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Startegy Formulation Project Deliverables

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Startegy Formulation Project Deliverables document sample

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									                HEPA           MACEDON IA

  HEPA Macedonia National Organization for the Promotion of Health -
Enhancing Physical Activity is established on 11 October 2005.

   The aim was to develop the steps to implement national policy, startegy
and programme on the key health determinant, physical activity in
accordance to the new EU Health Strategy (2007-2016).
   In February 2006 HEPA Macedonia was accepted as “temporary”
member by the Steering Committee of the WHO HEPA EUROPE until
confirmation by the network at 2nd Annual meeting on 14 June in Tampere,
Finland. Also it,s is a member of the World “Move for Health” network.

     There is a need for quick action to implement this strategy associated
with the implementation of the WHO Resolution WHA 57.16 on ”Health
Promotion and Healthy Lifestyle” and WHA 57.17 on “Global Srategy on
Diet, Physical Activity and Health” as well as with the A/RES/58/5 on “Sport
as a means to promote Education, Health, Development and Peace”.

                                                                               2
                   IN TRANSITION 1991-2003



   There is a strong evidence for the Macedonian
    physical activity initiative/strategy and programme.

   During last decade, statistic showed very bad public
    health situation.

   The major cause of death and disability are CVD, cancer, diabetes,
    obesity and respiratory diseases.

   CVD with predominant CHD mortality is continuosly increasing up
    to 57% of all deaths in 2002.



                                                                         3
Figure 1. Mortality rate from noncommunicable diseases in
Macedonia for the period 1991-2001 up to 100.000 population



 500
 450
                          464.9    464.9     458.7    468.6
 400
 350             385.9
        359.5
 300
 250
 200
 150
 100                               140.5     142.6    150.3
                          129.5
        108.3    111.4
  50                                                    KVB
                                                        Cancer
   0
        1991     1993     1995     1997      1999     2001


                                                                 4
Map 1. Deaths by causes in Macedonia, 2000




                                             5
Figure 2. Morbidity rate from circulatory diseases in
          Macedonia up to 100.000 population.




                                                        6
                               PUBLIC HEALTH APPROACH
                   RISK FACTOR IDENTIFICATION IN MACEDONIA


   High important public health problem are high prevalence of biological (morphfunctional),
    behavioural (lifestyle) and envoronmental risk factors responsible for development of the
    leading NCD in Macedonia.

   41.2% of Macedonian adult population was increasingly overweight and obese in 1988 and
    the percentage was increased up to 58.3% in 2000 (fig. 3)

   High prevalence of other major biological risk factors such as high total serum cholesterol,
    high blood presure and hyperglicaemia (fig. 5).

   The health of 64.5% of adult population was at risk from physical inactivity in 2002.

   PA are declined in 50% of school-age girls from 7-12 years old.

   Application of a standard questionnaire for PA such as IPAQ, periodically used was never
    undertaken.

   Assessment and comparison of socio-economic differences in PA levels and food habits
    included level of education were never done.



                                                                                              7
         Figure 3. BMI Distribution in adult population in Skopje
                    during the last 10 years (1990-2000)


    80         75,8
%
                             65,5                                                     BMI<25
    70                                            58,8                                BMI>25-29.9
                                                                                      BMI>30
    60

    50                                                               41,6     41,5

    40

    30                              15,9                 18,6
                                                                23
                14,9                       18,6                                      16,8
    20
                       9,3
    10

     0
              1990             1995                 1998                    2000



                                                                                                    8
Figure 5. Prevalence of risk factors for CVD and other NCD in adult
          population from central region in Skopje (1990-1998)

   80
                                                                                                      75
    %

   60



   40                                                                                         35,9                     35,2
                                           28,8                                                                 28,2
                             23,8   23,4
                                                                                 18,2
   20            14,2 18,2                                        15,8
          12,5
                                                        3,7
                                                  2,5
     0



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                                                                                                                              9
     WHO/FIMS PHYSICAL ACTIVITY RELATED ACTIVITIES, 1996-2006

