Building healthy communities and populations
This theme encompasses the following focuses and activities, carried out in the Pacific island countries and areas.
Pacific Island Countries face increasing challenges with respect to safe food and drinking water, clean air and safe human working and living environments. The special circumstances of the Pacific Islands make safe disposal of wastes and protection of communities from pollution essential. Fragile water resources are increasingly tapped to serve the needs of growing populations and industry, including the fast-growing demands of tourism. Where water is consumed wastewater is also generated. If not properly treated, wastewater discharges threaten precious water resources and ocean reefs that sustain both villages and tourism. Solid wastes – including harmful chemicals and health care wastes – also pose challenges for island nations with limited land and few disposal options.
Access to sufficient, nutritionally adequate and safe food is a basic human right. This right, however, is threatened by foodborne disease and food contamination, two growing public health concerns in the Pacific. Additionally, micronutrient deficiencies and non-communicable diseases continue to have extensive public health, social and economic consequences for people in the Pacific. The programme on food safety aims at assisting Pacific Island Countries in strengthening their national food control systems which are essential to protect the health of consumers, prevent fraud, avoid food adulteration and facilitate trade in safe and healthy food. The assistance includes technical support and capacity building for countries to develop and enforce food safety measures based on risk analysis.
The Health Promotion Programme aims to make healthy choices easy, early and exciting, everywhere by promoting health and well being among individuals, communities and populations, enabling them to address the broad determinants of health in order to reduce the vulnerability and risks to ill health and disability throughout the life cycle, especially among poor and marginalized groups. Objectives: 1. To promote health in the settings where people live, work, learn and play; 2. To prevent risks associated with age-specific development stages throughout the life course; 3. To enable individuals and communities to modify risks caused by unhealthy lifestyle, behaviour and the environment; 4. To reduce vulnerability of groups that are marginalized due to gender, ethnicity, age and socio-economic.
Since the Ottawa Chart development in 1986, movements of healthy settings had continued across the globe as the focus is shifted to empowering populations to take ownership of their own health and its determinants. In 1995 when the first Ministers of Health meeting was organized by WHO, there was a unified vision coined ‘Healthy Islands’ which was defined as places where children are nurtured in body and mind, environments invite learning and leisure, people work and age with dignity; and ecological balance is a source of pride. This formed the cornerstone of work in Healthy Settings for the Pacific as each country developed strategies for the realization of the vision.
Mental Health refers to a broad array of activities directly or indirectly related to the mental well-being component included in the WHO's definition of health: "A state of complete physical, mental and social well-being, and not merely the absence of disease". It is related to the promotion of well-being, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorders. Mental and neurological disorders such as depression, schizophrenia, epilepsy and substance abuse, among others, cause immense suffering for those affected, amplifies people's vulnerability and can lead individuals into a life of poverty. Despite the availability of cost-effective treatments, people have limited access to the treatment they need and are denied basic life opportunities given to other citizens. In the sub-region of the Pacific, completed suicide numbers range from 2-3 in small countries to 100 plus in bigger ones. Worldwide mental and behavioural disorders represented 11% of the total disease burden in 1990. In 2001 it was estimated that there were 340 million people with depression, 49 million with schizophrenia and 29 million with dementia. It accounted for 12% of Global Burden of Disease and this is predicted to increase to 15% by 2020. Depression was the fourth largest contributor to the disease burden in 1990 and is expected to be the second largest after ischaemic heart disease (heart attack) by 2020. Five of the ten leading causes of disability (depression, schizophrenia, bipolar disorders, alcohol use and obsessive compulsive disorders) are mental disorders.
The Making Pregnancy Safer is a Millennium Development Goal 5, which aims to improve maternal health. The maternal mortality ratio and the proportion of births attended by skilled health personnel are the two indicators used to monitor progress towards achievement of the MDG 5. It is the right of every mother and newborn child to survive pregnancy and childbirth. The maternal mortality ratio reflects women’s basic status, access to health care and the quality of care that has been provided. In the Western Pacific Region, every year there are 40 to 50 million pregnancies with 30,500 to 50,000 maternal deaths and majority are in the Asian Pacific regions. Measuring maternal mortality accurately is difficult in the South Pacific region in view of limited knowledge and technology. Most of the countries in the South Pacific encouraged skilled birth attendant at every birth and after care, though in some areas Traditional Birth Attendants are trained to be able to do safe delivery, identify their roles, refer promptly in cases of emergencies.
This programme aims to reduce morbidity, disability and premature mortality resulting from non-communicable diseases and to improve the quality of life of people with NCD through the development of comprehensive prevention and control programmes and strengthened surveillance and management of NCDs. Objectives: • to prevent or delay the onset and progress of NCD, slow down or reverse the increasing risk factors, and improve unhealthy environments; • to reduce prevalence of NCD and premature mortality, morbidity, prevalence, and disability associated with NCD; • to improve the quality of life of people with NCD
Tobacco Free Pacific 2025
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke. At the Tenth Pacific Ministers of Health Meeting in Apia in July 2013, the Ministers of Health as part of continuing effort to resolve the NCD crisis, adopted a Tobacco Free Pacific target (<5% adult tobacco use) for each Pacific Island country and territory to achieve by 2025.
Nutrition and physical activity
With the increase in noncommunicable diseases (NCD) in the Pacific such as obesity and diabetes there is an urgent need to address two of the main risk factors which are unhealthy diet and physical inactivity. In some Pacific island countries there are still high prevalence of undernutrition in the form of protein-energy malnutrition and micronutrient deficiency coexisting with obesity to form what is known as double burden of nutrition in the same region, country or community. To address these issues WHO developed the Global Strategy on Diet, Physical Activity and Health (DPAS) which was endorsed by member states in 2004. As part of its implementation in the pacific, promotion of healthy diet and increase of physical activity is done through multi-faceted programmes in settings of school, workplace and communities with supportive policies and advocacy at national level involving the multiple stakeholders.