More attention needed on non-communicable disease management
Non-communicable diseases are the leading cause of death. Currently, 65-75% of inpatients suffer from non-communicable diseases and the disease is tending to be younger.
Nghe An Newspaper had an interview with specialist doctor 2 Le Anh Tuan - Head of the Department of Non-communicable Disease Prevention, Nghe An Center for Disease Control about related issues.
Reporter (PV): According to the latest report of the Ministry of Health, it is estimated that each year in Vietnam, the number of deaths due to non-communicable diseases accounts for 77% of the total number of deaths from all causes. Could you explain more clearly what non-communicable diseases are? Why are non-communicable diseases the leading cause of death?
Doctor Le Tuan Anh:According to the World Health Organization, non-communicable diseases are non-communicable diseases, also known as chronic diseases, that are not transmitted from person to person. The disease progresses over a long period of time and slowly. Non-communicable diseases include many diseases, but the most notable are the following four main types: Cardiovascular diseases (such as high blood pressure, myocardial infarction and stroke), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and bronchial asthma), diabetes... In addition, there are also neurological and mental diseases, chronic joint diseases and injuries due to accidents.
Non-communicable diseases have a number of characteristics such as complex causes; many risk factors; no infectious origin, slow onset, long disease progression, persistent treatment and consequences for patients and society... Risk factors leading to non-communicable diseases include living habits, lifestyle, physical or chemical agents. When these factors appear, they will increase the possibility of contracting non-communicable diseases or dying from the disease. According to statistics, non-communicable diseases have 4 common risk factors: smoking (tobacco); lack of physical activity; alcohol abuse; and unhealthy diet.
According to the World Health Organization, non-communicable diseases are becoming more common in the community, are the leading cause of death and disability, cause economic damage in society, and create major challenges for the health sector of countries, especially in low- and middle-income countries.
According to a survey in Vietnam in 2016, there were 548,800 deaths nationwide, of which non-communicable diseases accounted for 77% (44% of deaths before the age of 70; mainly due to cardiovascular disease, cancer, diabetes and chronic obstructive pulmonary disease). On average, each year in Vietnam, there are about 12.5 million people with high blood pressure, 3.5 million people with diabetes, 2 million people with chronic heart and lung disease and nearly 126,000 new cases of cancer. Thus, 1 in 5 adults has high blood pressure and about 1 in 25 adults has diabetes. Of these, more than half of patients with high blood pressure and about 70% of patients with diabetes in the community have not been detected.
In Nghe An, according to statistical reports from commune health stations, in 2023, there were about 120,471 hypertensive patients and 33,230 diabetic patients detected in the province. At present, hospital reports show that 65-75% of inpatients are suffering from non-communicable diseases. Hospitals with departments specializing in cancer treatment, cardiovascular disease, endocrinology, etc. are always overloaded.
Non-communicable diseases are the leading cause of death because our country is a country that consumes a lot of alcohol and beer, and has a high smoking rate. The use of alcohol and beer increases accidents, strokes, and heart attacks. The high smoking rate is also a factor that causes many diseases such as cancer, chronic obstructive pulmonary disease, cardiovascular disease, etc.
In addition, the general public's awareness of non-communicable diseases is not high, so their behavior, lifestyle, and diet are not appropriate. In addition, the screening and early detection rate in Vietnam is also low; management and treatment of non-communicable diseases at the grassroots health care level face many difficulties.
The World Health Organization also warned that after the Covid-19 pandemic, the world will face another pandemic called non-communicable diseases. Therefore, countries need to continue investing and focusing resources on prevention activities as well as care and treatment for people with non-communicable diseases.
PV:It is clear that non-communicable diseases are very dangerous and on the rise. To prevent and control non-communicable diseases, what solutions are Vietnam in general and Nghe An in particular implementing?
Doctor Le Tuan Anh:Currently, the prevention and control of non-communicable diseases and mental health disorders is a priority in Vietnam's health policy. The Ministry of Health and the Government have issued many policies to gradually control non-communicable diseases and reduce the burden on upper-level hospitals by transferring the management and treatment of non-communicable diseases to grassroots health facilities. On January 29, 2022, the Prime Minister issued Decision 155/QD-TTg approving the National Plan for the Prevention and Control of Non-communicable Diseases and Mental Health Disorders for the 2022-2025 period.
Implementing the work of preventing and controlling non-communicable diseases under the direction of the Prime Minister, on November 29, 2023, the People's Committee of Nghe An province issued Plan No. 920/KH-UBND on preventing and controlling non-communicable diseases and mental health disorders for the period 2023-2025 in Nghe An province.
Based on the plan of Nghe An Provincial People's Committee, health units and People's Committees of districts, cities and towns have also issued their own plans for non-communicable disease prevention. Accordingly, the solutions that localities have implemented are: Strengthening management, leadership, direction and operation; solutions on mechanisms and policies, including allocating budget funds for non-communicable disease prevention and control and strengthening the enforcement of legal regulations on controlling risk factors and promoting health-enhancing factors; communicating to raise health awareness, reducing risky behaviors, preventing non-communicable diseases; increasing the provision of preventive services, early detection, management, treatment and care for non-communicable patients; developing and improving the capacity of the non-communicable disease prevention and control service delivery system; developing a system for monitoring and managing information on non-communicable diseases and risk factors.
