|
 |
WHO report on Global Forum on NCD Prevention and Control, Rotating International Visitors' Programme 2003
| |
|
|
|
WHO report
Global Forum on NCD Prevention and Control Rotating International Visitors
Program 2003
5-9 October 2003 Isfahan, Islamic Republic of Iran
|
 |
Contents
1. Background
2. Rotating International Visitors Program
3. Contents of the Program
3.1 Theoretical Components
3.2 Field Visit Component.
4. Comments
5. Recommendations
6. Acknowledgements
7. Appendices
A The program of the Rotating International Visitors Program 2003
B List of participants
C The
introduction of IHHP |
| |
Promotion and Dr. Oussama Khatib, Regional Advisor NCD/WHO/EMRO addressed the
meeting on the purpose of the Global Forum and the WHO/Regional Network and on
worldwide and national NCD trends and on the importance of RIVP. Professor N.
Sarraf - Zadegan, Director ICRC, -outlined the history and activities oflCRC and
introduced the program
 |
| |
3.1 Theoretical Component
The first two days provided an opportunity to discuss experiences worldwide,
regionally and locally.
The international speakers addressed pertinent topics which included: the
development of the Global Forum and Regional Networks; the Intervention
experience of NCD/CVD Prevention and Health Promotion; Building up local and
national frameworks for NCD control and methods of monitoring, surveillance and
evaluation. prevention in the health services.
 |
| |
The specific experience of North
Karelia project was discussed as well as specific topics such as control
ofhypertension, tobacco and diet related problems and those activities as
well as integration of NCD.
The national speakers outlined the size of the problem, policies and
legislations both in action or planned with a view to enhance prevention and
control of NCD in Iran.
 |
The local speakers from ICRC, described the llIHP and the specific ongoing
intervention activities in the three targeted areas of smoking, diet and
physical inactivity. They also discussed the specific intervention programs
targeting special groups' children, worksite employees and women.

|
The participants from Oman, Bahrain, Jordan, Bangladesh, Fiji, China and Saudi
Arabia gave an
overview of the size of the problem and the status of NCD control and prevention
programs in their countries. They addressed the barriers facing them and their
future plans towards NCD prevention and control.
A panel discussion was held on the first day where the international speakers
responded to questions from the participants. The theme of the discussion was
community-based interventions, their rationale, structure, feasibility and
importance as the most effective strategy for NCD prevention and control taking
into consideration the specific needs and prevailing conditions in each country.

3.2 Field Visit Components: {Tues.-wed 7th-8th)
The 13 international participants from 10 countries: Bahrain, Bangladesh,
Belgium, China, Fiji, Finland, Jordan, Kuwait, Oman, Saudi Arabia, as well as
WHO temporary advisors, Dr. Mustafa Khogali, K.Srinath Reddy, and Erkki
Vartiadnen and WHO secretariat R. Shao; were taken on well structured field
visits covering the intervention projects. The visit were comprised of the
following:
3.2.1 Worksite Intervention Project:
Participants visited Isfahan Electricity
Company. The intervention was developed on the already existing occupational
health service and had an impact on periodical medical examination; improvement
of environment; education of employees and introduction of healthy food menu in
the company canteen. Also a big factory (Pishro Yadak) for producing mini-bus
body was visited and the ways of intervention like daily exercise sessions,
serving healthy food, removing salt
shakers from tables and strict tobacco control rules were introduced.
|

|
3.2.2 Heart Health Promotion from Childhood The visit covered a primary school
and private kindergarten. In the kindergarten children are educated about
healthy habits through drawings and puzzles, exhibitions etc. In both schools,
children presented songs, which effectively communicated health messages. The
Healthy Heart Buffets with healthy snacks were introduced also. Schoolchildren
IHHP role models took care for the visit. Both governmental and private
schools and kindergartens are included in the initiative.

3.2.3 Healthy food for Healthy Community
Two bakeries were visited, Khageh
Bakery (traditional bread) and Daneshjou Bakery (for Fantasy bread). They
produce different types of healthy bread and other bakery products at reasonable
cost. Also participants visited a 4star hotel (Kosar Hotel) which embraced the
healthy food Program. The healthy breaks, which were produced by cooperating
healthy food industries &
shops, lunches and dinner offered during the programme, were also part of this
activity. |

3.2.4 Isfahan Exercise Project
The visit to Exhibition Street was illuminating. One day a month the street is
closed for 4-6 hours for traffic Different kiosks and stands offer free BP
cheek, weight measurement and different healthy snacks health messages (in
posters, pamphlets etc) are communicated by NGO volunteers and people
participate in group exercise activities.
 |
| |
3.2.5 Women's Healthy Heart Project
At health Centers No. 1 and 2 where
different activities of the Women Healthy Heart Project are carried, were
visited on the second day. The activities include NCD risk factors and its
prevention, premarital counseling and family planning. |
| |
3.2.6 Healthy Lifestyle for Cardiac Patients
Participants visited two sites: the park where cardiac patients and their
families organize on the last Friday of every month exercise followed by healthy
breakfast and social gathering. The second site was the cardiac centre where a
secondary and tertiary prevention program is ongoing. All patients start
rehabilitation the day they are admitted. On discharge, they and their spouses
are given face to face education, and provided with a folder containing
instructions to follow at home. Already Insurance companies have started
covering the cost of preventive services and education offered by physicians in
these hospitals. |
 |
3.2.7 NGO and volunteers participation
Women volunteers after training provide
NCD preventive and health promotive education to the community in different
settings including homes, social gatherings, Mosques etc. The participants met
with a number of the volunteers.
3.2.8 Second site of the intervention
A visit was paid to Najaf-Abad -the second
site of the intervention 37 kilometres away from Isfahan. A rural health centre
and health house where the health professional project introduced their
activities was visited.
