Enhancing Non-communicable Disease Prevention and Control

Background and rationale Primary Health Care is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people's needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation, and palliative care, and as close as feasible to people's everyday environment (1). Primary Health care (PHC) is a path towards achieving universal health coverage (UHC), health-related sustainable development goals (SDGs), and health security (2). Enhancing PHC interventions across low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030 (1).

Ethiopia has been implementing the PHC approach since the mid-1970s. The three interrelated and synergistic components of PHC are comprehensive integrated health services, multi-sectorial policies, and empowering communities for increased social participation (2). Though there have been noticeable changes in PHC services coverage in Ethiopia, the UHC Index remains at 43% (3).

Ethiopia is in both demographic & epidemiologic shifts with the burden of non-communicable diseases (NCDs) is steadily increasing & is expected to grow at an alarming rate in the next couple of decades (4). In Ethiopia, the prevalence of NCDs ranges from 19-35%. The pooled prevalence of Diabetes Mellitus is 5%, cardiovascular conditions ranged from 13.4 to 32.2%, cancer mortality ranged from 4 to 18%, and respiratory conditions ranged from 1-18% (4).

Non-communicable diseases are lifelong chronic diseases that result in huge morbidity & mortality as well as catastrophic health care cost. Nearly half of all deaths in Ethiopia are attributable to NCDs & injuries. Ethiopian citizens have 18.3% risk of dying prematurely from one of the four main NCDs. The economic loss due to NCDs is 31.3 billion birr annually (5). Hence, NCDs are very serious problems resulting in high burdens to patients, families, communities, and the country at large (4).

The risk factors of NCDs are unhealthy dietary habits, sedentary lifestyle, risky sexual behavior, tobacco use, drinking alcohol, and Khat chewing (5). Low community awareness about NCDs, poor trend of early screening for NCDs, and low NCD service-seeking practices are key challenges contributing to the high prevalence & complications of NCDs. Moreover, most of the cases are unaware of their conditions and come to health care services after the advanced stage (5). This problem is worst in rural communities.