    Sedentary lifestyle with reduced level of physical activity (PALs) and cardiorespiratory
     fitness under the recommended minimum (VO2 max ml-1 kg -1min -1) is clearly kay
     risk factors for major NCD.
    1986 - WHO CINDI Programme: Protocol for Integrated preventive interventions are
     aimed to those risk factors that can be modified and are common for several NCD
     such as lifestyle risk factors: physical inactivity, unhealthy diet, smoking and stress.
    1996 - The FIMS and WHO had increased efforts toward PA.
    2000 - WHO estimates that physical inactivity leads to more than 2 million deaths/yrs.
    Worldwide, it is estimated that at least 60% of the population is not active enough to
     benefit their health.
    7 April 2002 - World Health Day ”Move for Health - Reduce the Risk”;
    10 May 2003 - WHO “Move for Health” Initiatives Around the World
    2004 - “Move for health - Active Youth”,
    2005 - ”Move for health - Supportive Environments”,
    2005 - Starting the WHO HEPA EUROPEAN NETWORK
    2005 - WHO strategy on PA recommendations: implementation of an integrated,
     comprehensive and coordinated approach with stable intersectoral partnership.
    2006 ”Move for Health - Active Communities"
                                                                                                10
The vision and main goal of HEPA Macedonia




People in Macedonia should enjoy to achieve better health
through increasing physical activity.

To strengthen and support efforts and actions that
increase participation and improve the conditions
favourable to a healthy lifestyle, in particular with
respect to health - enhancing physical activity (HEPA).

To initiate national approache and network for physical activity
promotion, inter-ministerial and -sectoral approache and
a general framework for physical activity promotion policy.




                                                                   11
                                 The a i m s

1. To promote health through PA using population-based approach.

2. To formulate National strategy and programme for the promotion of
   health-enhancing PA - ”HEPA Programme”:
  - the main objective is to reduce major chronic disease morbidity/mortality
  - the intermediate objectives are to reduce the population levels of biological
    risk factors for chronic disease by introduction changes in the lifestyle:
    increased PA, balanced nutrition and smoking cessation.

3. In addition to provide the background for the identification and development
   of an overview of relevant HEPA Action Plan for implementation of HEPA
   startegy/programme in Macedonia (2005-2010).

4. To strengthen cooperation, partnership and collaboration with other relevant
   programmes, sectors, NGOs e.t.c in promotion of HEPA.

5. To formulate organizational structure and establishement a national network.

6. To prepare annual work programme for the main planned activities and
   events

7. To establish specific outcomes, monitoring and evaluation, and deliverables
   for HEPA Europe.                                                            12
               START OF HEPA PROMOTION WITHIN THE NATIONAL
                 CINDI PROGRAMME IN MACEDONIA (2001 - 2004)


   In September 2001- National PA startegy is initiated as part of CINDI conceptual model:
    “The health promotion and NCD prevention/control dimensions of the PA strategy”.

   In 2001/02 - Formulation of the Action Plan for development, implementation
    and monitoring the PA programme within the contex of the first Draft-Plan
    of Action for CINDI Programme in Macedonia, 2002-2007.
   Action Plan is based on:

    - the best scientific evidence on health, social and economic benefit of PA
    - intersectoral and multidisciplinary

   2001 - Planning CINDI coordinative centre in Skopje with an information base and
    organization structure for implementation of the CINDI programme.

   2001 - Realised “pylot“ study “CINDI Health Monitor” survey on demonstration level;
         - Planning a national register for NCD risk factors focused on PA

   2001 - Planning seminar/lecture in Skopje
     Modern aspects of NCD primary prevention: programmed PA and dietary interventions
                                                                                          13
           START OF THE PROMOTION OF HEPA WITHIN THE NATIONAL
                  CINDI PROGRAMME IN MACEDONIA (2001-2003)
                                            II part


    2002 - Initiation of preventive interventions and national quidelines for
     reduction of lifestyle risk factors: PA and diet.

    2003 - “Move for Health 2003 Initiative Around the World”
    The first step was made in collaboration with the WHO Department for
     NCD prevention and health promotion (Puska P, WHO/HQ, Geneva).

    10 May 2003 - Establishing a national coordination with Executiv Counsil
     Move for Health within Macedonian CINDI Programme.

    2003 - The website was developed “Macedonia on the Move”
     http://www.cindi.makedonija.com




                                                                                 14
   Ongoing activities on national level, 2004 - 2007:

10 May 2004 - Mass media campaign “Move for Health - Active Youth”.
              The Macedonian “Move for Health” Declaration was adopted.

11October 2005 - Establishing a National Public Health Organization
                 “HEPA MACEDONIA”.

2006 - Member of the” WHO HEPA Europe” and “ World Move for Health”
       network.

