UAE HEALTH PROMOTION STRATEGIC PLAN 2019-2023 Prepared By: ID number: Foundation of public health and health promotion Under supervision of: 2019/2020 1 References References ....................................................................................................................................... 2 1. Background ................................................................................................................................. 4 1.1 Introduction ........................................................................................................................... 4 1.2 Current health situation in the UAE ...................................................................................... 5 1.3 Vision & Mission .................................................................................................................. 6 1.3.1 Vision.............................................................................................................................. 6 1.3.2 Mission ........................................................................................................................... 6 1.4 Goals and Objectives ............................................................................................................. 7 1.5 Scope ..................................................................................................................................... 7 1.6 Time frame ............................................................................................................................ 8 2. Guiding principles for health promotion..................................................................................... 8 3. Health promotion plan ................................................................................................................ 9 3.1 Framework for developing the health promotion plan .......................................................... 9 3.2 Potential partners ................................................................................................................. 10 3.3 Priority strategic areas ......................................................................................................... 10 3.3.1 Health first .................................................................................................................... 11 2 3.3.2 Promoting cardiovascular health by encouraging healthy practices and avoiding harmful habits and enhancing the overall decision making process ..................................... 12 3.3.3 Building capacity .......................................................................................................... 14 3.3.4 Healthy settings ............................................................................................................ 16 3. Monitoring indicators................................................................................................................ 19 4. References ................................................................................................................................. 23 3 1. Background 1.1 Introduction In recent years, there was an undeniable dominance of cardiovascular diseases (CVDs) as the leading cause of death around the world. In fact, back in 2005 the registered number of fatalities due to Cardio Vascular Diseases was 17.5 million, an astonishing increase from 14.4 million registered back in 1990, taking into account all the technological and medical related advancement that has been made ever since. In addition to that, the world health organization (WHO) estimated that 30% of the annual, global fatalities each year are attributed to CVDs. CVDs are group of defects of the heart and the blood vessels and it includes; coronary heart diseases (defects affecting blood vessels that supplies the heart), Cerebrovascular disease (defects affecting the blood vessels that supplies the brain), heart attack and rheumatic heart disease among other multiple conditions. The origin of CVDs is multifactorial as; age, sex, smoking, high blood pressure, high cholesterol, diabetes have all been shown to contribute in escalating the CVDs. However, four out of each five deaths resulted from CVDs are caused by heart attacks and strokes, and almost one third of these deaths occur prematurely (in people below 70 years old). 4 Heart attack is an acute event mainly caused by an obstruction that is preventing blood from flowing freely to and from the heart. The simplest explanation for this to happen is the accumulation of a substance (example fatty tissues can be nicotine as well) inside the inner walls of the major blood vessels that supply the heart to the point that it caused a complete blockage. Common symptoms of heart attack include but not limited to; pain in the center of the chest, sweating, breathing difficulty, light headedness and fainting to name a few. The most important behavioral risk factors of heart attacks are; unhealthy diet, lack of physical activity, the consumption of tobacco based products, in addition to that, the usages of alcohol can equally be devastating. The effects of these risk factors may materialize as; high blood pressure, high blood glucose, high blood cholesterol, as well as overweight and obesity. 