Non-communicable Disease Mortality Research Articles

Epidemiology of chronic multimorbidity and temporary migration in a rural South African community in health transition: A cross-sectional population-based analysis.

In sub-Saharan African settings, the increasing non-communicable disease mortality is linked to migration, which disproportionately exposes sub-populations to risk factors for co-occurring HIV and NCDs. We examined the prevalence, patterns, and factors associated with two or more concurrent diagnoses of chronic diseases (i.e., multimorbidity) among temporary within-country migrants. Employing a cross-sectional design, our study sample comprised 2144 residents and non-residents 18-40 years interviewed and with measured biomarkers in 2018 in Wave 1 of the Migrant Health Follow-up Study (MHFUS), drawn from the Agincourt Health and Demographic Surveillance System (AHDSS) in rural north-eastern South Africa. We used modified Poisson regression models to estimate the association between migration status and prevalent chronic multimorbidity conditional on age, sex, education, and healthcare utilisation. Overall, 301 participants (14%; 95% CI 12.6-15.6), median age 31 years had chronic multimorbidity. Multimorbidity was more prevalent among non-migrants (14.6%; 95% CI 12.8-16.4) compared to migrants (12.8%; 95% CI 10.3-15.7). Non-migrants also had the greatest burden of dual-overlapping chronic morbidities, such as HIV-obesity 5.7%. Multimorbidity was 2.6 times as prevalent (PR 2.65. 95% CI 2.07-3.39) among women compared to men. Among migrants, men, and individuals with secondary or tertiary education manifested lower prevalence of two or more conditions. In a rural community with colliding epidemics, we found low but significant multimorbidity driven by a trio of conditions: HIV, hypertension, and obesity. Understanding the multimorbidity burden associated with early adulthood exposures, including potential protective factors (i.e., migration coupled with education), is a critical first step towards improving secondary and tertiary prevention for chronic disease among highly mobile marginalised sub-populations.

Trend analysis of noncommunicable diseases and their risk factors in Afghanistan.

Afghanistan is suffering from 40-year chronic conflicts, displacement, and demolition of its infrastructure. Afghanistan mortality survey 2010 shows nearly 46% of all deaths in the country were attributed to noncommunicable diseases (NCDs). In this study, we aimed to understand the differences in mortality and premature death due to NCDs by sex and the trend for the next 8 years. We applied trend analysis using the secondary data from the Institute for Health Metrics and Evaluation, Global Burden of Diseases 2019. The information on NCD mortality, NCD deaths attributed to its risk factors, NCD percent of total years lived with disability (YLDs) attribution to each risk factor extracted from this database from 2008 to 2019. We investigated the trend from 2008 to 2019 for the mentioned factors and then forecast their trends until 2030. Our study shows that Afghanistan has had an increasing death number due to NCDs from 2008 to 2019 (50% for both sexes) and this will reach nearly 54% by 2030. Currently, half of NCDs deaths are premature in Afghanistan. The mortality rate and prevalence of risk factors are higher among women. More than 70% of YLDs will be due to NCDs in Afghanistan till 2030. Five risk factors including high systolic blood pressure (28.3%), high body mass index (23.4%), high blood glucose (20.6%), high low-density lipoproteincholesterol (16.3%), and smoking (12.3%) will have the highest contribution to NCDs death in 2030, respectively. In general, our study indicates that without any specific intervention to address NCDs in Afghanistan, not only the Sustainable Development Goal target for NCDs will not be met, but an increase in almost all risk factors prevalence, as well as NCD mortality,will be seen in Afghanistan.

Trends in mortality and causes of death among Chinese adolescents aged 10-19 years from 1990 to 2019.