2006 - Collaborative Partner of the EU network and research project for PA
       and Aging - “EUNAAPA” . www.eunaapa.org

May 2006 - WHO “Quit & Win” Programme for smoking cessation in
          Macedonia with title “Tobacco - Free Sport”;
          www.nosmoking.cjb.net

22 September 2007 - “European day without cars” - Ohrid.




                                                                             16
                  MAIN ACTIVITIES OF HEPA MACEDONIA
              NATIONAL PUBLIC HEALTH ORGANIZATION FOR
        THE PROMOTION OF HEALTH – ENHANCING PHYSICAL ACTIVITY




RESEARCH:
•  Effects of applied programmed PA at children, youth and adult population
•  Efficacy of PA on reduction on diet-related risk factors for chronic diseases
•  Researches in area of public health
   - health promotion through PA and healthier nutrition
   - monitoring and evaluation of outcomes

HEALTH PROMOTION IN GENERAL:
•  Healthy lifestyle
•  Skills for health

PROMOTION OF PHYSICAL/SPORT ACTIVITY:
•  On population and individual levels
•  On national, regional and local level in Macedonia




                                                                                   17
  TEACHING / ADVOCACY ON PHYSICAL ACTIVITY, 2006 - 2007:


- Continuing doctoral education - CME, accrediated by Macedonian Medical
  Association, Faculty of Medicine and Doctor Chamber of Macedonia.

- Traening seminars, workshops and teaching courses.

- Mass-media campaigns: “Move for Health” and “Quit & Win”

- Policy and strategy documents: Health strategy of Macedonia
  including PA Strategy / Programme.

- Statute for transformation of Sports medicine institutions countrywide.

- Strategy for Sport-decentralization of sport in Macedonia.

- Legislation (Low for Sport).

- Recommendations and guidelines.

- Preparing proposal basic preventive medical services in area of
  Sports Medicine and Medical dietology. Project Unit at Ministry of Health and
  Health Insurance Company.
                                                                                  18
                CONTINUING DOCTORAL EDUCATION, 2006

Workshop: New way of presenting of the reccommendations for physical
activity and application in the preventive-therapeutic programmes focused on
obesity. Simovska V., MD., PhD. Institute of Sports Medicine, Skopje, 31 May 2006 -
www.lkm.org.mk.

Professional - scientific meeting: Non-pharmacological combined therapeutic
threatment at obese population. Simovska V., MD., PhD.
Faculty of Medicine, Clinic for pediatric disorders, Skopje, 21 April, 2006.

The First Annual HEPA Macedonian Conference.
Public Health Institute of Sports Medicine, Skopje, 26 December 2006 - mld.org.mk.
  Topics:
1. Vision and goals of HEPA Macedonia - National Public Health Organization for
   the Promotion of Health-Enhancing Physical Activity.
  Simovska V. MD., PhD, President of HEPA Macedonia.
2. Anthropometric,s characterisitics in patients with M. Cushing.
  Doc. dr Stratovska - Subevska S, Faculty of Medicine. Clinic of Endocrinology.
3. Startegies in treatment of obesity: dietotherapy in individuals with
   overweight and obesity. Simovska V.MD., PhD.
4. Annual Report of HEPA Macedonia 2006.
5. Annual HEPA Macedonian Work Programme 2007.

                                                                                     19
        CONTINUING DOCTORAL EDUCATION, 2007



Annual Conference of the National Organization HEPA Macedonia.
Plenary lecture: Simovska V., HEPA Macedonia.
“National startegy for the promotion of HEPA integrated in
multidimanzional health policy - fats and perspectives”.
Skopje, 29 November 2007 - www.lkm.org.mk.


Worshop: Influence of physical inactivity, obesity and psycho-social
stress on process of atherosclerosis and/or diabetes mellitus-type 2:
Patophysiology and treatment of Syndrom X.
Skopje, 10 January, 2008.




                                                                        20
            Physical Activity Promotion Policy Framework



                                   Outcomes of Policy
                    Policy         Develop and Implement Policy
                                   Determinants of Policy
                                   Identify Policy



                 Health
Parks/Public Spaces                                     Scale
  Transportation          Sector
   Worksite
   School                                                         21
Developing a HEPA PROGRAMME in Macedonia

Key point 1.
Explore and resolve the potential relationship, role and
function between HEPA promotion and two key groups:
  - Health professionals and HEPA, especially in PHC
  - Sport and HEPA

Key point 2.
Cultivate and recruit other potential HEPA organization and
professionals groups at the national, regional and local levels
  - Medical personals in public health
  - Health promotion staff
  - Exercise and fitness professionals
  - Sports pedaqouges and coaches



                                                                  23

								
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