3.2.9 Young Healthy Heart Yacht
The intervention activities targeting the young group 19-25 years in the
community was introduced in the Red Crescent Society with the presence of the
project authorities. |
| |
1. Background
Non-communicable diseases (NCD) are the leading cause of mortality and
disability worldwide. In 2002 NCDs accounted for about 60% of all deaths and 43%
of the global burden of disease. Low and middle- income countries suffered 79%
of the deaths due to NCDS and 85% of the burden of disease. One of the main
objectives of the Global Forum on NCD Prevention and Control (GFNCDPC) is to:
"Contribute to training and capacity building and develop guidance packages for
NCD prevention and control particularly in low and middle-income countries.
2. Rotating International Visitors Program (RIVP)
To fulfil the above- mentioned objective the RIVP , was initiated. Its aim is to
present theory and practice of integrated NCD prevention programs for
participants who are or will be involved in the planning, implementation, and/or
evaluation of local or national projects in the field ofNCD prevention and
control, and in health promotion.
The RIVP should be conducted in settings that have established ongoing model
projects of comprehensive, integrated, community-based NCD prevention
activities. Participants are exposed to principles, practical implementation of
different intervention and evaluation process.
This first RIVP was hosted by Isfahan Healthy Heart Program (IHHP), which was
launched in late 1999.Isfahan city and Najaf-Abad, covering rural and urban
areas, were defmed as intervention areas with a population of 1,900,000. Arak
province was identified as the reference area with a population of 420,000 of
similar age and sex distribution as the intervention area. The population sample
surveyed in the 1 st phase was 12600 aged 319 years, of whom 6300 are in the
intervention areas and 6300 in the reference area. Also 2000 schoolchildren aged
6-18 years, 2000 health professionals and 2000 high risk and patients were
studied in both intervention and reference areas. |
During the period since its inception the IHHP has attained a well-structured
status with different activities suitable for training. It is now in the second
(intervention) phase which will last for 4-5 years and is conducted on the whole
population in Isfahan and Najaf-Abad. While Activities comprise 9 intervention
projects:
(1) Worksite Intervention Project
(2) Heart Health Promotion from Childhood (3) Healthy Food for Healthy Community
(4) Isfahan Exercise Project
(5) Health Professional Project
(6) Women Healthy Heart Project (7) Young Healthy Heart Yacht
(8) Healthy Lifestyle for Cardiac Patients
(9) NGOs and Volunteers Participation in IHHP
The APPX C shows the whole design and , methodology, the objectives and
intervention strategies
of the 9 intervention projects. In the last phase the whole studies of the Ist
phase will be repeated on an independent random samples in intervention and
reference areas.
3. Contents of The Program
The program had two main components, theoretical based on presentations and
discussions (Sunday 5th - Monday 6th) and field visits (Tuesday -Thursday 6-
9th)
The Director Bureau of Scientific & International Affairs (ruMS), Dr. A.Z. Zadeh
welcomed the meeting in Isfahan Cardiovascular Research Centre (ICRC) Isfahan
University of Medical Sciences (IUMS). Professor M. Pour Moghaddas was elected
chairman of the meeting and Professor Mustafa Khogali, Deputy Chairman and
Rapporteur.
During the opening session Prof. A. Rezaie, President ruMS, Dr. H. Gezairy,
Regional Director WHO/EMRO and Dr. M. Pezeshkian, Minister of Health and Medical
Education, welcomed participants and emphasized the importance of RIVP to WHO
strategies and they commended the GF NCD -PC for its activities. Dr. Pekka Puska
Director NCD Prevention and Health |
4. Comments
The participants and the temporary advisors were highly impressed
with the commitment and dedication of the managers of the different 9
intervention programs. They have intimate and objective relationship with the
community, leaders and members of the teams of the different programs. They have
to be strongly commended for their work and respect of the responsibilities they
are undertaking. |
5. Recommendations
The training program was well organized and addressed many
issues. For future programs it is advisable.
5.1 To limit the number of papers and presentations and to combine the visits
with the seminars and presentations i.e. each morning there should be a visit to
two intervention programs followed by the presentations and discussions in the
afternoon so to allow enough time for interaction between participants and
managers.
5.2 To limit the theoretical session to major four areas addressing concepts and
comparative experiences.
5.3 To give up a greater role for the temporary advisors to moderate and lead
the discussions towards identifying the barriers and the different approaches to
overcome them.
5.4 International participants should be identified at least six months before
the training program so that they can prepare their presentations on the bases
of a structured framework-which will guarantee a more effective and interactive
training sessions.
5.5 At the end of the visits, participants should work together in groups of two
to try and apply the interventions they have seen, to their situation, identify
barriers and difficulties and suggest methods of overcoming the barriers. These
exercises will then be presented to the group for discussion.
5.6 Although we are advocating teamwork, nearly all the participants were
physicians- it is strongly recommended that other members of the team should
attend the training program. |
Acknowledgments
Our great thanks to the organizing committee for such a great effort and for its
hospitality and especially for Prof. Nizal-SarrafZadegan. Great appreciation to
the managers of the different intervention projects, they have been super in
their dedication and knowledge of the project. They were greatly accommodating
and made every effort to answer all questions.
Our thanks to professor A. Rezaie the President IUMS, Dr. A. Zargar Zadeh
Director of Scientific and International Affairs IUMS, and to the Governor
General Isfahan Mr. M. Hussieni for his hospitality and support.
Also our thanks to the executive and research managers and all other members
of ICRC, the unknown soldiers, whose efforts made this training program
successful and special appreciation to Dr. Roya Kelishadi and her colleagues,
who quietly and efficiently orchestrated the different efforts prior and during
the training, workshop and field visiting.
