NCD COUNTRY PROFILE: KEY CONCEPTS AND QUESTIONS
A
INSTITUTIONAL CAPACITY AND RESPONSE TO NCD
B
HEALTH REPORTING/INFORMATION SYSTEMS, SURVEYS AND SURVEILLANCE
C
COMMUNITY AWARENESS AND NGO INVOLVEMENT
D
HEALTH SERVICES FOR NCD
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
A
May 2008
Institutional Capacity and Response to NCD
Institutional Capacity
1. Is there a focal person(s) in the national Ministry of Health with responsibility for an overall
NCD policy?
- Does the position have responsibility to develop policies to address NCD?
- Is the position dedicated 100% to NCD?
Why ask the
questions
- resources within
the MOH for NCD
Comments
2. Is there a unit or department in the Ministry of Health with responsibility for the national NCD
policy?
- Does the unit or department have responsibility to develop policy to address NCD?
- Is the unit or department dedicated 100% to NCD?
- Supply an organogram (organizational chart) or web link that shows the location of the
unit within the Ministry of Health structure.
3. Is there a dedicated budget at the national level for:
- health promotion
- NCD prevention
4. Does the national government fund research on NCD?
- research on NCD
5. Is there a national institute for general public health?
- Does it have responsibility for NCD?
- Does it have a dedicated budget for
o health promotion
o NCD prevention
- Does it have responsibility to develop policy to address NCD?
- resources outside
the MOH for NCD
6. Is there a national institute dedicated to NCD?
- Does it have responsibility to develop policy to address NCD?
2
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
Response to NCD
Questions
Legislation and Regulations
Checklist below
1. Check the act, law, legislation, regulation or ministerial
decree that exists
2. For each act, law, legislation, regulation, ministerial decree
above, is it enforced?
May 2008
Why ask the
questions
- existence of
legislation and
regulations
Comments
- enforcement of
instruments
3. If yes, does enforcement have a dedicated budget?
4. If yes, where does enforcement responsibility reside?
3
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
May 2008
LEGISLATION & REGULATION CHECKLIST
Policy
environments
Physical
For tobacco control
For healthy eating
For physical activity
For alcohol control
100% smoke free enclosed
environments1 in:
 Health facilities
 Educational Facilities
 Governmental buildings
 Workplaces (excluding restaurant,
bars, casinos, discothecs)
 Workplaces (including restaurants,
bars, casinos, discothecs)
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Restrictions on retail
availability (specify):
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Hours and days of sale
Where can be sold
Density of outlets
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Access to healthy ready-to-eat
foods
Limited fat, salt and sugar
content of processed foods
Nutritious food and beverage
availability in schools
Elimination of trans fats in the
market
Economic
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1
Smoking is forbidden in all enclosed
areas and there are no-smoking
designated areas inside buildings.
 Increased taxes and final price of
tobacco products
 Reduced out-of-pocket costs of
cessation programmes
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Improving relative food pricing
Incentives for production,
processing and trade in fruits
and vegetables
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Communications
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Complete ban of advertisement,
promotion and sponsorship of
tobacco products.
Strong restrictions on
advertisement and promotion of
tobacco products and events
sponsorship by the tobacco
industry.
Strong warning labels on tobacco
product packages (matching FTCT
requirement)
Media campaigns targeted at high
risk populations
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Consumer-friendly food
product / nutrition information
Restricted advertising of food
to children
Sustained healthy food
promotion campaigns
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Creation of recreation facilities
and access to them
Urban planning/ zoning favoring
compact and diverse
communities that promote
physical activity
Obligatory school based physical
education programs
Roadway design that promotes
cycling, walking
(Expanded) Class A rapid public
transit alternatives
Street safety and crime control
Funding for mixed use projects
(shops walking distance to
residences)
Subsidized public transportation
Commuter parking cash-outs
Zoning that encourages more
area on streets for pedestrians
Gasoline taxes cover
externalities
Point of decision prompts e.g.
encourage use of stairways
Community-wide campaigns
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Increased taxes and final price
of alcoholic beverages
Reduced out-of-pocket costs of
screening and brief
interventions and for treatment
of alcohol use disorders
Complete ban of
advertisement, promotion and
sponsorship of alcoholic
drinks.
