Non-Communicable Diseases in Cameroon- The Way Forward
Cameroon like one of those LMIC (Low and Medium Income Countries) in Africa, with most of the people in the country living below 1US dollar per day is also experiencing and increase morbidity and mortality as a result of this NCDs. According to the 2014 NCD profile report for Cameroon, NCDs accounted for 239,000 deaths and an estimated 31% of total deaths that same year were NCD-related (WHO, 2014). This report also states that there is a 20% probability of dying between the ages of 30 and 70 years from the 4 main NCDs in Cameroon (diabetes, cardiovascular diseases, cancers and chronic respiratory diseases) which could worsen with an increasing population aged 50 or more, and an increase in obesity, because of urbanization and social mobility (Echouffo-Tchegui and Kegne, 2011).
Cameroon is a country were the main foods of consumption are very rich in starch, oils, and sugars, and most people are increasingly exposed to contemporary and unhealthy diets leading to increase in obesity rates. Obesity is rapidly becoming a health problem in Cameroon; this is encouraged by the fact that being fat (obese) is perceived by some people as a sign of good living because it confers respect and influence (Kiawi et al., 2006). Also qualitative survey conducted by Dapi et al. (2010), among Cameroonian adolescents, showed that more and more are strongly having preference for sweetened foods; with an increased transition over time from a traditional diet in rural areas to a more westernized diet. Furthermore, the adoption of unhealthy lifestyle behaviors that are risk factors for NCD has been emerging not only in the urban areas but also in the rural areas as well. More so, health beliefs, knowledge, lay perceptions, and health behavior have strongly contributed to the occurrence of chronic NCDs. Misconceptions indicated by popular health beliefs, has caused many Cameroonians to fail to take appropriate actions for prevention and control of NCDs such as diabetes and CVD, and their risk factors (Kiawi et al. 2006; Awah et al., 2008)
According to the WHO report of 2014, this situation is increasing due to limited operational policies, strategies or action plan to reduce the harmful use of some toxic substances like alcohol and tobacco. This can be seen by the poor implementation to prevent young people below 18years from consuming alcohol and cigarettes as seen in other civilized nations. Lack of operational policy or strategy that integrates several NCDs and shared risk factors, the absence of operational NCD units within the Ministry of Health (MoH), no evidence-based national guidelines and protocols for the management of major NCDs through a primary care approach, and the non-existence of surveillance systems or monitoring systems that enable reporting against global NCD targets has led to more and more cases that could be prevented.
Despite all these difficulties, efforts have been made to reduce the prevalence of NCDs in Cameroon. But due to the weak health system, health policies, the burden of infectious diseases and poverty (30% of the population living below the poverty line) (Echouffo-Tchegui and Kegne, 2011), the process is very slow.
Although this NCD problem may seem insurmountable due to socioeconomic and political difficulties, they are several multi-sectored and holistic solutions that can be implemented to reduced its impact. The following interventions if put into place will help the health sector reduce this burden of NCDs in Cameroon.
1. Creation of a National NCDs program to promote the fight against NCDs by the MoH.
This program will enable the MoH to fight NCDs through health education, training of medical personnel on the important of keeping a watchful eye on these diseases. The national program as an arm of the MoH can create environmental policy or sustainable ideas in collaboration with the other sectors to come up with a national health strategy that will help fight these diseases. This program with the help of the experts will also formulate a national protocol for the management of these diseases.
2. Prevent the harmful use of alcohol.
· Alcohol is the one of the product that if real feasible enforcement of the laws prohibiting the sale to school children are being practice, then much will be accomplished. Cameroon is the second consumption of alcohol after Poland as of the WHO report of 2015 with a consumption of 800 million hectoliters of beer. This consumption was mostly by school children. So reducing the harmful use of alcohol will greatly reduce this burden and this can be improved by;
· Implementing the effective use of tax and price measures (increasing the taxes on alcohol producers and retailers, and increasing the consumer price of alcohol) to control the demand for alcohol.
· Creating public awareness via mass media on the dangers of alcohol consumption and its related risks.
· Introducing an age limit on the purchase and consumption of alcoholic products.
· Creating and integrating alcohol abuse management and rehabilitation at all levels including the community, healthcare system and workplace.
· Reducing the number of alcohol vendors and increase the difficulty in acquiring an alcohol-vending license.
· Monitoring and prohibiting the misleading advertising, promotion and sponsorship of alcoholic beverages.
· Introducing legislations that reduce drink driving and heavily penalize drink-drivers.
· Improving policing of illegal, informally produced, and imported alcohol, as well as increasing the proportion of alcohol that is taxed. This is because of the high amounts of unrecorded alcohol production and consumption in Cameroon.
3. The promotion of Healthy Diets
This could be done by;
Promoting the provision of health foods in public schools while also implementing nutrition component in school curriculum; Creating institutions to train nutritionist and dieticians; Developing policymeasures that encourage food produces to utilize healthy agricultural products; Increasing taxes on unhealthy food products while providing incentives and subsidies to food producers.
4. Promoting Physical activities
This can be achieved by;
Conducting evidence-informed campaigns through mass media, social media etc to inform and motivate young people on the benefits of physical activity; Creating free gyms and open air work spaces; Stengthening the current implementation of physicall education in school curriculum; Amending national and subnational urban planning and transport policies to improve accessibility, acceptability, safety of and supportive infastructure for walking and cycling.
5. Tobacco control
Tobacco control Policies should be aimed at: protecting people from tobacco smoke (secondhand smoking); supporting tobacco cessation; warning the general public about the dangers of tobacco consumption; enforcing bans on advertising; raising taxes on tobacco products;monitoring tobacco use and Providing smookingcessation servicewhich should include access to nicotine replacement therapy and counselling for people who want to quit smoking or reduce their exposure to tobacco smoke.
· Create and raise public awareness on the dangers of tobacco consumption and secondhand smoking by providing health information and evidence-based mass-media campaigns with large and clear visible health warnings.
· Implementing bans on tobacco advertisings, promotion and sponsorship through government legislation. Tobacco companies are required to package their products in packaging that carries images or inscriptions of health warning. This intervention eliminates misleading advertising, gives greater prominence to health warnings, helps smokers quit, and discourages children and youths from smoking.
If all these majors are put into placed and well implemented, then we are sure that the burden of NCDs will certainly diminish over time.
6. Strengthen community Health Care systems
Almost every health area in Cameroon communities has a health center, most of which are not capacitated enough to run awareness raising campaigns on NCDs. Building the capacity of community health workers by empowering them with information and skills to educate the population on predisposing factors to these NCDs will foster the adoption of healthy practices at community level.
If the above measures are put in place; we look towards not only having an emergent Cameroon 2035 but a healthy and happy country!
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