Promoting adolescent health is essential to achieving the goals of the Healthy China 2030 (HC 2030) initiative. As socioeconomic conditions improve and medical practices and disease patterns evolve, adolescent mortality rates and causes of death vary considerably. This study provides up-to-date data on adolescent mortality and causes of death in China, highlighting key areas of focus for investment in adolescent health. Data regarding mortality and causes of death in Chinese adolescents aged 10-19 years were extracted from the Global Burden of Disease study from 1990 to 2019. The data variables were examined according to year, sex, and age. The autoregressive integrated moving average model was used to predict non-communicable disease (NCD) mortality rates and rank changes in the leading causes of death until 2030. The all-cause mortality rate (per 100,000 population) of Chinese adolescents aged 10-19 years steadily declined from 1990 (72.6/100,000) to 2019 (28.8). Male adolescents had a higher mortality (37.5/100,000 vs. 18.6 in 2019) and a slower decline rate (percent: -58.7 vs. -65.0) than female adolescents. Regarding age, compared with those aged 10-14 years, the mortality rate of adolescents aged 15-19 years had a higher mortality (35.9/100,000 vs. 21.2 in 2019) and a slower decrease rate (percent: -57.6 vs. -63.2). From 1990 to 2019, the rates of communicable, maternal, and nutritional diseases declined the most (percent: -80.0), while injury and NCDs mortality rates were relatively slow (percent: -50.0 and -60.0). In 2019, the five leading causes of death were road injuries (6.1/100,000), drowning (4.5), self-harm (1.9), leukemia (1.9), and congenital birth defects (1.3). Furthermore, NCDs' mortality rate decreased by -46.6% and -45.4% between 2015-2030 and 2016-2030, respectively. A notable decline was observed in all-cause mortality rates among Chinese adolescents aged 10-19 years. In addition, the mortality rates of NCDs are projected to meet the target from the Global Strategy for Women's, Children's, and Adolescents' Health (2016-2030) and HC2030 reduction indicators by 2030. However, it should be noted that injury is the leading cause of death, with sexual and age disparities remaining consistent.

Determinants of COVID-19 cases and deaths in OECD countries.

This research aims to examine the effects of variables that can affect COVID-19 deaths and cases in Organisation for Economic Co-operation and Development (OECD) countries during the years 2020 (first wave), 2021 (vaccine available), and 2022 (vaccine available and Omicron variant appeared). The factors that are thought to affect the case and death rates in 37 OECD countries were examined by multiple linear regression analysis using SPSS 22. The dependent variables were the COVID-19 deaths and cases per 10,000 (in 2020, 2021, and 2022); the independent variables were universal health coverage, physicians, nurses, intensive care beds, hospital beds, non-communicable diseases mortality per 100,000 people, population over 65 years of age, out-of-pocket expenditure, private expenditure, and health expenditure per capita and percent of % GDP. It was determined that the non-communicable diseases mortality is the relatively important variable COVID-19 cases and deaths in 2020 and 2021. After controlling for the scores of other variables, according to the ß coefficients, a one-unit increase in the number of physicians variable increases COVID-19 cases by 1.14 units in 2022; a one-unit increase in the universal coverage variable decreases COVID-19 deaths by 0.33 units in 2022. The results of this research provide evidence that the effects of the COVID-19 outbreak have changed between 2020, the first wave of the epidemic, 2021, when the vaccine is available, and 2022, when both the vaccine is available and the Omicron variant is seen. With the increase in vaccination in 2022, the impact of non-communicable diseases mortality on the number of COVID-19 cases has decreased.

US and EU Free Trade Agreements and implementation of policies to control tobacco, alcohol, and unhealthy food and drinks: A quasi-experimental analysis.