Our thanks to the Directorate ofNCD prevention and Health promotion from WHO/HQ
and WHO/EMRO.
|
7. Appendices
A The programme of the Rotating
International Visitors Programme 2003
B List of participants
C The introduction of IHHP
|
| |
Global Forum on NCD Prevention and Control Rotating International Visitors'
Programme 2003
Programme Outline
Venue: Isfahan Cardiovascular Research Centre Isfahan University of Medical
Sciences Isfahan, Islamic Republic of Iran
Sunday, 5th October 2003
Opening Ceremony:
08:15.09:30 Welcome and Introduction :
08:15-08:25 Holy Quran Recitation National Anthem
08:25-08:30 Welcome and Introduction
(Dr. A. Zargar Zadeh), Director Bureau of Scientific &
International Affairs, Isfahan University of Medical Sciences 08:30-08:45
Introduction of the Programme
(Prof N. Sarraf-Zadegan), Director of Isfahan Cardiovascular Research Center
08:45-08:55 Welcome Speech
(Prof A.Rezaie),President, Isfahan University of Medical Sciences 08:55-09:15
Addressing the forum
(Dr. H. Gezayeri), Regional Director, WHO/EMRO 09:15-09:30 Inaugurating the
forum(Dr.M.Pezeshkian),
The Minister of Health, Treatment and Medical Education, Islamic Republic of
Iran . 09:30-10:00 WHO Global Strategy on NCD Prevention
(Dr. P. Puska), Director Non-Communicable
Disease Prevention and Health Promotion, WHO/HQ 10:00-1 0:30 WHO Regional
Networks on NCD Prevention
(Dr. 0. Khatib), Regional Adviser Non-Communicable Diseases, WHO/EMRO
10:30.11 :00 Break
11 :00-11 :30 Global forum and regional networks for integrated NCD Prevention
and control
(Dr. R. Shao), MedicalOfficer, National and Community Programmes,
Non-communicable Disease Prevention and Health Promotion, WHO/HQ
11 :30-12:00 International experiences in CVD/NCD Prevention and Health
Promotion
(Prof S. Reddy), Professor of Cardiology, Coordinator, Initiative for
Cardiovascular Health in the Developing Countries
12:00-12:30 General Evaluation and Monitoring Principles and NCD Prevention (Dr.
P. Puska),Director, Non- Communicable Disease Prevention and Health Promotion,
WHO/HQ
12:30-13:00 Risk Factors; Surveillance, Trends, Predictions
(Prof E. Vartiainen), Director, Department of Epidemiology and Health Promotion,
National Public Health Institute, Finland
13:00-14:00 Lunch
14:00-14:30 Elements of practical demonstration programme in NCD Prevention and
Health Promotion (~ Reddy), Professor of Cardiology, Coordinator, Initiative for
Cardiovascular Health in the Developing COUntries
14:30-15:00 General description of Isfahan Healthy Heart Programme(IHHP)
(Prof N. Sarraf-Zadegan), Professor of Cardiology and Internal Medicine,
Director of Isfahan Cardiovascular Research Center
15:00-15:30 Break
15:30-17:00 Short presentations by the visitors
17:00 Closure of 1 St day
Monday, 6th October 2003
8: 15-8:30 Policies and legislations (Prof M. E. Akbari) Deputy of Health,
Ministry of Health in Iran
8:30-9:00 Tobacco Control activities in NCD Prevention (Dr. P. Puska), WHO/HQ
9:00-9:30 Diet-related activities in NCD prevention (Prof S. Reddy), Professor
of Cardiology, Coordinator, Initiative for Cardiovascular Health in the
Developing Countries
9:30-9:45 The role of NGOs in interventions for disease prevention and health
promotion
(Dr. M. Gooya), Chairman, Center of Disease Control, Ministry of Health in Iran
,
(Dr. A. Delavari), Manager, Non-Communicable Diseases, Ministry of Health in
Iran 9:45-1 0:00 Stress management in practice (Dr. H. Rooh Afza), Assistant
Prof of
Psychiatry, Head of Mental Health Unit, Isfahan Cardiovascular Research Center,
Manager of Young Healthy Heart Yatch (YHHY) Project, IHHP
10:00.10:30 Break
10:30-11 :00 Community control of hypertension (Prof S. Reddy), Professor of
Cardiology, Coordinator, Initiative for Cardiovascular Health in the Developing
Countries
11 :00-11 :30 Diabetes related activities and results (Dr. S. Yarahmady), Expert
of Cardiovascular Diseases Center of Disease Control- Ministry of Health in Iran
11 :30-11 :45 Health Promotion in childhood(Dr.R. Kelishadi), Assistant
Professor of Pediatrics, Head of Preventive Pediatric Cardiology Department,
Isfahan Cardiovascular Research Center, Manager of Heart Health Promotion from
Childhood (HHPC) Project, IHHP
11 :45-12:00 How to integrate NCD prevention in health services(Prof A.
Nissinen), Department of Epidemiology and Health Promotion, National Public
Health Institute, Finland
12:00-12: 15 Youth interventions for NCD prevention (Prof E. Vartiainen),
Director, Department of Epidemiology and Health Promotion, National Public
Health Institute, Finland
12: 15-12:30 Healthy lifestyle for patients (Prof M. PourMoghaddas), Professor
of Cardiology, Director of Chamran Hospital, Isfahan University of Medical
Sciences
12:30.13:30 Lunch
13.30-14:00 Feasibility of disease prevention and health promotion in countries
with economic constraints (Dr 0. Khatib), WHO/EMRO
14:00-14:30 Building up a local/national framework for NCD control (Prof M.
Khogali), American University of Beirut
14:30-15:00 Evaluation &Monitoring of Isfahan Healthy Heart Pogramme (Dr. A.
