National Action Plan For Prevention And Control Of NCDs (2017-2021)
4.National Action Plan For Prevention And Control Of NCDs (2017-2021)
STRATEGIC AREA 1: ADVOCACY AND LEADERSHIP FOR MULTI-SECTORAL ACTION
Year of
Hold Regular meetings of National Technical
X X X X
Adequate national • NCD unit
Strategic Group on NCDs under MHSCC
Establish and hold regular meetings of
stewardship for
• MoHS
NCDs
Technical Working Group for specific
X X X X X
Strengthen MoH
diseasesrisk factorsareas
X X X X X
capacity for
Strengthen NCD unit in Ministry of Health
effective leadership
with adequate human resources including
for multi-sectoral
consultant in specific areas as per need
action
Identify specific training needs for leadership
A strengthened
• NCD unit
X X X
in multi-sectoral action for NCDs and send
NCD unit in
• MoHS
NCD unit staff for regional and global
MoHS
trainings To upgrade NCD unit to NCD Division by the end of the plan
X
X
Advocate to make NCDs as a line item in
Increase in
• NCD Unit
MoHS budget
allocation of
• MoHS
X
Advocacy for Earmarking a “sin” taxcess on
funds for NCDs
• Ministry of
tobacco, alcohol and unhealthy food products
Finance
• Regional and
for Health system strengthening and health
State
promotion for NCDs
Advocacy within
Governments
Advocacy with sub-national governments
X X X X X
Government
(States and Regions) for higher resource allocation for NCDs Prepare a policy brief for government to
X
Availability of
• NCD Unit
advocate higher investment in NCD prevention policy brief
• WHO
and control
• HelpAge Int.
X
Create a parliamentarian forum for advocacy
Roles and
• NCD Unit
responsibilities of
• WHO and other
X
Hold an inter-ministerial consultation to
Key Ministries in
international
Partners
discuss mechanisms for dialogue within
NCD prevention
• All Relevant
ministries
and control and
Prepare ministry specific background paper for mechanisms
key ministries
Identified
X
Hold Ministry specific consultations to
advocate for aligning their policies and programs with NCD prevention and control.
X
Advocacy for establishment of NCD alliance
An NCD alliance
• WHO
with all stakeholders
of all the
• HelpAge Int.
X
Hold Annual National NCD meeting with al
stakeholders
• Other Civil
stakeholders to review progress and make joint established and
Society Partners
plans for the next year.
functional in
Advocacy with non-
Compile and disseminate National
International Good Practices in multi-sectoral
partners
actions through onlineoffline platforms Explore additional resources for NCD
X
prevention and control from International partners and donors Mobilize the UN Country Team and link
X
Inter UN Agency
WHO Other UN
NCDs into the UNOPS processes
work harmonized
Agencies
STRATEGIC AREA 2: HEALTH PROMOTION
Year of
Cost Budget source
Create an Institutional framework for
Establish new or identify an existing
• MoHS
agencyunit for leading Health Promotion
An agencyunit for
leadership and co-
• NCD Unit
X
activities in the country
health promotion
ordination for health
• Health Literacy
X
promotion activities in
Provide sufficient resources for its working
established
X X X
Promotion Unit
the country
through tax and public-private partnership Design mass media campaigns targeting
X
Increase in
• National Health
X X X
different risk factors and risk groups
population level
Promotion
X
Printpublishbroadcast IEC materials
reach of IEC
Agency X X X
• Health Literacy
including of related health programs
Campaigns
Promotion Unit
X
Conduct Events to promote awareness at
and other related
X X X
Conduct Mass media
national subnational levels
agenciesUnits
X
campaigns on NCDs
Develop and maintain a website portal as a
under MoHS
X X X
one stop resource on information related to
• Ministry of
NCDs
Information
• Ministry of
X
Identify and use celebritiesleaders as role
X X X
models to reinforce messages
Transport and Communications
• Media
X
Rationalize and simplify taxes on smoked
Increased
• Tobacco Project,