Strong restrictions on
advertisement and promotion
of alcohol and events
sponsorship by the alcohol
industry.
Strong warning labels on
alcoholic drink packages
Media campaigns targeted at
high risk populations
4
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
May 2008
Response to NCD
Questions
Policies, Strategies, Action
Plans and Programmes
□ integrated chronic disease
prevention
□ tobacco and alcohol
□ diet/nutrition and physical
activity
□ other specify
1. Is there policy that integrates the main areas of NCD
prevention?
- If so, which areas, diseases, risk factors?
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2. Which individual policies, strategies, action plans or
programmes exist?
- For each that exists, in what year was it declared?
Give the title and a website where available.
- existence of
individual
policies,
strategies, action
plans or
programmes
3. At what level is each of the policies, strategies, action plans
and programmes directed?
- national
- region/state/autonomous area
- city
- municipality
- urban areas only
- rural areas only
- coverage of
policies,
strategies, action
plans or
programmes
Tobacco control
Food safety/sanitation
Nutrition/diet/healthy eating
General physical activity
Sports/recreation/leisure
Alcohol control
Overweight and obesity
Diabetes
Hypertension
Hyperlipidemia
Heart disease
Stroke
Cancer
COPD
Other, specify
Why ask the
questions
- existence of
integrated NCD
policies
Comments
- For each policy that exists, in what year was it
declared? Give the title and a website where available.
2
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
Response to NCD
Questions
4. If tobacco control is operational at the national level
- Has the FCTC been signed by the government?
- Is there a National Programme for Tobacco Control?
o If so, does the Programme have an action plan?
 If so, is the action plan funded?
May 2008
Why ask the
questions
- FCTC
5. Has the country implemented the Global Strategy on Diet
and Physical Activity (DPAS)?
- If yes, what is the title of the national strategy and
provide the web link
o Is there a national action plan for the strategy?
 If so, is the action plan funded?
- If no, are there plans for implementation of DPAS?
- DPAS
6. What are the constraints hindering the development of
policies, strategies, action plans or programmes where they do
not exist?
- Insufficient funds
- Shortage of personnel
- Excessive workload of staff
- Insufficient scientific information
- Low priority assigned by Ministry of Health
- Other _______________________
- why policies,
strategies, action
plans or
programmes do
not exist
7. For each policy, strategy, action plan or programme that
exists, what government departments and organizations were
involved in development?
- Health
- Finance
- Education
- Agriculture
- Transportation
- Sports/leisure
- Environment
- Other government departments (specify)
- profile of
consultations in
the policy
development
process
Comments
3
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
Response to NCD
Questions
-
May 2008
Why ask the
questions
Comments
Sub-national governments (eg states, regions, cities,
municipalities)
WHO
National NGOs
Citizens/community representatives
Associations of specific population groups and
organizations (eg sports organizations, seniors groups)
Consumer organizations
Medical/health professional associations/societies
Disease-specific associations/societies (eg cancer,
diabetes)
International NGOs
Academic institutions
Public health institute
Private sector organizations
Other (specify)
8. What was the duration of their participation?
- Throughout policy development
- Only at the initiation of policy development
- Only when the policy was already developed
9. Who officially endorsed each policy, strategy, action plan or
programme once developed?
- governor
- president
- secretary of health
- budget allocation authority
- other high ranking person or office, specify
10. For each of the policies, strategies, action plans and
programmes, what is the target population?
- general population
- children 15 years and under
- young people and adolescence, 15-24 years
- extent of
consultation in
the policy
development
process
- level of
authority
endorsing the
policy, strategy,
action plan or
programme
- target
populations
4
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
Response to NCD
Questions
-
May 2008
Why ask the
questions
Comments
pregnant mothers
young adults, 25-34 years
middle age, 35-64 years
older age, 65 years and over
marginalized, vulnerable populations, specify
other, specify
11. For each of the policies, strategies, action plans and
- settings
programmes, what is the specific setting where implementation
is directed?
- communities
- health care centres
- work places
- schools
- cities
- other, specify
12. For each of the policies, strategies, action plans and
programmes, are there quantitative targets/goals as expected
outcomes?