Baghaei) , Head of Evaluation Committee, IHHP
15:00.15:30 Break
15:30-17:00 Experiences with various interventional methods:
15:30-15:45 Promotion of exercise and physical activity (Dr. A. Khosravi),
Assistant Professor of Cardiology, Executive Manager Isfahan Cardiovascular Research Center
15:45-16:00 The role of volunteers, role models and intersectoral cooperation
(Dr. Gh. Sadri), Vice Chancellor of Health and Head of Provincial Health Office,
Isfahan University of Medical Sciences
16:00-16:10 Use of mass media (Dr.K.Rabiei), Head of Rehabilitation Department,
Isfahan Cardiovascular Research Center, Manager of Isfahan Exercise
Project(IEP), IHHP
16: 10-16:25 Food industry collaboration (Mrs. N. Mohammadi-Fard), Head of
Nutrition Unit, Isfahan Cardiovascular Research Center
16:25-16:35 Quit and Win competitions (Dr. R. Moilabashi), Head of Tobacco
Control Unit, Isfahan Cardiovascular Research Center
16:35-16:45 Women's Healthy Heart Project-lsfahan experience (Dr. M. Sadeghi),
Assistant Professor of Cardiology, Head of CVD in Women Unit, Isfahan
Cardiovascular Research Center, Manager of Women Healthy Heart Project (WHHP),
IHHP
16:45-17:00 Worksite intervention programme-lsfahan experience (Mrs. M.
Boshtam),
Manager of Worksite Intervention Project (WIP), Isfahan Healthy Heart Programme
17:00 Closure of 2nd day
19:00 The General Governor Esfahan Province Message. The 3'rd & 4'th Day
Field Visit: 08:00-17:00 Tuesday-Wednesday, 7th-8th October 2003
Field visits to Isfahan Healthy Heart Programme activities:
Schools, Kindergartens and Universities .Factories & Companies
.Urban/Rural health centers .Rehabilitation centers
.Restaurants, pizza shops, bakeries etc .Supermarkets
.Food Industries
.Healthy Heart Exhibition
.Healthy Heart related NGOs
The 5th Day
Thursday, 9th October 2003
08:00-11 :00 Visit to Isfahan Cardiovascular Research Center
11 :00-13:00 Closure of the Programme
|
| |
GLOBAL FORUM ON NCD PREVENTION AND CONTROL
ROTATING INTERNATIONAL VISITORS' PROGRAMME 2003 ISFAHAN, I. R. IRAN, 5-9
October, 2003
List of Participants
|
International Participants
Dr Jamal AI Sayyad
Chief of the Chronic Diseases Control Programme And Coordinator of the Cancer
Registry Public Health Directorate Ministry of Health P.O.Box: 12
Tel: 00973-279224, 9690770 Fax: 00973-279292,422047
e-mail: sayyadjj@batelco.com.bh Manama Bahrain
Dr. Meerjady Sabrina Flora
Associate Professor of Epidemiology
National Institute of Preventive and Social Medicine (NIPSOM)
Tel: 0088028829337 Fax: 8821326
e-mail: flora@eitechco.net Mohakhali, Dhaka 1212 Bangladesh
Prof. Hugo Kesteloot
Department of Epidemiology School of Public Health
University zeikenhuizen Saint-Rafael Kapucijnenvoer 33 B-3000 Leuven Belgium
Dr. Liping Zhu Director
NCD prevention and control CDC of Jiangxi Province
Tel: (+86791) 8319809(0), 8507173(H) Fax: (+86791) 8319858 Nanchang, China
e-mail: ZLP210@yahoo.com.cn, jxmbk@163.com
Dr. Salanieta Saketa National Epidemiologist Ministry of Health Fiji
e-mail: ssaketa@health.gov.fj
Prof. Aulikki Nissinen, M.D., Ph.D. Research Professor
Department of Epidemiology and Health Promotion National Public Health Institute
Mannerheimintie 166
Tel: 0358947448336 Fax: +358947448338
e-mail: aulikki,nisinen@ktl.fi FIN-00300 Helsinki Finland
Dr. Meyasser Zindah
Manager of National Non Communicable Diseases Programme
Head of NCD Division
Control Disease Directorate/MOH Ministry of Health
e-mail: meyasserz@yahoo.com Mobile: 00962-79-5646658 Amman, Jordan
Dr. Yousef AI Nesef
Assistant Undersecretary for Medical Supportive Services
Ministry of Health
Tel: 00965-4863722 Fax: 00965-4862535
e-mail: drnesef@hotmail.com Kuwait
Mr. Saleh AI-Hadabi
Director General of Health Services/ WHO Muscat, Oman
Mrs. Raha AI-Salmi
Project Nurse Covered by the Nizwa Project Oman
Miss. Rabha AI-Sulaimani Nutritionist, NCD Section,
Ministry of Health, Sultanate of Oman, Tel: 00968-696187
e-mail: raI2000@hotmail.com
Dr Nabil Hazza'a AI Kahtani
Director General for Non-Communicable Diseases Ministry of Health Tel: 014057494
Fax: 014028941
e-mail: nhkahtani@moh.gov.sa Riyadh
Saudi Arabia
Dr. Abeer AI-Saweer
Focal Person for CVD in Kingdom of Bahrain Tel: 973-9633188 Fax: 973-793579
e-mail: salman24@batelco.com.bh
WHO Temporary Advisers
Prof. K. Srinath Reddy Professor of Cardiology Coordinator
Initiative for Cardiovascular Health in the Developing Countries T -7 , Green
Park Extn .