The provincial Center for Disease Control has also issued a plan to prevent non-communicable diseases. It focuses on measures to strengthen communication to help people understand the dangers of non-communicable diseases; improve the quality of non-communicable disease management services at health stations to reduce the management of non-communicable patients in the community more effectively through monitoring activities, capacity building training, etc.
To prevent and control non-communicable diseases, currently, 100% of health stations in the province have implemented management and treatment of hypertension and screening for hypertension and high risk factors for diabetes at the stations, helping people easily access management and treatment services for non-communicable diseases, especially in remote areas.
PV: The proposed prevention and control measures are very positive, but why are non-communicable diseases on the rise? Is it because we have not implemented the above measures well?
Doctor Le Tuan Anh:In fact, the prevention and control of non-communicable diseases in Vietnam in general and Nghe An in particular still face many difficulties and limitations. That is, the rate of screening and early detection of non-communicable diseases is still low; management and treatment of non-communicable diseases at the grassroots level face many difficulties... some commune health stations have not ensured the list and quantity of essential drugs for management and treatment of non-communicable diseases and have not performed capillary blood sugar tests for management and treatment of diabetic patients; management of information on non-communicable diseases and mental health disorders in the area is not adequate.
Non-communicable diseases often progress silently, and are only discovered when complications occur. People are not yet fully aware of the dangers of the disease, so they do not pay attention to prevention and control. Uncontrolled smoking and drinking are common. People still have many harmful habits and lifestyles that increase the risk of non-communicable diseases.
Specialist Doctor 2 Le Anh Tuan - Head of Non-communicable Disease Prevention Department, Nghe An Center for Disease Control
The reason is that prevention and control activities have not received due attention and have not been considered as important as the prevention of infectious diseases. Funding sources allocated and arranged for prevention and control at the health care level are almost non-existent or have not been allocated. Due to lack of funding, prevention and control activities have not been fully and synchronously implemented, especially screening for disease detection and risk of disease. Health stations are currently facing difficulties in human resources when they have to carry out too many health programs, while the number and qualifications are still limited.
To overcome these difficulties, towards effective prevention and control of non-communicable diseases, and reduction of risk factors, it is necessary to continue to promote communication about risk factors and risky behaviors that cause non-communicable diseases, and raise awareness among people. Local authorities need to allocate funding for more effective non-communicable disease prevention activities.
Changing harmful lifestyle behaviors, early screening and timely treatment are extremely important in preventing non-communicable diseases.
PV: It is known that the rate of non-communicable diseases is increasing alarmingly among young patients. Meanwhile, the phenomenon of young people "sleeping during the day and working at night"; children hugging smartphones and computers all day long with little exercise... is gradually becoming more common. What can you advise people about this worrying issue?
Doctor Le Tuan Anh:Due to the development of science and technology, nowadays we see many young people "sleeping during the day and working at night", causing disruptions in daily life; along with that is the unreasonable eating habits with the increase of fast food restaurants, sweet and fatty foods, carbonated and alcoholic drinks... The rate of obesity and myopia among young people is also ringing alarming bells. This explains the sharp increase and rejuvenation of non-communicable diseases.
Equally dangerous is the trend of increasing and younger children using e-cigarettes and heated tobacco products. Cigarettes, e-cigarettes, and new addictive substances have gradually penetrated the school environment at all levels from middle school to high school. The rate of e-cigarette use among students in the 13-17 age group increased from 2.6% in 2019 to 8.1% in 2023. In the 13-15 age group, the rate has more than doubled from 3.5% in 2022 to 8% in 2023.
The above risk factors will lead to a series of non-communicable diseases in children from overweight, obesity, diabetes, blood pressure, depression and mental disorders, cardiovascular, metabolic disorders, eye diseases, musculoskeletal diseases... to diseases of impaired lung function due to obstruction, acute lung injury, respiratory disorders, chronic cough, chronic bronchitis; causing cardiovascular damage, increasing the risk of arteriosclerosis, thrombosis, atherosclerosis, myocardial infarction, coronary artery disease, hypertension and history of stroke; causing DNA damage, increasing the risk of cancer; causing oral diseases, digestive diseases.
To prevent and stop the development of non-communicable diseases, we clearly need to eliminate risk factors. That is, we need to quit smoking; increase physical activity, actively participate in sports; limit alcohol and have a reasonable diet... Regarding diet, we need to limit salt, limit processed foods, fried foods; sweet and carbonated drinks; increase green vegetables, fresh fruits... A healthy diet will help protect health, limit the risk of non-communicable diseases.
Preventing non-communicable diseases in children requires creating healthy playgrounds, attracting children to participate, focusing on nutrition and appropriate food portions for children. Families need solutions to adjust children's lifestyle, behavior and activities; especially having good coordination to prevent the rate of children using electronic cigarettes and heated tobacco products.
PVThank you!