1.2 Current health situation in the UAE Since 1970, the United Arab Emirates has experienced a tremendous transformation, in order for it to reach the place that it’s currently occupies among the world best countries in terms of quality of life. However, this drastic transformation has increased the risk factors associated with CVDs in general and more specifically heart attacks, as obesity, smoking, hypertension and diabetes among other, are all a well-known contributor to UAE inhabitants suffering and 5 dying from heart attacks. Furthermore, the leading cause of death in the UAE are CVDs. Moreover, a study published by “Emirates cardiac society” stated that people in the UAE die of heart attack 20 years younger than the rest of the world, (average of 45 years old, compared to the rest of the world 65 years old). On the other hand, a study published by “Abu Dhabi health service” (SEHA) stated that 80% of the country’s population are in fact overweight, with 30% of them can be considered obese. In addition to that, one in three Emirati have hypertension, more than two hundred thousand Emirati have diabetes, and all of the previously mentioned factors have been shown to be a high risk factors associated with suffering and dying from heart attacks. 1.3 Vision & Mission 1.3.1 Vision Healthier hearts for all UAE residents 1.3.2 Mission To enhance the decision making ability of all UAE residents and enable them to make healthy choices that will lead to reduction in mortalities resulted from heart attack and ultimately eliminate them. 6 1.4 Goals and Objectives - Reduce the public exposure to major risk factors like tobacco usages, unhealthy diet, and lack of exercises. - Enhance inter agency cooperation’s in an attempt to address all the social and economic factors that plays a role in people suffering from heart attacks. - Reduce the mortality caused by heart attacks. - Reduce the risk of heart attacks. - Encourage prevention of heart attacks. - Increase involvement of all sectors as well as all members of the society in promoting awareness about heart attack. 1.5 Scope A heart attack is preventable, although current evidence suggests that of all CVDs, heart attack register the largest contribution in terms of mortality than any other type of CVDs. However, reducing the exposure to the escalating factors of the disease such as: tobacco usages, unhealthy diet and physical inactivity can reduce the mortality resulted from it. 7 1.6 Time frame The plan will be implemented over the course of 4 years (2019-2023). 2. Guiding principles for health promotion The commitment to reduce cardio vascular diseases epidemic in the UAE requires a long term and sustainable plan, one that not only engage all member of the society but also make sure that each stake holder are completely invested in making the plan work. The following are guiding principles for UAE health promotion plan: - Health promotion is the responsibility of all individuals, private organizations and government agencies. - Local community and individual’s engagement are crucial to the successful implementations of the plan. - Address all underlying factors and determinants that contribute to heart attack and the bad habits that the general public may unknowingly be doing and that lead to them suffering from heart attack. - Maintain the transparency and have a multiple lines of open communications and listen to what people have to say 8 3. Health promotion plan Health promotion is the process of empowering people in order to enabling them to improve their general health and increase their control over it. In other words, make the necessary adjustments to improve the quality of the society’s health. The following provide an overall view of UAE health promotion strategic plan for 2019-2023. An annual budget as well as four years action plan and evaluation plan will be developed to ensure that the strategic goals are being met. 3.1 Framework for developing the health promotion plan The three most important roles of public health includes but not limited to: assessment, policy development and assurance. Assessment refers to the monitoring activities of the overall health status and needs of the country in order to detect any patterns. After that, policy development work towards developing the necessary policies in response to the current status and the country’s needs. And finally the assurance refer to the country’s effort to providing the highest standards of health services to all members of the society by a well trained staff and well equipped medical organizations. 9 3.2 Potential partners In order to achieve success in the plan implementations, it requires cooperation’s of all concerned parties. However, the UAE health agencies will be the cornerstone for fulfilling the core objects of our plan, nevertheless, the roles and responsibilities of private and voluntary organizations and individuals are also very important and crucial to the success of our plan. Potential partners include but not limited to: - Privately owned health organizations (such as clinics) that is owned by non-governmental entities. - Non-health sector partners (representors from various areas such as education, agriculture & food Production Company, media, etc.) - The general public and representative of specific group or settings. 3.3 Priority strategic areas The strategic framework for UAE health promotion plan to reduce morbidity and mortality from cardio vascular disease and especially heart attack 2019-2023 contains the following elements: - Health First 10 - Promoting cardiovascular health by encouraging healthy practices and avoiding harmful habits and enhancing the overall decision making process. - Building capacity - Healthy settings (educational institutions) 3.3.1 Health first It’s a holistic approach to all public policies across all sectors, which always give the utmost priority to health consequence of the decision above everything else, and always try to avoid any potential harmful practices that may jeopardize the health of the population. This approach usually shaped by social, economic, physical and environmental practices. Although, the ministry of health in the UAE are the responsible entity for legislating and organizing these practices. Nevertheless, it’s absolutely necessary to engage all other governmental entities as well as private sector organization in the decision making process. To ensure that these practices become within the core practices of all sectors and allocate the necessary resources to ensure successful implementations of such practices. 