Tel: 91-11-26167459,26101980 Fax: 91-11-26167397
e-mail: ksreddy@ccdcindia.org New Delhi India
Prof. Erkki Vartiainen Director
Department of Epidemiology and Health Promotion National Public Health Institute
Tel: +358-9-47448622 Fax: + 358-9-47448338
e-mail: erkki.vartiainen@ktl.fi Mannerheimintie 166 00300 Helsinki Finland
Prof. Mustafa Khogali
American University of Beirut Beirut, Lebanon
Dept. Family medicine Faculty of Medicine P.O.Box: 113-6044
America University of Beirut Tel: 961-1-374-374 X5450/1 Fax: 961-1-744464
e-mail: khogali@aub.edu.lb
National Participants
Prof. M. Pezeshkian
Minister of Health, Treatment and Medical Education I.R. Iran
Prof. M. E. Akbari
Deputy minister for Health MOH & ME I.R.lran
Prof. A. Rezaie Chancellor
Isfahan University of Medical Sciences Isfahan, Iran
Dr. M M. Gouya
Director General, Center of Disease Control MOH & ME
Tel: (+9821) 8827265 Fax: (+9821) 8300444
e-mail: mgoya57@yahoo.com South Iranshahr Ave. No: 68
Center for disease control, TEH-lRAN I.R. Iran
Dr. A. Delavari
Deputy Director General for NCDs
MOH & ME
Tel: (+9821) 8827265 Fax: (+9821) 8300444
e-mail: delavariar@yahoo.com I.R.lran
Prof. M. Pour Moghaddas Professor of Cardiology
Chief, Cardiology Division Dep. of Internal Medicine
Isfahan University of Medical Sciences Mobile: 0911-318-758
Tel: (+98311)-2225134 Isfahan, Iran
Prof. N. Sarraf-Zadegan
Prof of Cardiology and Internal Medicine Director of Isfahan Cardiovascular
Research Center
Office Phone: ( +98 311) 4460787, 3359696, 3359797 and 3359090
Office Fax: ( +98 311) 4459023 P.O. Box: 81465-1148
Office e-mail: crc@mui.ac.ir
e-mail: sarafzadegan@med.mui.ac.ir Isfahan, Iran
Dr. Gh. Sadri
Vice Chancellor of Health, Director of Provincial Health Office
Isfahan University of Medical Sciences Tel: (+98311) 2644399 Fax: (+98311)
2643402 Isfahan, Iran
Dr. A. Salehi
Chancellor, Hamedan University of Medical Sciences
Tel: 09118114010
e-mail: chancellor@umsha.ac.ir Hamedan, Iran
Dr. A. Khosravi
Assistant Professor of Cardiology
Executive Manager, Isfahan Cardiovascular Research Center
Office Phone: ( +98 311) 4460787, 3359696 Office Fax: (+98311) 4459023 P.O. Box:
81465-1148
Office e-mail: crc@mui.ac.ir Mobile: 9133143710
Personal e-mail: dr_alireza108@yahoo.com Isfahan, Iran
Dr. R. Kelishadi
Assistant Professor of Pediatrics
Head of Prevention Pediatric Cardiology Department
Isfahan Cardiovascular Research Center
Local Secretary, Global Forum on NCD Prevention & Control
Isfahan, Iran
Office Phone: (+98311) 3377881 e-mail: kelishadi@med.mui.ac.ir
Dr. A Fayaz-Bakhsh
Head of Section for International Affairs
National Research Center of Medical Sciences Mobile: 09132277218
Fax: (+9821) 8730830
e-mail: aafayaz@yahoo.com Tehran, Iran
Dr. H. Talebi
Vice Chancellor of Medical Treatment, Arak University of Medical Sciences Tel:
3134817
e-mail: hoshang_talebi@yahoo.com Arak, Iran
Dr. S. Yarahmady
Expert of Diabetes and Endocrine Diseases, Center for Disease Control, NCD Dept.
MOH & ME
Tel: (+9821) 8250883, 8273185 Mobile: 09132083983
e-mail: yarahmad@hotmail.com Tehran, Iran
Dr. H. R. Tolouie
Deputy, Isfahan Provincial Health Office Tel: (+98311) 2644399 Fax: (+98311)
2643402
e-mail: h_tolouei@mui.ac.ir Isfahan, Iran
Dr. A. Mahdavi
Expert, Center of Disease Control, NCD Dept. MOH & ME
Mobile: 09112452231 Tel: 8822334 (0) : 8002426 (H)
e-mail: armahdavi@yahoo.com Tel fax: (+9821) 8002426 Fax: (+9821) 8300444 (0)
Tehran, Iran
Mr. A. Norouzi Nezhad
Expert, Center of Disease Control, NCD Dept. MOH & ME
Tel: (+9821) 8822334 (0) Fax: (+9821) 8300444 (0)
e-mail: sabzvar@hotmail.com Tehran, Iran -
Mrs. E. Hojatzadeh
Expert, Center of Disease Control, NCD Dept. MOH & ME
Tel: (+9821) 8822334 (0), (+9821) 7206162 (H) Fax: ( +98 21 ) 8300444
e-mail: alieghh@yahoo.com Tehran, Iran
Dr. A. Bahonar
Deputy, Isfahan Provincial Health Office Tel: (+98311) 2644399 Fax: (+98311)
2643402
e-mail: ab_bahonar@mui.ac.ir Isfahan, Iran
Dr. A. M. Baghaei Research Manager
Isfahan Cardiovascular Research Center Isfahan University of Medical Sciences
e-mail: baghaei@mui.ac.ir Tel: 0098-913-311-1176 Isfahan, Iran
Dr. Roohafza
Assistant Professor of Psychiatry Head of Mental Health Unit
Isfahan Cardiovascular Research Center Isfahan University of Medical Sciences
Tel: (+98311) 6615872
e-mail: dr_roohafza@yahoo.com Isfahan, Iran
Dr. Siamak Alikhani
Senior Heart Health Professional Center for Disease Management MOH & ME
Tel: 8822334 Fax: 8300444
e-mail: sialik@yahoo.com
WHO Secretariat:
Dr. Hussein A. Gezairy Regional Director
Regional Office for the Eastern Mediterranean Office
World Health Organization
Dr. Oussama Khatib Regional Adviser
Non-Communicable Diseases
Regional Office for the Eastern Mediterranean Office
World Health Organization
e-mail: khatibo@emro.who.int I ncd@emro.who.int website: www.emro.who.int/ncd/
Tel: 002022765364 Fax: 00202 2765415
Dr. Antonio Filipe Jr. Regional Adviser
Non-Communicable Disease Prevention and Control African Regional Office
World Health Organization Tel: +4724139344 Fax: +4724139514
e-mail: filipea@afro.who.int Brazaville, Congo
Dr. Pekka Puska
Director, Non-Communicable Disease Prevention and Health Promotion
World Health Organization, 20, Avenue Appia
CH-1211 Geneva 27 Switzerland
Dr. Ruitai Shao Medical Officer
National and Community Programmes Noncommunicable Disease Prevention and Health
Promotion
World Health Organization 20 Avenue Appia
CH-1211 Geneva 27 Switzerland Tel: + 41227913329 Fax: +41227914186 Email:
shaort@who.int
Dr. EL-Fatih EL Samani WHO Representative
World Health Organization Tehran, Iran
Dr. Ali R Mafi Medical Officer WHO
Tel: (+9821) 6700361
Fax: (+9821) 6708969
e-mail: mafia@ira.emro.who.int Tehran I Iran
Dr. Atarod Mojtabaie STP/NCD/EMRO
13928 ESWORN/RN TEL: 301 5279090 |
| |
Annex C:
Example of the project plan
Introduction to Isfahan Healthy Heart Programme
The Isfahan Healthy Heart Programme (IHHP) is a comprehensive integrated
community-based intervention programme for the prevention and control of
noncommunicable diseases. The programme began in late 1999 and will last until
2006. The intervention communities are Isfahan and Najafabad (rural and urban
areas) in the central part of Iran (1,900,000 population). Arak has been
selected as the reference community (about 700,000 population).
