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The Interphase of Agriculture,
Education and Health in addressing
NCDs in CARICOM States
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Brief overview
• Structure of health system
• Some challenges
• Burden of disease
• Determinants of health
• Involvement of external partners to achieve desired health
outcomes
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St. Kitts & Nevis
• Located in the NE Caribbean, leeward islands
• Independent twin Island Federation
• 104 sq. miles
• Population just over 50,000
• Per capita GDP $15,573
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Structure Health system
• Office of policy development and information
Management
• Community based Health Services. (16 health centers)
• Institution Based health Services (4 hospitals and a
geriatric home
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Health Indicators • Life expectancy 75 years
• Infant mortality=11.3%
• Maternal Mortality=3 deaths (06-10)
• Crude birth rate= 13.2 per 1000 pop
• Crude death rate=6.8 per 1000 pop
• Fertility rate= decline 2.3-1.85
• Access to clean water= over 99% pop
• EPI= over 95% in all vaccines
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Some challenges
• Renewal of our primary health system to
meet demands of shifting epidemiological
profile
• Diseases of under Nutrition, communicable,
diseases associated with poor sanitation,
poor hygiene
• And now, Over nutrition and the NCD
burden
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Burden of Chronic Diseases
• They are the leading causes of morbidity and mortality in
SKN
• 2008 steps study revealed the following
• Over weight-33.5% Obesity-45% in adult pop
• Diabetes=20% adult pop
• Hypertension=34.5% adult pop
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Financial Burden
• 6% GDP Health Expenditure (NHA 2013)
• Majority of which gobbled up by the treatment and
prevention of NCDs
• Stroke, heart disease some cancers
• New and emerging diseases ( ADHD, H1N1)
• Chronic Kidney Disease (CKD)
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Determinants of Health
• Social and economic environment
• Physical environment
• Persons individual characteristics and behaviors (life
style choices)
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Critical Challenge
Many factors combine together to affect the health of
individuals and communities. Whether people are healthy
or not, is determined by their circumstances and
environment. To a large extent, factors such as where we
live, the state of our environment, genetics, our income
and education level, and our relationships with friends and
family all have considerable impacts on health, whereas
the more commonly considered factors such as access
and use of health care services often have less of an
impact.
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Important Interphase
• Looking outside of health systems for solutions
• Inclusive participatory approach to understanding
complex health issues and finding common solutions.
• Health, Agriculture and Education
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Land Mark Achievements
• In the earlier days the focus was on a whole of society
approach that advocated the inclusion and prioritization of
NCDs on the development agenda at various high level
meetings.
• This was accomplished in the UN high level meeting on
NCDs
• 2007 Port of Spain declaration
• Inextricable link between health and economic
development
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Present NCD trends are evolving
• Prevention and control now trending towards the life
course approach.
• We are now looking at the youth where its easier to
influence life style change.
• Safe guarding the health of our youth for a brighter
Caribbean future
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Early Intervention in Primary schools in
keeping with current trends
• Improving quality of school meals
• Menu Modification, changing unhealthy diets
• Lifestyle changes and choices through education
• More physical activity
• Education on tobacco use
• Obesity and harmful use of alcohol
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Building and testing farm to fork model
• Improve Nutrition and Health outcomes in CARICOM
through available intake of local fresh fruits and
Vegetables
• Decrease caloric Intake and increase micronutrients
• Reduce incidents of Preventable NCDs, through renewed
commitment to primary health care through early
intervention programs such as the CARICOM food
security project.
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Future
• Increased Financial sustainability of our fragile health
systems as the burden of disease as it relates to NCDs
would be lessened
• Over the years a reversal of the threat to economic
development posed by unchecked NCDs
• Healthier adult population leading to enhanced quality of
life to accompany longevity.
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Education
• More informed students as it relates to Healthier choices
• Smarter Students due to infusion of healthy micronutrients
in modified school meal menus
• More favorable anthropometric measurements in school
kids (BMI)
• More physically active students, based on accompanying
education.
• A brighter future for our kids
• Generation of more data to inform policy makers
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Agriculture
• Farmers with a ready market for their produce
• More locally grown fresh fruit and vegetables
• Increased food security
• More diversity in crops, increased yields in string beans,
pumpkin, watermelon, tomatoes
• The all essential increased technology, i.e. Genetic
engineering, green houses, drip irrigation, etc.
• A more successful transition from Sugar production
adding more diversity to our agricultural product.
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And so This Farm to Fork
approach is virtually a win
win situation for all!
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Gracias
Thank you!