Identifying and tackling the factors that undermine regulation of unhealthy commodities is an essential component of effective noncommunicable disease (NCD) prevention. Unhealthy commodity producers may use rules in US and EU Free Trade Agreements (FTAs) to challenge policies targeting their products. We aimed to test whether there was a statistical relationship between US and EU FTA participation and reduced implementation of WHO-recommended policies. We performed a statistical analysis assessing the probability of at least partially implementing 10 tobacco, alcohol, and unhealthy food and drink policies in 127 countries in 2014, 2016, and 2019. We assessed differences in implementation of these policies in countries with and without US/EU FTAs. We used matching to conduct 48 covariate-adjusted quasi-experimental comparisons across 27 matched US/EU FTA members (87 country-years) and performed additional analyses and robustness checks to assess alternative explanations for our results. Out of our 48 tests, 19% (9/48) identified a statistically significant decrease in the predicted probability of at least partially implementing the unhealthy commodity policy in question, while 2% (1/48) showed an increase. However, there was marked heterogeneity across policies. At the level of individual policies, US FTA participation was associated with a 37% reduction (95%CI: -0.51 to -0.22) in the probability of fully implementing graphic tobacco warning policies, and a 53% reduction (95%CI: -0.63 to -0.43) in the probability of at least partially implementing smoke-free place policies. EU FTA participation was associated with a 28% reduction (95%CI: -0.45 to -0.10) in the probability of fully implementing graphic tobacco warning policies, and a 25% reduction (95%CI: -0.47 to -0.03) in the probability of fully implementing restrictions on child marketing of unhealthy food and drinks. There was a positive association with implementing fat limits and bans, but this was not robust. Associations with other outcomes were not significant. The main limitations included residual confounding, limited ability to discern precise mechanisms of influence, and potentially limited generalisability to other FTAs. US and EU FTA participation may reduce the probability of implementing WHO-recommended tobacco and child food marketing policies by between a quarter and a half-depending on the FTA and outcome in question. Governments negotiating or participating in US/EU FTAs may need to establish robust health protections and mitigation strategies to achieve their NCD mortality reduction targets.

Best Investments in Chronic, Noncommunicable Disease Prevention and Control in Low- and Lower–Middle-Income Countries

AbstractThe world remains off-track for the sustainable development goal (SDG) target 3.4, which calls for a one-third reduction in noncommunicable diseases (NCDs) mortality by 2030. This paper presents benefit–cost analyses of various NCD interventions in low-income (LICs) and lower–middle-income (LMCs) countries. We looked at 30 interventions recommended by the Disease Control Priorities Project, including six intersectoral policies (e.g., taxes) and 24 clinical services. We used a previously published model to estimate intervention costs and benefits through 2030, discounted at 8%. We focused on interventions with benefit–cost ratios (BCRs) > 15 and their contribution toward achieving the SDG target. We found that intersectoral policies often provided great value for money, with BCRs ranging from 40 (trans-fat bans) to 100 (tobacco excise taxes). However, seven clinical interventions (e.g., basic treatment of cardiovascular disease or breast cancer) also had BCRs > 15. The overall population impact of clinical interventions over the 2023–2030 period would be much higher than that of the intersectoral policies, which can take many years to reach their peak effects. Fully implementing the best-investment interventions would accelerate progress toward SDG 3.4 everywhere, but only one in 10 countries would achieve the target. This strategy would require an additional US$ 2.4 billion annually across all LICs and LMCs. We conclude that there are several cost-beneficial opportunities to tackle NCDs in LICs and LMCs. In countries with very limited resources, the best-investment interventions could begin to address the major NCD risk factors and build greater health system capacity, with benefits continuing to accrue beyond 2030.

The global agenda on obesity: what does this mean for Singapore?

The global agenda on obesity: what does this mean for Singapore?

Evaluating the role of salt intake in achieving WHO NCD targets in the Eurasian Economic Union: A PRIME modeling study.

The World Health Organization has set clear global targets in reducing non-communicable disease mortality by 2030 in its sustainable development goals. This study models the number of deaths that could be averted if Eurasian Economic Union (EEU) member states met the target of reducing their population's current mean salt intake by 30% to achieve mortality reduction targets. Using the WHO Preventable Risk Integrated ModEl (PRIME), we modelled the mortality impact of reducing salt consumption by 30%, as well as according to WHO recommended levels (5 g/person/day), for the five member states of the EEU. PRIME models the number of averted deaths from reducing salt intake by applying established risk ratios to a given population. The baseline demographic and mortality data that are required to generate these estimates were obtained from the relevant government statistical bodies, and salt intake data were referenced from surveillance studies. Uncertainty intervals were generated using Monte Carlo simulation. If salt consumption was reduced by 30%, we estimate that there would have been 94,150 (95%UI: 47,329 to 137,131) fewer deaths due to cardiovascular disease in the EEU in the baseline year, with males and the elderly being more affected. If the WHO-recommended maximum salt intake of 5 g/day was achieved, a total of 193,155 (95%UI: 98,548 to 272,536) deaths would have been prevented. These findings underline the importance of incorporating effective policy changes to meet targets in reducing NCD mortality by one-third by 2030.