and smokeless tobacco products
compliance to
NCD Unit under
X
Start tobacco cessations services at select
• Health Literacy
secondary level hospitals in a phased
strategies
Implement all
manner
Promotion Unit
X
provisions of FCTC
Establish a national telephonic helpline for
under MoHS
• General
effectively
tobacco cessation
Administration
X
Mandatory warning on both smoked and
Department
smokeless tobacco products consistent with
Myanmar Police
FCTC guidelines
Force under
X
Stricter enforcement of ban on smoking in
Ministry of
X X X
Home Affair
Strengthen Legislation to ban marketing of
• City
X X X X
tobacco products through sponsorship,
Development
advertising and point of sale
Committees • Ministry of
X
Strengthen efforts to eliminate illicit trade
Commerce
of tobacco products, including smuggling,
• WHO
illicit manufacturing and counterfeiting
• NGOsINGOs
X
Develop a national alcohol policy consistent Improvement in
• NCD Unit
with WHO guidelines
coverage with
• Mental Health
Global Alcohol
Project, NCD
X
Enact a National Alcohol Control
Prevention Strategy
Unit
provisions
• General
legislation addressing sale, access and
marketing of alcohol
Administration Department
Effectively implement current drink and
Union Attorney
X X X X
drive legislations
General's Office • City
Initiate measures to
X
Development
reduce harmful use of
Raise tax on alcohol containing products for
alcohol
human consumption
Committees
• Ministry of
X
Reduce the public health impact of illicit
Planning
alcohol and informally produced alcohol
Finance
• Union Attorney
through identified measures
General's Office • Ministry of
X X X X
Transport and
Substantially strengthen alcohol cessation
Communications
services within and outside government
• WHO
sector in a phased manner
• NGOsINGOs
Establish national guidelines for physical
• NCD unit
X
activity for adults and children
Improved
• Department of
X
Create demonstration projects within large
compliance to
Sports and
Promote Physical
cities for aligning urban transport policy to
Global Strategy on
activity
Physical
promote physical activity
Diet and Physical
Education
Organize Mass sports activities on special
Activity
• Ministry of
X X X X
occasions.
Education
X
• City
X X X
Start a school and college based program
Development
for promoting sports culture among youth
Committees
X
Identify food products to be identified as
Improved
• NCD Unit
“unhealthy” in the national context
compliance to
• Nutrition Unit
X
Global Strategy on
• Ministry of
Levy additional taxcess on the above
identified unhealthy food products
Diet and Physical
Agriculture,lives
X
Enact a legislation to regulate marketing of
Activity
tock and
Irrigation
sugar sweetened beverages and foods high
• Ministry of
in salt sugar and fat to children
commerce
X
Develop guidelines for nutrition labeling for Specific National
• Food and Drug
all pre-packed and cooked food
level policies
Administration
X
Enact a legislation to reduce levels of
promoting healthy
• Ministry of
saltsaturated fat, free and added sugar and
diet present
Planning
to replace trans-fats in packaged foods
Finance
X
Promote Healthy Diet
Invest in improving fruits and vegetable
• Union Attorney
X X X
production and storage
General's Office
X
• WHO
Harmonize the need of iodized salt program
• NGOsINGOsC
with salt reduction initiatives
Promote breast feeding and supplementary
nutrition programs aimed at pregnant
Department
women and children Ensure guidelines and mechanisms are in
X
X X X
place to ensure food safety Initiate Dialogue with Nutrition Unit and
X
X X X
other sectors for an harmonized nutrition policy
X
Strengthen Laboratory Capacity for testing
of food products for nutrients Establish national guidelines for Healthy
X
Increase in number
• School Heath
Schools, Healthy workplaces and Healthy
of “settings”
Unit
Promote Healthy
Townships and villages
adopted Healthy
Occupational
Settings in various
Implement and evaluate Demonstration
