NCDs still a burden on the health system

Younten Tshedup 

If numbers are any indication, Noncommunicable diseases (NDC) remain a major burden to the health system today as it was five years ago.

Hypertension, cardiovascular diseases, cancer, and diabetes accounted for 71 percent of the reported deaths in 2019, according to the annual health bulletin 2020.

The second NCD risk factor survey report 2019, which was launched yesterday highlights a slight reduction (by 7.9 percent) in the alcohol usage from the last survey in 2014.

However, alcohol usage in the country still remains high with two out of five Bhutanese currently drinking alcohol. Similarly, although tobacco usage saw a slight decrease of 0.9 percent in the last five years, one in five Bhutanese continues to use tobacco.

The prevalence of current alcohol and tobacco use were estimated at 34.5 percent and 23.9 percent, respectively, according to the survey.

Health Minister Dechen Wangmo during the launch said that besides having numerous laws, policies and regulations in place, it was evident from the findings of the survey that the health of the nation had not improved in the last five years.

“The achievements in the last five years are a variation of a few percentage points. Statistically, I don’t know if they are significant and be levelled as an achievement.”

Lyonpo said that although alcohol users have dropped in the past five years, this was considering the age groups from 18-69 years. “If we include the age groups from 15-69 years, the numbers are high. This is more alarming as it includes underage groups indulging in drinking, which is illegal.”

According to the survey, 11.4 percent of the population were obese and 33.5 percent were overweight, and 3.1 percent were underweight. The prevalence of raised blood pressure, blood sugar and cholesterol were recorded at 28 percent, 1.9 percent and 11.1 percent, respectively.

Also, 7.3 percent of the population did not meet the recommended standard of 150 minutes of physical activities every week. Close to 90 percent did not consume five servings of fruits and vegetables and the average consumption of salt intake was 8.3 grams, which was double the recommendation of 5 grams per day.

Lyonpo said that the data from the survey provided an opportunity for evidence-based planning and programming going forward.

“In the five years, the health of the nation has remained the same. As a small nation, we cannot let this continue. We know some things have worked but the majority has not,” she said. “I feel this is the right time to reflect on our existing strategies and review it.”

With the highest political will at the moment, Lyonpo said that it was an added advantage for the health ministry and its partners to push the healthy nation agenda forward.

“We must design interventions that are solely targeted to one population at a time.”

The population-based household survey was carried out with an objective to assess the trends in the prevalence of NCD risk factors, health response, service coverage and utilisation of the services.

A total of 5,575 people aged between 15-69 were interviewed for the survey that was carried out in three steps. Besides physical measurements such as height, weight and blood pressure, biochemical measurement such as the salt intake, blood glucose and cholesterol level were assessed including sociodemographic and behavioural information related to dietary habits, physical inactivity, alcohol and tobacco use.

NDC screening 

Along with the launch yesterday, the ministry also started the NCD screening services for the civil servants. More than 100 health ministry staff were screened for hypertension, body mass index, cholesterol, and oral health, including eye and ear check-ups.

Lyonpo said, “This is where it starts. If we aren’t mindful of our own health, we cannot be the champions of advocating healthy living for the public.”

She said that majority of the health workers have not done the pap smear test for themselves although cervical cancer was the number one killer among Bhutanese women. “It has to start with you. It is time for action.”

Lyonpo said that although the achievements from the recent survey were not significant, the findings in the next survey should be able to see statistically significant achievements through the ministry’s targeted programmes and interventions.

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