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Health

1. Health Problems Dr. Abdalnasir Mohammed Almagzop MBBS – MPH – MD of comm. Med. – MS.c of trop. med.

2. The problems are ranked according to their priorities or urgencies for allocation of resources. 2

3. Discuss how Economic , Political , Socio-Demographic and Geographical factors influence health services organization in Sudan? 3

4. 1. Economic factors: These factors affect the availability of fund/s for health services (i.e. financing), which include: Human resources : cadres training, recruitment and deployment,... Supplies : availability, adequacy, distribution,… Technology : quality, lack of recent technology,.. Information : data processing cycle 4

5. 2. Political factors: Political conflicts result in destruction of health services (availability & accessibility) Policy has effect on the equity in distribution of health services . Legislations, regulations and policy development have direct or indirect effect on health services delivery . 5

6. 3. Social factors: Norms and beliefs about certain diseases which affect health seeking behaviors and utilization of health services. Attitudes: health seeking behavior and compliance with medication may affect effectiveness and efficiency of health services. it depends on health awareness & education. 6

7. 4. Demographic factors: Increased population size lead to shortage of resources (budget, human resources,..) Displacement, migration: affect coverage, equity and accessibility to health services. 7

8. Geographic factors: Health services delivery will be affected by Difficulties of accessibility to the settings due to: Far distances Geographical barriers(rivers, mountains,..) Climatic changes( rains, floods,…) 8

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14. Health problems: The HEALTH PROBLEMS in general may be conveniently grouped under the following heads : Communicable disease problems Non-communicable disease problems Nutritional problems Environmental sanitation problems . Medical care problems Population problems . 14

15. Communicable disease problems: Communicable diseases continue to be a major problem in Sudan. Diseases considered to be of great importance today are : Malaria : Malaria continues to be a major health problem in Sudan. Tuberculosis. Diarrheal diseases. Acute respiratory tract diseases (ARI): are one of the major causes of mortality & morbidity in children below 5 years old of age. Meningitis. Kalazar . Viral hepatitis. AIDS. Others: Filariasis , enteric fever, helminthic diseases, Leprosy. 15

16. Non-communicable disease problems Definition : ( Any impairment of body structure and/or function that necessitates a modification of the patient’s normal life, and has persisted over an extended period of time ) (EURO symposium, 1957) 16

17. Other definition for NCDs: All impairment or deviation from normal which have one or more of the following characteristics : They may be permanent more than often. They Leave residual disability. Are caused by non reversible pathological changes. 17

18. NCDs Have complex and multiple causes. NCDs Usually have a gradual onset, although they can have sudden onset and acute stages. NCDs Require a long period of supervision, observation or care. 18

19. National status of NCDs: 47% of the total burden of disease in Sudan is due to non-communicable diseases and it is expected that this will rise to 60% by the year 2020. 19

20. Common NCDs in Sudan Include: Hypertension Diabetes mellitus Asthma Ischemic heart disease Cancers Renal disease Road traffic accidents (injuries) Mental health disorders These selected diseases accounted for 41% of all deaths in 2005. This was 143,000 from 346,000 total deaths 20

21. Health system for NCDs in Sudan To cope with current and future demand of non-communicable diseases the health sector must achieve significant and sustainable change. Sudan does not have a surveillance system for NCDs and NCDs risks, This is due to difficulties in the health information system and lack of research resulting from shortage of human and financial resources. 21

22. Nutritional problems: National situation: food security Types of nutritional disorders: Protein-energy malnutrition, Nutritional anemia, Low birth weight, Nutritional blindness (exophthalmia), Iodine deficiency disorders. West Darfur, Northern Bahr El Ghazal, Warap and Jonglei states are the most food insecure states since 40-60 % of households in these states are found to have poor food consumption. <20% households with poor food consumption in the rest of the states. 22

23. one-third (31 %) of children <5 years old were found to be moderately underweight. 9.4 %were severely underweight. one-third of children <5 (32.5 %) were moderately stunted. 15.2 % were severely stunted, or in other words chronically malnourished. 3.6 % of children were overweight. 23

24. National Status: Moderately Malnourished Children 0-59 months, Sudan 2006 . <10% 10-15 >15% 24

25. Environmental sanitation problem is multifaceted and multifactorial . Awakening which took place in england in 1840’s is yet to be born in some areas in Sudan. The problems of environmental sanitation are lack of safe water in many areas of the country and primitive methods of excreta disposal . International Situation: 2.5 billion people lack improved sanitation facilities. over 884 million people still use unsafe drinking water sources. 1.2 billion people ( f ifth of the world’s population ) practice open defecation. Environmental sanitation problems: 25