1 Goal and Objectives
1.1 Goal
To improve NCDs prevention and control and promote healthy lifestyles in the
Intervention Community .
1.2 Objectives
(1) Assessment and comparison of the prevalence of NCD risk factors in the
first
and final phases of the programme (intervention versus reference communities).
(2) Assessment and comparison of the prevalence of some NCDs (coronary artery
diseases, stroke, diabetes mellitus, and hypertension) in the first and final
phases of the programme (intervention versus reference communities).
(3) Assessment and comparison of the annual incidence of coronary arterial
diseases and stroke in the first and final phases of the programme (intervention
versus reference communities).
(4) Assessment and comparison of cardiovascular causes of mortality rate in
the first and final phases of the programme (intervention versus
reference communities).
(5) Assessment and comparison of morbidity from coronary arterial diseases and
stroke in the first and final phases of the programme (intervention versus
reference communities).
(6) Assessment and comparison of trends of the general population's BASK2 about
NCDs and their risk factors between intervention and reference communities.
(7) Assessment and comparison of trends of health professionals' BASK about NCDs
and their risk factors between intervention and reference communities.
(8) Assessment and comparison of trends of CVD patients' and high-risk
population' BASK about NCDs and their risk factors between intervention and
reference communities.
(9) Drawing up the CVD risk chart for Iranian society and related risk
assessment. 2
3 IHHP Phases
The Isfahan Healthy Heart Programme is designed in three phases:
2.1 Phase I- Situation analysis: Identification of the intervention and
reference populations
This first phase of the programme, which includes mainly community diagnosis,
evaluates the characteristics of the population (3) and the distribution of
variables selected as programme indicators in random samples of the two
intervention populations (Isfahan and Najafabad) and the control population
(Arak).
1 Dyslipidaemia, hypertension, smoking, diabetes mellitus, obesity, physical
inactivity. 2 BASK: Behavior, Attitude, Skill, Knowledge
3 General adult population, health professionals, CVD patients, high-risk group,
young population and children.
|
Annex C: Example of the project plan
Introduction to Isfahan Healthy Heart Programme
The Isfahan Healthy Heart Programme (IHHP) is a comprehensive integrated
community-based intervention programme for the prevention and control of
noncommunicable diseases. The programme began in late 1999 and will last until
2006. The intervention communities are Isfahan and Najafabad (rural and urban
areas) in the central part of Iran (1,900,000 population). Arak has been
selected as the reference community (about 700,000 population).
1 Goal and Objectives
1.1 Goal
To improve NCDs prevention and control and promote healthy lifestyles in the
Intervention Community .
1.2 Objectives
(1) Assessment and comparison of the prevalence of NCD risk factors in the
first
and final phases of the programme (intervention versus reference communities).
(2) Assessment and comparison of the prevalence of some NCDs (coronary artery
diseases, stroke, diabetes mellitus, and hypertension) in the first and final
phases of the programme (intervention versus reference communities).
(3) Assessment and comparison of the annual incidence of coronary arterial
diseases and stroke in the first and final phases of the programme (intervention
versus reference communities).
(4) Assessment and comparison of cardiovascular causes of mortality rate in the
first and final phases of the programme (intervention versus reference
communities).
(5) Assessment and comparison of morbidity from coronary arterial diseases and
stroke in the first and final phases of the programme (intervention versus
reference communities).
(6) Assessment and comparison of trends of the general population's BASK2 about
NCDs and their risk factors between intervention and reference communities.
(7) Assessment and comparison of trends of health professionals' BASK about NCDs
and their risk factors between intervention and reference communities.
(8) Assessment and comparison of trends of CVD patients' and high-risk
populations' BASK about NCDs and their risk factors between intervention and
reference communities.
(9) Drawing up the CVD risk chart for Iranian society and related risk
assessment. 2
3 IHHP Phases
The Isfahan Healthy Heart Programme is designed in three phases:
2.1 Phase I- Situation analysis: Identification of the intervention and
reference populations
This first phase of the programme, which includes mainly community diagnosis,
evaluates the characteristics of the population3 and the distribution of
variables selected as programme indicators in random samples of the two
intervention populations (Isfahan and Najafabad) and the control population
(Arak).