Lifestyle Interventions for Prevention and Management of Diet-Linked Non-Communicable Diseases among Adults in Arab Countries.

The increased incidences of diet-related non-communicable diseases (NCDs) such as diabetes, obesity, and cardiovascular diseases among adults are becoming the chief public health concern in most Arab countries. Economic expansion has contributed to a nutrition shift from a traditional seasonal diet to Westernized eating habits coupled with a sedentary lifestyle. Despite the rising concern for NCD mortality, public health policies are inadequately addressed. This narrative review aims to discuss the effectiveness of nutritional interventions focusing on diet and physical activity in the management of NCDs among Arab adults. A comprehensive literature search was performed using different database platforms such as Cochrane reviews, Scopus, and PubMed for articles published between 1 December 2012 and 31 December 2021. Fifteen recent research articles addressing NCDs, mainly diabetes and obesity, from different Arab countries were included in this review. Structured lifestyle interventions involving behavioral therapy approaches and personalized goals for diet and physical activity were found to improve specific health outcomes in most studies. Significant improvements in health outcomes were reported for longer-duration interventions with follow-ups. A combination of both online and face-to-face sessions was found to be effective. It is important to identify barriers to physical activity for a culturally acceptable lifestyle intervention and conduct further studies to evaluate interventions for the long-term maintenance of health outcomes.

Release of Bioactive Peptides from Erythrina edulis (Chachafruto) Proteins under Simulated Gastrointestinal Digestion.

The estimated and concerning rise in world population over the next few years and the consequent increase in food demand will lead to a deterioration in global food security. To avoid or reduce this world crisis, informed and empowered consumers are turning to sustainable and nutrient-rich foods that substitute animal products, also reducing their associated environmental impact. Moreover, due to the demonstrated influence of diet on the risk of high incidence and mortality of noncommunicable diseases, the current established food pattern is focused on the consumption of foods that have functionality for health. Among these new foods, traditional and underutilized plants are gaining interest as alternative protein sources providing nutritional and biological properties. In this work, the potential of Erythrina edulis (chachafruto) proteins as a source of multifunctional peptides after transit through the gastrointestinal tract has been demonstrated, with antioxidant and immunostimulating effects in both biochemical assays and cell culture. While low molecular weight peptides released during the digestive process were found to be responsible for protection against oxidative stress mediated by their radical scavenging activity, high molecular weight peptides exerted immunostimulating effects by upregulation of immunoresponse-associated biomarkers. The findings of this study support the promising role of chachafruto proteins as a new antioxidant and immunostimulatory ingredient for functional foods and nutraceuticals.

The Effect of Metabolic Syndrome and its Components on Long Term Outcome in Patients with Cardiovascular Disease in Bangladesh

