DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.May 2008

NCD COUNTRY PROFILE: KEY CONCEPTS AND QUESTIONS

AINSTITUTIONAL CAPACITY AND RESPONSE TO NCD

BHEALTH REPORTING/INFORMATION SYSTEMS, SURVEYS AND SURVEILLANCE

CCOMMUNITY AWARENESS AND NGO INVOLVEMENT

DHEALTH Services FOR ncd

AInstitutional Capacity and Response to NCD

Institutional Capacity / Why ask the questions / Comments
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? / - resources within the MOH for NCD
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
  • health promotion
  • 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?

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DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.May 2008

Response to NCD / Questions / Why ask the questions / Comments
Legislation and Regulations
Checklist below / 1. Check the act, law, legislation, regulation or ministerial decree that exists / - existence of legislation and regulations
2. For each act, law, legislation, regulation, ministerial decree above, is it enforced?
3. If yes, does enforcement have a dedicated budget?
4. If yes, where does enforcement responsibility reside? / - enforcement of instruments

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DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.May 2008

LEGISLATION & REGULATION CHECKLIST

Policy environments / For tobacco control / For healthy eating / For physical activity / For alcohol control
Physical / 100% smoke free enclosed environments[1] in:
Health facilities
Educational Facilities
Governmental buildings
Workplaces (excluding restaurant, bars, casinos, discothecs)
Workplaces (including restaurants, bars, casinos, discothecs)
1Smoking is forbidden in all enclosed areas and there are no-smoking designated areas inside buildings. / 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 / 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 / □Restrictions on retail availability (specify):
□Hours and days of sale
□Where can be sold
□Density of outlets
Economic / Increased taxes and final price of tobacco products
Reduced out-of-pocket costs of cessation programmes / Improving relative food pricing
Incentives for production, processing and trade in fruits and vegetables / 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 / Increased taxes and final price of alcoholic beverages
Reduced out-of-pocket costs of screening and briefinterventions and for treatment of alcohol use disorders
Communications / 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 / Consumer-friendly food product / nutrition information
Restricted advertising of food to children
Sustained healthy food promotion campaigns / Point of decision prompts e.g. encourage use of stairways
Community-wide campaigns / 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

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DRAFT 6 FOR DISCUSSION ONLY. PLEASE DO NOT CIRCULATE.May 2008

Response to NCD / Questions / Why ask the questions / Comments
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?
- For each policy that exists, in what year was it declared? Give the title and a website where available. / - existence of integrated NCD policies
□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 / 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
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?
  • If so, does the Programme have an action plan?
  • If so, is the action plan funded?
/ - 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
  • 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)
-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) / - profile of consultations in the policy development process
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 / - extent of consultation in the policy development process
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 / - level of authority endorsing the policy, strategy, action plan or programme
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
-pregnant mothers
-young adults, 25-34 years
-middle age, 35-64 years
-older age, 65 years and over
-marginalized, vulnerable populations,specify
-other, specify / - target populations
11. For each of the policies, strategies, action plans and programmes, what is the specific setting where implementation is directed?
-communities
-health care centres
-work places
-schools
-cities
-other, specify / - settings
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?
  • Insufficient scientific information on which to base targets
  • Low priority assigned by Ministry of Health
  • Reluctance by Ministry of Health to set targets
  • 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
-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 / - extent of consultation on quantitative targets
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)
-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 / - implementation responsibility
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
- other, specify / - mechanisms to coordinate and integrate implementation between MOH and other sectors
18. Within the department of health, for each NCD policy, strategy, action plan and programme, are there staff dedicated to 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?
  • total if for multiple years______
  • annual allocation _____
-What proportion of the budget for each policy, strategy, action plan and programme has been expended to date? Specify ____ / - existence of resources for implementation
19. Is there a pilot phase to the policy, strategy, action plan and programme implementation?
-If yes, indicate the number of pilots______
-Implementation of pilots occurs at which level
  • National (across the country)
  • Regional
  • some regions
  • all regions
  • City/municipality
  • some municipalities
  • all municipalities
  • some cities
  • all cities
  • rural areas only
  • urban areas only
/ - evidence of implementation
20. For each policy, strategy, action plan and programme, what are the sources of financing for implementation:
-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 / - financing sources for implementation
21. Is there routine monitoring relative to quantitative targets/goals?
Have policies, strategies, action plans or programmes been evaluated:
-process evaluation
-outcomes evaluation against targets/goals
  • If so, give the title of the evaluation report(s) and web site if available.
/ - monitoring and evaluation against targets

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