- If so, specify them including dates by which targets are
to be met
- If no, what are the constraints hindering the setting of
targets/goals?
o Insufficient scientific information on which to
base targets
o Low priority assigned by Ministry of Health
o Reluctance by Ministry of Health to set targets
o Other, specify
- existence of
quantitative
targets as
expected
outcomes
13. For each of the policies, strategies, action plans and
programmes, what government departments and organizations
were involved in setting quantitative targets/goals?
- Health
- Finance
- extent of
consultation on
quantitative
targets
5
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
Response to NCD
Questions
-
May 2008
Why ask the
questions
Comments
Education
Agriculture
Transportation
Sports/leisure
Environment
Other government departments (specify)
Sub-national governments (eg states, regions, cities,
municipalities)
WHO
National NGOs
Citizens/community representatives
Associations of specific population groups and
organizations (eg sports organizations, seniors groups)
Consumer organizations
Medical/health professional associations/societies
Disease-specific associations/societies (eg cancer,
diabetes)
International NGOs
Academic institutions
Public health institute
Private sector organizations
Other, specify
14. What government departments and organizations are
responsible for implementation?
- Health
- Finance
- Education
- Agriculture
- Transportation
- Sports/leisure
- Environment
- Other government departments (specify)
- Sub-national governments (eg states, regions, cities,
municipalities)
- implementation
responsibility
6
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
Response to NCD
Questions
-
May 2008
Why ask the
questions
Comments
WHO
National NGOs
Citizens/community representatives
Associations of specific population groups and
organizations (eg sports organizations, seniors groups)
Consumer organizations
Medical/health professional associations/societies
Disease-specific associations/societies (eg cancer,
diabetes)
International NGOs
Academic institutions
Public health institute
Private sector organizations
Other, specify
15. What is the timeframe for implementation for each policy,
strategy, action plan and programme?
- Within 1 year
- Within 2 years
- Within 5 years
- implementation
timeframe
16. Is there a mechanism(s) to connect/coordinate/integrate the
implementation of various NCD-related policies, strategies,
action plans and programmes within the Ministry of Health?
- If yes, describe the integrating mechanism(s) e.g. task force,
joint committee, etc.
- mechanisms to
coordinate and
integrate
implementation
within MOH
17. Is there a mechanism(s) to connect/coordinate/integrate the
implementation of various NCD-related policies, strategies,
action plans and programmes between the department of health
and other departments and organizations involved in
implementation?
- If yes, describe the integrating mechanism(s)
- inter-departmental task force
- whole-of-government committee
- mechanisms to
coordinate and
integrate
implementation
between MOH
and other sectors
7
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
Response to NCD
Questions
May 2008
Why ask the
questions
Comments
- other, specify
18. Within the department of health, for each NCD policy,
- existence of
strategy, action plan and programme, are there staff dedicated
resources for
to implementation?
implementation
- If yes, what proportion of their time is dedicated to the
NCD policy, strategy, action plan or programme?
Specify ____
- If yes, what is the amount of the budget for
implementation for each policy, strategy, action plan
and programme?
o total if for multiple years______
o annual allocation _____
- What proportion of the budget for each policy, strategy,
action plan and programme has been expended to date?
Specify ____
19. Is there a pilot phase to the policy, strategy, action plan and - evidence of
programme implementation?
implementation
- If yes, indicate the number of pilots___________
- Implementation of pilots occurs at which level
o National (across the country)
o Regional
 some regions
 all regions
o City/municipality
 some municipalities
 all municipalities
 some cities
 all cities
o rural areas only
o urban areas only
20. For each policy, strategy, action plan and programme, what - financing
are the sources of financing for implementation:
sources for
8
DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.
Response to NCD
Questions
-
annual central government allocation
annual regional/state government allocation
annual city/municipality government allocation
tax revenues from sale of tobacco products
tax revenues from sale of alcohol
tax revenues from sale of unhealthy foods
international aid
fund raising
private sector
other, specify
21. Is there routine monitoring relative to quantitative
targets/goals?
May 2008
Why ask the
questions
implementation
Comments
- monitoring and
evaluation against
targets
Have policies, strategies, action plans or programmes been
evaluated:
- process evaluation
- outcomes evaluation against targets/goals
o If so, give the title of the evaluation report(s)
and web site if available.
9