Background: The "Metabolic Syndrome" (MetS), a clustering of risk factors including abdominal obesity, poor glucose tolerance, hypertriglyceridemia, decreased high density lipoprotein (HDL) cholesterol, and/or hypertension. Cardiovascular disease (CVD) is the cause of 46.2% of non-communicable disease mortality, attracting attention on a global scale. One of the key reasons for early mortality and disability is CVD. According to the National Health and Nutritional Examination Survey (NHANES), approximately 30% of overweight and 60% of obese men and women are diagnosed with MetS. People with CVD have a greater rate of MetS than patients without the condition. Objective: The aim of the study is to assess the effect of Metabolic Syndrome and its components on long term outcome in patients with cardiovascular disease in Bangladesh. Methods: The study consisted of 415 persons who were aged between 35-84 years, during June 2020–May 2022. Data were collected through interview, clinical examination, and laboratory tests, and their survival status until April 2022 was ascertained. We defined MetS following the NCEP ATP III criteria, with minor modifications, i.e., presence of any three of the following: hypertension (BP ≥130/85 mm Hg); random blood glucose (RBG) level ≥7.0 mmol/L; hyper-triglyceridemia (≥2.28 mmol/L); low level of HDL-cholesterol (<1.04 mmol/L for men and <1.29 mmol/L for women); and BMI ≥25.0 kg/m2. Data were analysed with logistic regressions for the influential factors of MetS, and with Cox models for the association of MetS with the survival status. Results: MetSwas found in 137 (33.1%) participants and were older (57.9 ± 13.0) and primarily male (60.6%).Participants with MetS showed a greater prevalence of diabetes, hypertension, hypercholesterolemia, and overall worse management of risk variables at baseline, as predicted. The most common feature across all patients was raised fasting blood glucose (93.4%), followed by blood pressure (91.2%), ......

The cost of inaction on physical inactivity to public health-care systems: a population-attributable fraction analysis

Physical inactivity is an important modifiable risk factor for non-communicable diseases (NCDs) and mental health conditions. We aimed to estimate the public health-care costs associated with these diseases because of physical inactivity, which will help policy makers to prioritise investment in policy actions to promote and enable more people to be more active. We used a population-attributable fraction formula to estimate the direct public health-care costs of NCDs and mental health conditions for 2020-30. The disease outcomes that we included were incident cases of coronary heart disease, stroke, type 2 diabetes, hypertension, cancer (breast, colon, bladder, endometrial, oesophageal, gastric, and renal), dementia, and depression in adults aged at least 18 years. We used the most recent health and economic data evidence available for 194 countries. 499·2 million new cases of preventable major NCDs would occur globally by 2030 if the prevalence of physical inactivity does not change, with direct health-care costs of INT$520 billion. The global cost of inaction on physical inactivity would reach approximately $47·6 billion per year. Although 74% of new cases of NCDs would occur in low-income and middle-countries, high-income countries would bear a larger proportion (63%) of the economic costs. The cost of treatment and management of NCDs varied-although dementia accounted for only 3% of new preventable NCDs, the disease corresponded to 22% of all costs; type 2 diabetes accounted for 2% of new preventable cases but 9% of all costs; and cancers accounted for 1% of new preventable cases but 15% of all costs. This health and economic burden of physical inactivity is avoidable. Further investments in and implementation of known and effective policy interventions will support countries to reach the Sustainable Development Goal of reduction of NCD mortality by 2030. None.

When women win, we all win-Call for a gendered global NCD agenda.

Gender is a social determinant of health, interacting with other factors such as income, education, and housing and affects health care access and health care outcomes. This paper reviews key literature and policies on health disparities and gender disparities within health. It examines noncommunicable disease (NCD) health outcomes through a gender lens and challenges existing prevailing measures of success for NCD outcomes that focus primarily on mortality. Chronic respiratory disease, one of the four leading contributors to NCD mortality, is highlighted as a case study to demonstrate the gender gap. Women have different risk factors and higher morbidity for chronic respiratory disease compared to men but morbidity is shadowed by a penultimate research focus on mortality, which results in less attention to the gap in women's NCD outcomes. This, in turn, affects how resources, programs, and interventions are implemented. It will likely slow progress in reducing overall NCD burden if we do not address risk factors in an equitable fashion. The article closes with recommendations to address these gender gaps in NCD outcomes. At the policy level, increasing representation and inclusion in global public health leadership, prioritizing NCDs among marginalized populations by global health societies and political organizations, aligning the gendered global NCD agenda with other well-established movements will each catalyze change for gender-based disparities in global NCDs specifically. Lastly, incorporating gender-based indicators and targets in major NCD-related goals and advancing gender-based NCD research will strengthen the evidence base for women's unique NCD risks and health outcomes.