3.3.1.1 Proposed actions - Identify and seize any opportunity that presents itself to enhance any and all health policies in all sectors. 11 - Establish and maintain open line of communications between all agencies to ensure swift compliance with the new policies - Generate evidence that support the claim on the impact and effectiveness of health first policies in order to get everybody invested. 3.3.1.2 Target population The entire community of the United Arab Emirates 3.3.1.3 Partners All public sectors and private sectors health organizations 3.3.2 Promoting cardiovascular health by encouraging healthy practices and avoiding harmful habits and enhancing the overall decision making process Reduce the level of exposure of the general populations to the factors that is associated with CVDs like tobacco product consumption, unhealthy diet and lack of physical activities. Meanwhile, encourage the general population to take and make smarter and healthier decisions when it comes to their lifestyle choices. 12 3.3.2.1 Proposed actions 3.3.2.1.1 Tobacco control - Offer help to people who want to stop using tobacco products - Warn people about the danger of tobacco products - Raise tobacco products prices and taxes - Raise the insurance fees for smokers 3.3.2.1.2 Promote healthy diet - Enforce food establishments like restaurants to cut down the usages of salt in their meals preparations. - Eliminate the use of trans fat altogether and replace it with healthy fat like olive oil - Provide accurate and detailed information for consumers to educate them on decision making when choosing and preparing their food at home. 3.3.2.1.3 Promote physical activity - Encourage sport day once a month in all organizations. - Organize a nationwide weight losing competition to encourage people to become physically active. 13 - Encourage sporting events that the entire family can take part participating in. - Support and enhance the quality of sports programs at school and other educational settings 3.3.2.2 Target population The general population of the United Arab Emirates 3.3.2.3 Partners All public sectors and private sectors related entities such as food industry, sports clubs, etc. 3.3.3 Building capacity There must be additional focus on developing sustainable skills, organizational structures, resources and overall general commitment to health improvement in all related sectors. With main focus on the following key areas: Health infrastructure like hospitals and other well-being organizations. Regular training programs for staff (like nurses) Self-sustainable programs. Enhance Problem solving ability and decision making process of the organization 14 3.3.3.1 Proposed action Implement the culture of partnership, collaboration, and multi-sectoral actions towards healthy settings and approaches. Enable all entities and organizations at all levels to implement the United Arab Emirates Health Promotion Strategic plan to reduce morbidity and mortality from CVDs. Allocate the necessary resources to enable the successful implementations of the plan for all organizations Provide the right amount of supervision on the implementations of the plan in these organizations. 3.3.3.2 Target population All the public, private and semi-governmental organizations that is related to the health sector in anyway. 3.3.3.3 Partners All public sectors and private sectors and semi-governmental entities that choose to implement the health promotional plan 15 3.3.4 Healthy settings The healthy settings approach is one of the most important aspects of any health promotional plan. As it enable people to improve their work environment, living, playing and learning environment while at the same time enable them to make healthier choices. In our plan we are targeting the following settings: health promoting schools, health promoting hospitals, and healthy cities/towns/villages/workplaces. 3.3.4.1 Health promoting schools Schools can play a major role in improving Cardio Vascular health awareness and practices. However, current setting needs adjustments in order to achieve the desired outcome. In fact, Studies have shown that receiving health education from a very young age encourages children to adopt healthy behaviors from a very young age and then they will grow up with that life style, and even allow them to monitor their family and friend and suggest adjustments for their respected lifestyles. 3.3.4.1.1 Proposed actions Implement the health promotion plan in schools and other educational institutions. 16 Create a safe and supportive environment to allow the students and the staff to maintain healthy habits, (eating healthy food, being physically active) from a very young age Allow schools to have a health open day where the entire families of the students can participate in. 3.3.4.1.2 Target population All the students from all ages and the entire staff that work in schools 3.3.4.1.3 Partners The entire educational sector (schools, institutions, universities, etc.). 