1 Dyslipidaemia, hypertension, smoking, diabetes mellitus, obesity, physical
inactivity. 2 BASK: Behaviour, Attitude, Skill, Knowledge
3 General adult population, health professionals, CVD patients, high-risk group,
young population and children.
2.2 Phase 11- Implementing population interventions and periodical evaluations
In this phase, the population strategies for interventions are designed and
performed within the framework of nine projects in the entire intervention
communities (Isfahan and Najaf-Abad). Evaluation at the formative and process
levels is performed simultaneously with continuous implementation of
interventions and within defined timeframes in intervention areas. Impact
evaluation is conducted annually in both intervention and reference communities.
2.3 Phase III -Final programme evaluation In this phase, based on the
above-mentioned objectives of the programme and as in Phase I, data and
indicators corresponding to the objectives are collected from independent random
samples from both intervention and reference communities. Data is analysed and
compared between the two societies. The overall efficiency and effectiveness of
the programme are shown in this phase. The risk chart of the population is also
drawn up. This phase of the programme is scheduled for the first half of2006.
Programme evaluation is done at four levels (formative, process, impact and
outcome). While outcome evaluation is done at the beginning and in the last
phase of IHHP on independent random samples in both communities, impact
evaluation on BASK about diseases and their risk factors is conducted annually
on independent samples from the two communities.
4 Main Strategies and Domains for Interventions
3.1 The four main areas of intervention are as follows: ( 1) Healthy nutrition
(2) Increased physical activity (3) Tobacco control activities
(4) Dealing with stress and tensions.
3.2 The intervention criteria are as follows:
( 1) Simplicity, feasibility and cost-effectiveness (2) Applicability to large
populations
(3) Exploiting available resources and facilities
(4) Possibility of integration into the health care system, and implementation
as part of the responsibilities of health professionals
(5) Sustainability of activities
(6) Possibility of being readily carried out at the national level (7)
Possibility of being evaluated.
3.3 Main Strategies
(I) Focusing on main NCD risk factors
(2) Focusing on all prevention levels (primordial, primary, secondary and
tertiary) for NCD prevention and control (3) Carrying out comprehensive
integrated interventions using population and high-risk approaches
(4) Introducing suitable models applicable to other parts of the country, and to
developing nations in general, for correcting unhealthy lifestyles.
5 IHHP Projects
4.1 Heart Health Promotion from Childhood
4.1.1 Target Population
Children and adolescents younger than 18 years, parents, school and kindergarten
administrators.
4.1.2 Objectives:
(1) Improving BASK about prevention and control ofNCD risk factors from an early
age
(2) Providing integrated facilities in the existing system in schools and
kindergartens to correct lifestyles (3) Contributing to development of healthy
lifestyles from an early age.
4.1.3 Activities:
(I) Conveying health messages on healthy lifestyles to parents via the children
(2) Correcting unhealthy eating habits to prevent nutritional disorders
(3) Increasing scientific potential and encouraging avoidance of
NCD-predisposing factors from childhood and adolescence, and creating the
ability to withstand the influence of negative advertising later in life.
|
4.2 Youth Healthy Heart Project
4.2.1 Target Population
Youth aged between 19 and 25 years.
4.2.2. Objectives:
(I) Improving BASK about NCDs and risk factors among youth
(2) Modifying lifestyles (i.e. smoking cessation, increasing physical activity,
coping with stress, and healthy nutrition) (3) Reducing NCD risk factors in
youth.
4.2.3 Interventions
(I) Education: Group education, face-to-face education, the use of learning aids
such as pamphlets, brochures, posters, educational leaflets, using mass media,
including radio and television, to communicate educational guidance
(2) Introducing healthy patterns of behaviour, promoting the culture of cycling
at university, and organizing recreational and scientific camps
(3) Legislating and ensuring strict observance of anti-smoking regulations in
universities, discouraging the use of automobiles and creating bicycle tracks on
university campuses
(4) Using cultural and artistic activities (theatre and cinema) to raise
awareness in regard to NCD prevention and control.
4.3 Healthy Life for Cardiovascular Patients Project
4.3.1 Target Population
Patients with definite diagnosis of ischaemic heart disease (IHD) or stroke and
the high-risk group (population with at least one major risk factor like
diabetes mellitus, hypertension, dyslipidaemia, smoking, positive family history
for IHD or stroke).
4.3.2 Objectives:
(1) Improve BASK of the target population about CVD risk factors (2) Reduce
mortality in CVD patients (IHD or stroke) (3) Reduce morbidity in CVD patients
(IHD or stroke) (4) Improve CVD patients' quality of life.
4.3.3 Activities:
(1) In-hospital education for CVD patients about their disease, its
complications, medication and healthy lifestyle changes
(2) Educating the patients' relatives and families before discharge from CCUs
and cardiology wards in hospitals, and offering them information on means of
secondary or tertiary prevention
(3) Holding cardiac rehabilitation sessions (in and out of hospitals) and
providing all necessary education (4) Public education via mass media.
4.4 Women's Healthy Heart Project
4.4.1 Target population
Women in the intervention community.
4.4.2 Objectives:
(I) Identification of NCD risk factors and behaviors regarding NCD in women,
prior to and after interventions (2) Improving BASK of women in dealing with
risk factors and healthy lifestyles for their families (3) Reducing NCD risks in
high-risk individuals
(4) Improving BASK of women in dealing with IHD patients.
4.4.3 Activities:
(1) Activating field professionals from the health service system in areas such
as education, arranging educational contests, face-to-face education of women
referred to health houses and other health and treatment centres, organizing
group activities, establishing educational kitchens
(2) Educating marrying couples upon their referral to the health centres
regarding healthy lifestyles
(3) Motivating the cooperation of company illiteracy instructors to implement
educational programmes in their literacy courses with regard to NCD risk factor
prevention and healthy lifestyles
(4) Motivating the cooperation of administrators of Municipal Culture Houses and
health and treatment centres in holding practical courses on healthy cooking,
cardiopulmonary resuscitation, and indoor exercise for women during seasonal
educational terms
(5) Motivating the support of mosque clerics (religious leaders) in educating
people attending mosque services
(6) Holding theoretical and field courses on healthy cooking, physical exercise
and risks of passive smoking in women's theology schools, and conveying
educational messages on these topics
(7) Encouraging the family counselors of the Imam Khomeini Relief Committee (a
charity institute) to exploit supportive educational opportunities in their
sessions with families.