settings approach
Health under
settings
X X
projects on Healthy Schools, Healthy
MoHS
• Educational
workplaces and Healthy communities
X
Disseminate widely among educational
institutions,
institutions and industry for their voluntary
universities,
adoption
school boards, under Ministry of Education
• Ministry of Labour, Immigration and Population
• StateRegional Governments • General Administration Dept under MOHA
• City Development Committees
• Ministry of Border Affairs • NGOsINGOsC SOs
X
Strengthen advocacy f o r transition to
Increase in uptake
• Ministries of
X X X
cleaner technologies and fuels (LPG, bio-
of safercleaner
Electric Power
gas, solar cookers, electric methanol,
alternatives
and Energy
ethanol)
• Ministry of
Develop and implement programs aimed at
Planning
X X
encouraging the use of improved cook-
Finance
stoves, good cooking practices
• Ministry of
Effectively address
Use fiscal and regulatory measures to
Outdoor and indoor
Transport
promote cleaner fuels for transport sector
• DMR under
Air Pollution
X
Conduct studies to identify share of
MoHS
different sources of out-door air pollution
• City
Strengthen public transport system and
Development
X X X
incentivize its use
Committees
Replace in phased manner all public
X X X
transport vehicles with vehicles using CNG or other cleaner fuels
Formulate and Effectively implement a
Improved road
• Injury
X X X X
comprehensive legislation covering five key safety and
Prevention
areas – speeding, drink-driving, helmet use,
compliance to
Project, NCD
seat-belt use and child restraint.
national laws
Unit under
Establish safety standards for vehicles and
MoHS
X X X X
mechanisms for their regular monitoring
• Ministry of
Promote use of non-motorized transport by
Transport
X X X X
Address effectively
financial incentives and improved urban
Communications
risk factors for road
environment
• Myanmar Police
traffic injuries
Advocate for improved design and
Force under
X X X X
construction of roads and their lighting
Ministry of Home Affair
• Union Attorney General's Office
Improve availability of anti-snakebite
• Ministry of
venom in health facilities
Construction
STRATEGIC AREA 3: HEALTH SYSTEM STRENGTHENING
Outcome Indicators
Year (2017-2021)
• Relevant NCD
Projects
Standard treatment
• NCD unit
Guidelines are
Develop national guidelines for management
• Medical
available
of common NCDs and mental disorders at
Universities
primary care level
• WHO
Strengthen Primary Health Care
• NCD Unit,
Include select NCD related medicines and
facilities for
technologies in the national essential
DPH
Increase in
X
medicine list
• PSM Units,
addressing NCDs
availability of
X
Make available essential technologies and
MoHS
essential technologies
• MoHS
medicines at primary care facilities
and medicines in
• Regional and
X
Expand the implementation of the WHO
primary care facilities
PEN project to the whole of country State Public
Health Departments
X
Implement demonstration projects for
Decrease in treatment
• NCD Unit,
integrated technology based solutions
delays NCDs
DPH
• HMIS, DPH
including use of mHealth, eHealth, electronic
• MoHS • Regional and
medical records for NCD service provision
X
Strengthen linkages
Make available Free Referral transport
mechanisms for emergency care nationally
State Public
to secondary and tertiary care
X
Strengthen secondary and tertiary health
facilities for acute care needed for different
Departments
NCDs in a phased manner
• Ministry of
Transport Communicati ons
X
Launch a cancer screening program for
Improved access to
• Cancer Project
common cancers
affordable cancer
• DMS, MOHS
X
Strengthen Cancer
Upgrade cancer treatment facilities in
care
• DPH, MOHS
care
• NCD Unit
secondary and tertiary care facilities
• MRH Unit
X
Establish Palliative care in select health
Hospices
X
Reduction in
• MOHS
Price Control mechanisms and revision of
Financial impact due
• Ministry of
import duties for making NCD drugs
to NCDs on
Planning
affordable.