Transfer or tailor? Implementing a technology‐supported intervention for noncommunicable diseases across contexts

Transfer or tailor? Implementing a technology‐supported intervention for noncommunicable diseases across contexts

Chronic non-communicable diseases: Hainan prospective cohort study

PurposeThe Hainan Cohort was established to investigate the incidence, morbidity and mortality of non-communicable diseases and their risk factors in the community population.ParticipantsThe baseline investigation of the Hainan Cohort study...

Inequities and Quality of Life in Argentina. Geography and Quality of Life in Argentina

This book explores the inequalities in the quality of life in Argentina from an interdisciplinary perspective. The text consists of nine chapters presenting contributions from disciplines in the social sciences (geography, economics, demography, history) and social medicine (mainly focused on non-communicable diseases). Each chapter covers the entire territory of Argentina, using two geographic scales (departments and provinces) and multiple time periods, from 1980 to 2013. A variety of data sources were used, from national censuses, vital statistics, and population surveys. The book can be divided into two parts. The firstconsists of the first three chapters, focused on the geography of living conditions (poverty, and human development index and its variants in Argentina). A second part is focused on the health geography of two demographic groups (women and adolescents) and on the risk factors and morbidity and mortality of non-communicable diseases. These health outcomes were related to indicators of the socioeconomic level of the provinces. This book constitutes an excellent opportunity for those who, not familiar with the Spanish language, are interested in the study of inequities in quality of life and, in particular, a current overview of the Geography of Health in Argentina.

May Measurement Month 2017-2019: an analysis of blood pressure screening results from Guatemala.

In 2018, the Ministry of Public Health and Social Assistance of Guatemala published the last update of the prevalence of noncommunicable diseases (NCDs), and as in other low-income countries, the prevalence of NCD morbidity and mortality had risen. The prevalence of hypertension in Guatemala has been reported in a range from 18.7 to 22.7% which could be underestimated, because the country does not have an adequate statistical surveillance system. May Measurement Month (MMM) 2017, 2018, and 2019 in Guatemala was an opportunistic survey, which followed the methodology previously published. Blood pressure (BP) measurements were carried out in various locations, mainly hospitals and clinics (48.9%) or pharmacies (34.2%) in Guatemala City. In all patients, three BP measurements were taken after 5 min of rest and sitting in the correct recommended position. The mean of the second and third BP measurements was used for the analyses. Multiple imputation was used to impute the missing readings, based on the global MMM data. After multiple imputation, of all 3265 participants, 43.4% had hypertension. Of all participants with hypertension, 74.7% were aware of their diagnosis, 69.2% were on antihypertensive medication, and 63.1% had controlled BP (<140/90 mmHg). Of all those with hypertension, 43.6% had controlled BP. MMM is the largest hypertension survey ever carried out globally. The MMM results from Guatemala reported here provide complementary and strong data on the impact of hypertension in the country and help to make hypertension visible as a priority health problem, which requires urgent solutions.

Trends in Non-Communicable Disease Mortality at the Bono Regional Hospital, Sunyani-Ghana

Cardiovascular disorders (such as heart attacks and strokes), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes are the most common non-communicable diseases in the world. Projecting mortality patterns can offer policymakers and planners with useful information. This study employed a retrospective approach which involved taking secondary data from events that have already occurred and making inferences and projections about the future. A trend line was used to forecast the death rate. The cause specific mortality rates of the four main NCDs (cancer, cardiovascular diseases, chronic respiratory diseases and diabetes) were extracted from DHIMs (District Health Information Management System). The information gathered was entered into Microsoft Excel 2016. The mortality rates were then categorized into their respective groups and a time- series graph was used to graphically present the trend of NCD mortality from 2013 to 2021. The projection for the upcoming years was done by fitting a ‘trend line’ into the time series graph that was already generated. The findings showed that cancer had a mortality rate of 0 for the seven-year period, CVDs had a mortality rate of 3.4% for the same period, CRDs had a mortality rate of 1.4% and diabetes had a mortality rate of 0.8% for the same period. The findings further showed that males had higher mortality rates than females for most years during the seven-year period. The mortality rates for three categories of non-communicable diseases will continue to increase (CVDs: 3.4% to 3.7%, CRDs: 1.4% in 2013 to 1.9% in 2020, diabetes 0.8% in 2013 to 1.2% in 2025). At Bono regional Hospital, by 2025, mortality rates from non-communicable diseases are expected to rise. This could be due to the fact that the country is still developing, and as a result, people are picking up unhealthy habits from the developed countries.