4.5 Health Professional Education Project
4.5.1 Target Population.
(1) Physicians (cardiologists, internists, neurologists and general physicians)
(2) Health workers and experts (3) Nurses
(4) Medical students
(5) Health volunteers and carers.
4.5.2 Objectives
Improving BASK of health professionals about NCDs and their risk factors, and
ways to bring about healthy lifestyle change.
4.5.3 Activities
(1) Arranging educational seminars for the target population (2) Holding
educational workshops for the target population
(3) Establishing educational task groups comprising physicians, nurses, health
instructors, etc.
(4) Self-education of physicians (remote education using books and leaflets)
which is approved by CME in Iran
(5) Preparing educational books and leaflets (e.g. leaflets for distribution in
seminars, the Healthy Heart book for nurses, educational booklets for health
assistants).
4.6 Worksite Intervention Project
4.6.1 Target Population
Worksite employees (governmental and private offices, companies, factories,
syndicates, etc.)
4.6.2 Objectives
(1) Improving BASK of factory workers, office employees, workers in other
trades in relation to risk factor prevention and control and healthy lifestyles
(2) Improving BASK of workplace managers and directors in regard to NCDs and
their risk factors.
4.6.3 Activities
(1) Improving healthy cooking in the restaurants ofworksites
(2) Providing education on ways of coping with stress in the workplace
(3) Physical activity and exercise-related interventions in factories and
organizations by designating certain times for physical exercise and enforcing
workplace exercise regulations; practical education
(4) Advocating and enforcing non-smoking regulations in the workplace
(5) Opportunistic screening of employees for hypertension and overweight obesity
in offices, factories, etc. (6) Using data regarding biological indicators and
NCD risk factors, if the project is ongoing in worksites. |
| |
|
4.7 Healthy Food for Healthy Communities
4.7.1 Target Population
General population, food industries, food providers, etc.
4.7.2 Objectives:
(1) Carrying out and following up necessary interventions in organizations
responsible for the supply of foodstuffs in the society, food-producing centres,
food industries, and food outlets
(2) Improving public BASK about healthy nutrition
(3) Improving the status of nutrition in the society at large.
4.7.3. Activities:
(1) Setting up healthy food stations ( e.g. restaurants, sandwich shops,
pizzerias, confectioners, bakeries, supermarkets, etc.)
(2) Providing education on cooking healthy food in organizations, etc. which
cater for their personnel
(3) Modifying and improving cooking procedures in food industries; encouraging
the production ofhigher-quality non- industrial food and low-salt bread,
substituting yeast for sodium bicarbonate in bakeries, producing low-fat and
low- sugar confections, producing low-fat dairy products
(4) Enforcing existing regulations in the community on the sale of healthy foods
to:
-Encourage food industries to produce healthier products
-Encourage the production and supply of liquid oil, reducing the production of
hydrogenated oil and lowering consumption oftrans-fatty acids
-Passing the necessary regulations related to supply ofhealthy food products in
stores
-Passing regulations on labelling of food products
(5) Educating and encouraging the public to buy and consume healthy food
products, and to heed food labels
(6) Publication and circulation of healthy
food cookbooks
(7) Arranging competitions with themes on choosing and making healthy food for
healthy hearts (8) Producing and broadcasting educational television and radio
programmes on healthy cooking.
4.8 Isfahan Exercise Project
4.8.1 Target Population
General population, sport clubs, exercise and training centres
4.8.2 Objectives:
(1) Improving the population's BASK in regard to regular daily exercise (2)
Decreasing air pollution
(3) Providing suitable physical exercise environments for different age and sex
groups for regular daily exercise.
4.8.3 Activities:
(1) Arranging healthy heart exhibitions and holding sports events in some
streets while closing the street and prohibiting private transport
(2) Educating the society via radio and television programmes about the benefits
of doing regular daily exercise
(3) Providing education on equivalent physical exercises that can be carried out
by housewives at home and by employees in the workplace
(4) Altering the prevailing models and habits toward a more physically active
society (5) Enforcing regulations about exercise in schools and the workplace
(6) Promoting the culture ofbiking and walking; making bicycle tracks and
encouraging people to ride rather than drive (7) Holding sports competitions
that encourage participation by women, men, children and adolescents.
4.9 NGOs and Volunteers in IHHP
4.9.1 Target Population
Non-governmental organizations, volunteers (health workers, Red Crescent etc).
4.9.2 Objectives:
(I) Improving BASK ofNGOs, health workers and other volunteers in relation to
NCDs risk factors and healthy lifestyles
(2) Organizing NGO activities in regard to risk factor prevention and healthy
lifestyles.
4.9.3 Activities:
(1) Arranging educational sessions for NGOs' members and officials and health
volunteers concerning risk factor prevention and healthy lifestyle changes
(2) Studying the existing activities conducted by those NGOs or volunteers whose
objectives include healthy lifestyles (3) Implementing joint educational
activities (materials, face-to-face, mass media, etc.) or services regarding
risk factor
prevention and control
Establishing and empowering the NGOs with main objectives ofprimary and
secondary CVD prevention and healthy lifestyle change (e.g. Iranian Chapter of
Heart Friends around the World, the food industry, healthy community groups,
Iranian Heart Foundation, etc). |
| |
|
|
| |
Last update: Sunday 1 March 2004 (1383/1/2) |
Back to top |
|