD-Africa leadership has been incorporated into the Kenya National Intersectoral Consultation Committees (ICCs); and

e. Leadership in key regional documents: i) NCD policies in Africa: current status and ii)  Non-communicable Diseases in Africa: A call to action

3. What would you say is the state of health promotion in Africa? What are some of the unique elements about the African context that have impacted the success of CNCD-Africa?

There are opportunities for growth, but at the moment, they are clouded by other priorities both within and outside the health sector. In sub-Saharan Africa, other underlying factors and wider socioeconomic issues still heavily influence priorities in public health and individual health seeking behavior. Most health systems in Africa operate from a reactive standpoint when responding to public health needs. This approach pushes health promotion to the fringes. There is currently a need for the reorientation of healthcare staff and the sensitization of the public on the benefits of health promotion, as well as the need to proactively work towards healthy outcomes.

Facts about CNCD-Africa

a. Establishment – The Department of Health, United Kingdom, funded the International Union for Health Promotion and Education (IUHPE) and the African Institute for Health & Development (AIHD) which marked the beginning of CNCD-Africa.

b. Partners – the Partner Group has since grown to include the newer partners such as The African Tobacco Control Alliance (ATCA), the Framework Convention Alliance (FCA), African Field Epidemiology Network (AFENET), African Physical Activity Network (AFPAN), Health NGOs Network (HENNET), and the African Population and Health Research Centre (APHRC) among others.

c. You can find out more about CNCD-Africa by visiting:

Website: www.aihdint.org/cncd

Facebook: www.facebook.com/pages/CNCD-Africa/103447589721012

Or email: cncdafrica@aihdint.org

 

4. How has CNCD-Africa contributed towards the growth of health promotion in the continent?

CNCD-Africa has engaged in lobbying, dialogue and mobilization among actors in health promotion and NCD work in the country and regionally. We have an active network of health promoters within Kenya and across the region, and have incorporated a range of stakeholders with various backgrounds in our advocacy activities. As a result, there are more direct linkages among partners and sectors, and we have seen a more unified voice in addressing challenges and synergizing strengths. Moving forward, CNCD-Africa is exploring avenues that will lead to the establishment of country charters of health promotion networks. We hope this will help strengthen and broaden the scope and impact of the network.

Physical activity in Kenya- Active sports as an NCD prevention strategy

5. What are some challenges you have experienced so far?

CNCD-Africa has met its short and long term objectives since inception despite operating on a small budget. Securing adequate funds that would diversify the scope of the Consortium’s engagement with partners has been challenging. Another challenge has been sustaining continued engagement among partners as this requires structured involvement, so that everyone is maximizing what they can expect to achieve through the partnership. We hold meetings regularly to assess our progress and strategize for the future.

6. Is there anything else you would like to share with ISECN members?

We appreciate this interview, knowing that our efforts are being recognized. We would encourage the IUHPE Student and Early Career Network, especially members in the African region, to join our network and be a part of our membership!

References

1.    WHO | WHO Director-General reminds health officials: never forget the people [Internet]. [cited 2011 May 18];Available from: http://www.who.int/dg/speeches/2011/wha_20110516/en/index.html

2.    WHO | Global status report on noncommunicable diseases 2010 [Internet]. [cited 2011 May 18];Available from: http://www.who.int/nmh/publications/ncd_report2010/en/

3.    Alwan A, MacLean DR. A review of non-communicable disease in low- and middle-income countries. International Health. 2009 Sep;1(1):3-9.

Published: May 2011

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