| Rokiah Mahmud |
THERE is an increase in physical activities among adults in Brunei and this is a positive indicator in the nation’s fight against non-communicable diseases (NCDs).
Based on health research findings conducted in the country, the percentage of lack of physical activity in adults has decreased from 36 per cent to 25 per cent.
The Minister of Health YB Dato Paduka Dr Haji Mohd Isham bin Jaafar said this responding to Legislative Council (LegCo) member YB Nik Hafimi binti Abdul Haadii.
She wanted to know the challenges or obstacles faced by the country in its fight against NCDs.
The minister also noted that Brunei is at a positive level in fighting NCDs based on recommended steps set by the World Health Organization (WHO).
Despite these positive indicators, he said the Ministry of Health (MoH) continues to implement other efforts and initiatives to address NCDs.
This is in line with the Brunei Darussalam National Multisectoral Action Plan for the Prevention and Control of Non-communicable Diseases (BruMAP-NCD) 2013-2018.
The minister noted that practical measures are the ‘best buy’ approach to fight NCDs.
These measures have been tested and proven to be effective and demonstrate satisfactory results in the prevention and control of NCDs.
Recreational activities such as ‘Bandarku Ceria’ and ‘Healthy Mukim’ have been able to nurture positive attitudes and awareness towards encouraging the people to be physically active.
Meanwhile, the prevalence rate of obesity and smoking (tobacco usage) in Brunei is at a stable level over the past five years without any significant increase.
This fulfils the global NCD’s target of ‘no increase in percentage for diabetes and obesity’.
Another global NCD’s target through ‘Agenda 2030 Sustainable Development Goals’ is to achieve positive health and wellbeing for the public.
This is done by reducing premature deaths due to NCDs among people aged 30-70.
In Brunei, the primary risk of premature death from the NCDs was 17 per cent in 2009 (for citizens and permanent residents) and 14 per cent in 2016.
In addition, apart from being measured by global NCD’s targets, it is equally important for the health sector to monitor the implementation of progress indicators.
This is to ensure that our fight against non-communicable diseases is progressing positively within the specified time frame.
Currently, Brunei has successfully implemented (fully or partially) nine out of 10 progress indicators to prevent and control NCDs according to a report from ‘WHO NCD Progress Monitor Report 2017’.
This includes establishing NCD SMART targets, having the proper NCD mortality database, carrying out NCD risk factor surveys, establishing a national NCD multisectoral action plan, implementing major measures of reducing smoking and alcohol consumption, reducing unhealthy eating habits, increasing physical activities, and establishing clinical management guidelines for NCDs and medical facilities for risky groups.
According to ‘WHO NCD Progress Monitor Report 2017’, Brunei is among the regional countries that have achieved the highest achievement.
With this new information and data, the minister hoped that there is actually no decline in the effectiveness of our efforts in suppressing the NCDs.
However, there are some challenges and the MoH has taken action to counter them.
The Government of His Majesty Sultan Haji Hassanal Bolkiah Mu’izzaddin Waddaulah ibni Al-Marhum Sultan Haji Omar ‘Ali Saifuddien Sa’adul Khairi Waddien, Sultan and Yang Di-Pertuan of Brunei Darussalam practises ‘Health in All Policies’ where the prevention and control of NCDs is a priority.
“In addressing the challenges of NCDs, we need to look into two corners, namely, clinical and non-clinical issues,” the minister said.
The first clinical issue involves the ministry’s effort to improve healthcare for NCD patients.
The MoH has spent $28 million out of the $46 million from the allocated budget 2016/2017 to purchase medicines for NCDs, which is estimated to be about 60 per cent of total medication expenses.
This expense is expected to increase if there are more patients with other NCDs such as high blood pressure, diabetes and heart disease. This means that the patients will need a variety of medicines (polypharmacy).
The second clinical issue involves the non-compliance of NCD patients in consuming medicines that have been prescribed to them.
Based on findings by the ministry, the total cost of medicines returned by patients to pharmacies across the country in 2017 was $281,799.01.
This showed that some NCD patients do not take their medications as directed.
A patient’s compliance with the medical treatment is likely to be related to the individual’s health literacy status.
Patients who are aware of their health risks will comply to proper medication as instructed by the medical officer.
On another note, to treat all NCD patients the MoH needs to increase its staff, which include local and foreign medical specialists.
The government has spent a huge amount of money to educate the people about NCDs – in hospitals, health clinics, schools, government and private offices, and villages.
In the field of non-clinical issues, the challenges include overcoming and changing the behaviours and mindsets of the people.
They must be prepared to make the tough but right choices on nutrition and healthy lifestyle.
Once their choice is made, their decision will influence those around them – their children, families, friends and communities.