individuals and
Finance
Reduce the financial
families
• Ministry of
X
Initiate an insurance scheme to cover the
impact of NCDs on
population below poverty line for treatment
Commerce
individuals and
• UMFCCI
of NCDs
X
families
• Private
Establish a national fund to provide free
treatment of cancers and other NCDs to
Entrepreneurs
patients below poverty line Promote the use of generic medicines in
X
public health facilities IdentifyRevise competencies for all levels of
X
health workforce based on their roles and
• NCD Unit,
Develop training manuals for all levels of
• HRH
health workforce based on above
• All\Medical
competencies
Increased in
Strengthen capacity
Universities
X
Revise and implement revised curriculum of
quantitative and
of Workforce to
• University of
qualitative competencies among
deliver NCD
all cadres of health workforce to address
Nursing
services
NCDs effectively
• University of
health workforce
X
Create a pool of institutionstrainers in public
Community
and private sector for conducting training of
Train existing workforce on NCD activities
including Health promotion
X
Draft national guidelines for screening for
Early detection of
• Relevant NCD
select NCDs and conditions
cases
Projects • NCD Unit,
X
Early detection and
Launch a pilot project for implementing
DPH
treatment of
screening program based on those guidelines
• MOHS • Medical
common NCDs
Universities • WHO
X
Expand pilot projects for reduction of
• Mental Health
treatment gaps for mental disorders based on
Project
WHO mhGAP interventions
• WHO
X
Develop National guidelines on
Increase in
• NCD Unit
Home-based care for management of NCDs
Encourage the formation of patient self help
empowerment for
• NGOsINGOs
Empower persons
groups and build their capacity
managing NCDs
• Civil Society
X
communities with
Establish guidelines and pilot projects for
Organizations,
NCDs for selffamily care
community based rehabilitation for stroke, mental disorders. Strengthen Consumer safety forums to
X
ensure consumer rights Establish guidelines Develop schemes for
X
Higher involvement
• NCD Unit,
involvement NGOs and private sector for
of private sector in
DPH
Management of
Involve private
NCDs related service provision
• MMA
NCDs
• Medical
X
sector in provision
Provide appropriate training to the NGOs and
of NCD Care
PCPs for provision of services as per national
Universities
• WHO
standard treatment guidelines
X
Conduct pilot testing of the schemes in select
districts Expand coverage with Hepatitis B vaccine in
X
Increased coverage
• EPI Unit, DPH
children
with key NCD
• Hepatitis
• GAVI
Initiate immunization program with HPV
• UNICEF
vaccine
X
Ensure integration of Integrate risk detection and risk reduction
• School Health
NCD activities into
strategies with school health programs
Unit, DPH
X
other health
Conduct a pilot study on inclusion of diabetic
• Diabetes
programs
retinopathy in the national blindness program
Project
X
Initiate pilots on gestational diabetes
• MRH Unit,
screening program within existing antenatal
DPH
care programs
• Blindness
X
Project
Initiate bi-directional screening for diabetes
• NTP, DPH
and tuberculosis
• WHO
• UNICEF • IUATLD • GFATM
X
Establish a roadside highway assistance Increased access to
• Ministry of
network of hotlines and ambulance services trauma care services
Transport
for early transportation of trauma cases
Communicati
X
Strengthen trauma care units in medical
ons
Strengthen trauma
colleges and tertiary facilities
• Myanmar
X
care facilities
Police Force
• Injury Project
Train first level responders like police and
• DMS,MOHS
ambulance drivers in pre-hospital trauma
• WHO
care Supplement the production of anti-snake
X
Increased access to
• Snakebite
venom in the country
treatment of
Project
X
Train basic health staff in prevention of
snakebites
• NCD Unit
Prevent Mortality
snake bites, identification of poisonous
• PSM Units,
due to snake bites
snakes and standard first aid measures