Building stronger public health institutions (BIS) project: Deciphering the burden of air pollution in Ethiopia, (2021-2025)

Linking air pollution and health at a national level demands the use of a wide variety of data. The current state of science and practice recommends, countries to monitor pollutant concentrations in microenvironments and through satellite technologies. For this reason, countries with better policies and regulations are relentlessly assessing population exposure to air pollutants using air monitoring systems, from fixed atmospheric monitoring stations, atmospheric dispersion modelling, or spatial interpolation techniques for pollutant concentrations. Moreover, the use of systematic diseases surveillance system to document diseases distribution tandem with census data, administrative registers, and data on the patterns of the time-based activities at the individual scale, allowed them to better understand the burden of air pollution. Hitherto, Ethiopia has not established a national air pollution and health impact surveillance program or system to generate data that can be translated into policy or action. For this reason, the global burden of diseases lacks to present the full depiction of Ethiopia. This was ascribed to the dearth of information available on temporal and spatially representative ambient and indoor air quality monitoring efforts; inadequate documentation of population exposure, activity pattern, and diseases incidence to represent wide range of the social fabric. To this effect, the Norwegian public health institute (NIPH) through its four years program, building stronger public health institutions (BIS) (2021-2025), agreed to work with the Ethiopian public health institute (EPHI), to develop environmental epidemiological studies, to link air pollution and health. In doing so, establishing monitoring sites in collaboration with pertinent national authorities will be the first phase of the project. The second milestone will be identifying sentinel sites so as to track sex and age specific mortality and morbidity data of non-communicable diseases attributed to air pollution. Overall, the epidemiological studies will benefit Ethiopia to understand the burden of air pollution.

Efforts to empowerment the Community and Health Involunters Related to Non-Communicable Diseases (PTM) through Strengthening Posbindu

Morbidity and mortality of Non-Communicable Diseases (NCD) tends to increase in the last few decades in Indonesia, including at the global level. Posbindu as a Community-Based Health Effort (UKBM) which is held in accordance with the abilities and needs of the community. This Community Service aims to empower cadres in early detection of PTM risk factors which is carried out through several activities including the establishment of PTM Posbindu, training of cadres on PTM Posbindu, and continued monitoring of PTM risk factors. The results of community service obtained data that there were differences in the level of knowledge of cadres about PTM Posbindu before and after being given additional material. There was 1 cadre (6.25%) with a decreased score after the intervention, 13 cadres (81.25%) experienced an increase in post-test scores, and 2 cadres (12.5%) with a fixed score. The intervention given to the cadres was in the form of knowledge about the PTM Posbindu which consisted of the role of cadres in the implementation of the PTM Posbindu, the concept of the PTM Posbindu which included definitions, types of non-communicable diseases, targets, objectives, risk factors for PTM, and the implementation of Posbindu activities by cadres. The conclusion of this community service is the formation of PTM Posbindu in Plosobuden Village, Deket District. Besides. there was an increase in the knowledge and skills of cadres to carry out early detection of PTM risk factors such as measuring blood pressure, weighing weight, measuring height, calculating body mass index, conducting random blood sugar checks, measuring abdominal circumference and cadres were able to fill KMS FR-PTM , conduct counseling and referrals to first-level health facilities, as well as record and report the results of PTM Posbindu activities