At a WCC 2016 plenary session on 6 June, Professor Krisela Steyn from the University of Cape Town addressed the issue of health systems for NCD prevention in developing countries.
Professor Steyn indicated the challenges of creating an equitable food system in developing countries, where the main buyers of crops are multinational corporations which often flood the market with cheap unhealthy food, undermining food security and leading to health inequality. She noted the increase in overweight and obesity in South Africa, and that the more sugar children consume, the less protein they get. “Food security is not just about enough calories”, she stated. “The food system needs to allow the production of calories to be wholesome, affordable and accessible in foods with sufficient protein and micro-nutrients.”
Professor Steyn then went onto to describe the intergenerational cycle of malnutrition and poverty: low-birth-weight babies lead to an increased adulthood risk of NCDs and malnutrition, in turn leading to intergenerational poverty, maternal malnutrition and back to low-birth-weight babies.
She also commented on how the tobacco industry had started to target women in advertising campaigns, and showed a map of hypertension in Sub-Saharan Africa that demonstrated poor control of the condition across the continent.
Health systems for NCD prevention in developing countries
Professor Steyn called for:
• Total risk assessment
• A revitalization of primary health care
• Task-shifting / sharing among different health workers
• Evidence-based, site-appropriate clinical management manuals
• An understanding of what community health workers and technology (for example SMS-text patient adherence) can achieve
• Communication between health care professionals and patients with NCDs and their risk factors
Professor Steyn also highlighted the importance of patient-centred care, emphasizing that the patient has to change their lifestyle to adhere to manage NCDs, and stating that: “Patients in poverty have many competing survival needs.”