Improve availability of anti-snakebite venom
in health facilities
STRATEGIC AREA 4: EVIDENCE GENERATION FOR DECISION MAKING
Budget
Partners
Year (2017-2021)
Cost source
Sub-Strategy
Actions
Outcome Indicators
Incorporate the data needs of NCD Program
into existing Health Management Information system Develop web based system for reporting and
X
Strengthen regular
compiling of all health facility data including
Better monitoring of
by private sector for NCDs
NCD Unit
monitoring of NCD
the NCD programs and
Hold Annual Review meeting of the NCD
initiatives
Program Managers
X
Develop Training programs to strengthen
capacity of program in program implementation and monitoring
X
Establish a national Technical Working
Better availability of
• All NCD
Group on NCD Surveillance to guide all
information on key
Projects
• NCD Unit
surveillance activities
parameters at national
• HMIS
X
Identify an institutionagency for co-
NCDs
• Nutrition Unit • DMR
ordination of all national NCD surveillance
activities
• UOPH
X
Strengthen capacity for NCD surveillance in
• WHO
Establish and
select individuals and institutions
• NGOsINGOs
X
implement
Conduct a survey to estimate salt intake and
sustainable
the source of salt in the diet as separate or
surveillance systems
integrate with existing nutrition surveys
X
for NCDs
Conduct a nationally representative cause of
• NCD Unit
death survey every five years
• HMIS
X
Conduct a nationally representative Survey
• School Health
to measure the national targets for risk factor
Unit
• DMR • UOPH
in adults
Conduct next round of School based Survey
X • NGOsINGOs
to measure NCD related risk factors among
• International
adolescents
X
Conduct a Service Availability and
partners,
Readiness Assessment including for NCDs,
WHO
mental health and injuries Create and maintain a website for
X
dissemination of all surveillance reports to public
X
Expand Cancer Registries in at least four
sites in the country
X
Strengthen hospital based injury surveillance
system in select sentinel sites
X
Conduct survey to estimate Mental Health
Better availability of
• NCD Unit
treatment gaps
evidence to support
• DMR
X
Hold a national consultation to identify
evidence based
• Medical
decision making.
research priorities
Universities
• WHO,
X
Strengthen research
Strengthen capacity of identified researchers
IUATLD and
in the priority areas
and institutions Liaise with donorsfunders of research for
other
X
of NCD prevention
international
and Control
creating a pool of resources
X
partners
Establish an operational research group with
members from departments and universities Identify and fill gaps in estimation of
X
epidemiological and economic burden due to NCDs including mental health in Myanmar
Annexures
Annexure 1. Global monitoring indicators and targets
Annexure 2. Trends of Risk Factors for NCD – Myanmar (2009-2014)
Age Group (years)
15-64 15-64 15-64 25-64 25-64 25-64
Sample Size
2862
4567 7429 3079 5678 8757
Proportion of people who use 44.8 7.8 22.0 43.8 8.4 26.1
smoked tobacco currently ()
Proportion of people who use 51.4 16.1 29.7 62.2 24.1 43.2
Smokeless tobacco currently ()
Proportion of people with 38.1 1.5 19.8 31.2 1.5 12.9
alcohol consumption in last 30 days ()
Proportion of people with 89.8 90.6 90.3 85.2 87.9 86.6
intake of <5 combined daily servings of fruits and vegetables ()
Proportion of people with 10.4 14.1 12.7 12.5 18.8 15.7
Inadequate Low Physical activity ()
Prevalence of raised blood 31.0 29.3 30.0 24.7 28.0 26.4
pressure () Prevalence of Overweight ()
17.7 30.3 25.5 14.1 30.8 22.4
Prevalence of raised fasting Not
blood sugar ()
Done Done Done
Source:
1. World Health Organization (2011) Noncommunicable Disease risk factor Survey Myanmar 2009. Delhi
• Ministry of Health, World Health Organization and World Diabetes
Federation. Report on National Survey on Diabetes mellitus and risk factors for noncommunicable diseases in Myanmar (2014), Yangoun