3.3.4.2 Health promoting hospitals It’s a new approach that represents a shift from hospitals image as health service providers that usually providing treatments for patients. It’s a revolutionary restructure of the entire organization. It’s a known fact that patient are more highly to response positively when provided health advice while they are experiencing illhealth. Thus, hospitals can have a lasting influence on the behavior of patients, more than just present them with the cure. 3.3.4.2.1 Proposed actions Implement this setting on all health care providers in the entire UAE 17 3.3.4.2.2 Target population The entire population that receives treatment in any medical establishment within the UAE 3.3.4.2.2 Partners All health care provider facilities and establishment anywhere in the UAE 3.3.4.3 Healthy cities/towns/villages/workplaces It’s a simple approach based on the assumption approach based on the assumption that everything within a community is connected and therefore in order to achieve the optimum result of your plan you have to form a network where everybody involved, where everybody contribute from its position. For example; in order For a city to be considered as a health city, the focus needs to be on taking care of all aspects that is related to people’s health, guaranteeing livability now and into the future through creating healthy and sustainable environments through planting trees, and ensuring healthy communities by making sure that everybody fully understand and committed to the cause which is living healthy at large. A healthy city is an ongoing work where you need to plan, execute, evaluate and then correct. 3.3.4.3.1 Proposed actions Start from small communities scale to reach city wide initiative 18 Organize city wide events where neighborhood competes against each other in sports, healthy eating and quitting smoking all of which contributes to healthier hearts. 3.3.4.3.2 Target population The entire UAE population 3.3.4.3.2 Partners Every member of the community from any age group 3. Monitoring indicators To ensure the sustainability of this health promotion plan and assure the long term success of this program, there is a need for constant review, evaluation and adjustments of the different aspects of the plan. For example we need to take into account the demographic shift toward an increasingly aging society that will only going to require more health services, therefore we need to make our plan dynamic and easily subjected to any necessary adjustment or modifications. For this and other reasons, it’s highly important to implement an evaluation process alongside the health promotional plan; any successful plan must include the following elements: 19 Comprehensive yet SMART (Specific, Measurable, Achievable, Realistic, and Time Bond) logical model of which will serve as the basis of all plan related evaluation. For this tool it is required to build a logical, sustainable and SMART model for which the success of the plan will be ultimately judged upon (at the end of the period). The model will demonstrate an ideal setting, one where the four elements of the plan have been successfully and effectively implemented and the expected results of that successfully implementation on the society as a whole. At the end of the proposed period (the four years) there will be an evaluation campaign that will compare the successful implementation of each element of the plan against the model, this model will give us a chance to judge the element separately and as a whole, as well as highlight the element that is lacking and suggest a way to enhance it in order to achieve the successful implementation of the plan as a whole, as well as allow us the chance to build on this plan in the future. Short-term. Mid-term and long-term evaluations criteria’s. For this tool we are require to set criteria’s and time frame to evaluate the successful implementation of the plan short, medium and long terms. For short 20 term evaluation (within the first 6 months of the plan initial implementation) we will rely on the public perception of the plan and the degree of their responsiveness and cooperation’s as the measuring criteria of the success of the plan in the short term. For mid-term evaluation of the plan (after 2 years of the plan implementation) we will rely on the degree of the general public change in behaviors (including physical activity in their daily routine) and smarter decision making (reduce salt and sugar intake in their daily diet) as the measuring criteria of the success of the plan in the mid-term. As for the long term (at the end of the plan proposed time frame) we will rely on reaching the overall targets and change in status and statistics that is related to reduce the number of people suffering from CVDs in the UAE and especially heart attacks as the measuring criteria of the success of the plan in the long term. Key indicators and data system In order to measure this tool, the first step is to identify the plan goals and objectives (reduce the CVDs in UAE and especially heart attack for example), then define indicators for tracking progress towards achieving those goals (Number of trainings held with health providers, Percent of youth reached with CVDs risk and management messages through the different media outlets). After that it is time to decide on methods for gathering data and how 21 often various data will be recorded to track indicator (surveys & in-depth interviews). Once the data have been collected, someone will need to compile and analyze it to fill in a results table for internal review and external reporting (specialized committee) Procedure for evaluation For this tool it is required to develop an evaluation plan which consist of the following elements - Clarify the plan objectives and goals so that it’s clear for all stakeholders, the authorities and the general public. - Developing evaluation survey so that the general public can answer and the data collected of such survey can be analyzed and interpreted and be used as feedback from the public on the plan. - Setting up a timeline for all evaluation activities. 22 4. References GOSA. (2011). The South Australian approach to Health in All Policies: Background and practical guide. H t t p: / / w w w. s a h e a l t h . s a . g o v. a u / w p s / w c m / c o n n e c t /cb6fa18043aece9fb510fded1a914d95/HiAPBackgroundPracticalGuide-v2. pdf?MOD=AJPERES&CACHEID=cb6fa18043aece9fb510fded1a914d95. 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