NON COMMUNICABLE

DISEASES
Prevention & Control
Anne Jo M. Ruiz, MSN, RN
 Lifestyle Related Diseases (NCDs)

1. Cardiovascular Disease
2. Diabetes Mellitus
3. Cancer
4. Chronic Respiratory Disease
 Risk Factors

● Tobacco Use
● Unhealthy Diet
● Lack of Physical
Activity/Sedentary Lifestyle
● Alcohol Use
 Vision
A Philippines free from the avoidable burden of
NCDs
 Mission
Ensure sustainable health promoting environments and accessible, cost-
effective, comprehensive, equitable and quality health care services for the
prevention and control of NCDs, and guided by the principle of “Health in
All, Health by All, Health for All” whereas Health in All refers to Health in
All Policies, Health by All involves the whole-of-government and the whole-
of-society and the Health for All captures the KP (Kalusugan Pangkalahatan)
or the Universal Health Care (UHC).
 Objectives
1. To raise the priority accorded to the prevention and control of non-
communicable diseases in national, regional and local health and
development plans 
2. To strengthen leadership, governance, and multi-sectoral actions for the
prevention and control of non-communicable diseases
3. To reduce modifiable risk factors for non-communicable diseases and
underlying social determinants through creation of health-promoting
environments
 Objectives
4. To strengthen health systems and increase access to quality medicines,
products and services, especially at the primary health care level,
towards attainment of universal health coverage
5. To promote and support research and development for the prevention
and control of non-communicable diseases
6. To monitor the trends and determinants of non-communicable diseases
and evaluate progress in their prevention and control
 01
Prevention & Control
Approaches and Strategies
 Approaches

● Comprehensive approach focused on primary prevention

● Community based approach
● Integrated approach
 Strategies

● Establishing program direction and infrastructure

● Changing environments
● Changing lifestyle
● Reorienting health services
1. Raise priority accorded to NCDs through international cooperation and advocacy.
2. Strengthen national capacity, governance, multisectoral action, and partnerships.
3. Reduce the major modifiable risk factors, such as tobacco use, harmful use of alcohol,
unhealthy diets, and physical inactivity.
4. Develop and implement effective legal frameworks.
5. Orient health systems through people-centred health care and universal health coverage.
6. Promote high-quality research and development.
7. Monitor trends, determinants and progress to achieve global, regional and national
targets through evidence-based interventions.

(Western Pacific Regional Action Plan for the Prevention and Control of NCDs (2014-2020), the Global Action Plan for the
Prevention and Control of NCDs (2013-2020)
 02
Causation Pathway of Major
Non-communicable Diseases
 Common Risk
Factors Main Chronic
Intermediate Risk Diseases
• Unhealthy Diet
Factors • Heart Disease
Underlying • Physical
• Raised blood sugar • Cancer
Determinants Inactivity
• Raised blood • Stroke
• Globalization • Tobacco and
pressure • Chronic
• Urbanization Alcohol Use
• Abnormal blood Respiratory
• Population Aging • Age (non-
lipids Disease
modifiable)
• Overweight/obesity • Diabetes
• Heredity (non-
modifiable)
 03
Non-Communicable
Diseases
 Cardiovascular Diseases

1. Hypertension
2. Coronary Artery Disease
3. Cerebrovascular Disease or Stroke
 Cancer

Among Filipino men, the 6 most common sites of cancer

diagnosed in 2010 (Globocan) were lung, liver,
colon/rectum, prostate, stomach, and leukemia. Among
Filipino women the 6 most common sites diagnosed were
breast, cervix, lung, colon/rectum, ovary and liver.
 Diabetes Mellitus

1. Type 1
2. Type 2
 Chronic Obstructive Pulmonary
Disease

1. Chronic bronchitis
2. Emphysema
 Bronchial Asthma

Bronchial asthma, commonly known as asthma, is the generic

term for various chronic inflammatory diseases of the
respiratory tract, wheezing sounds when breathing, a dry
cough and instances of respiratory distress.
 04
Screening Guidelines
Hypertension
 Cholesterol
Repeat tests, take average of both tests

Repeats every 5 years Further tests (Lipid

profile & treatment)
Diabetes Mellitus
 Cancer

C Change in bowel or bladder habits

O Obvious change in wart or mole

A A sore that does not heal

N Nagging cough or hoarseness in voice

U Unusual bleeding or discharge

U Unexplained anemia

T Thickening or lump in the breast or elsewhere

S Sudden weight loss

I Indigestion and difficulty swallowing

Breast Cancer
• Dimpling or inflamation “peau de
orange”
• Nipple retraction

Early Detection:
• Breast self examination
• Mammography
Cervical Cancer
• Abnormal vaginal bleeding (post coital bleeding)

Early detection:
• Pap’s Smear
Colon Cancer
• Change in stool, rectal bleeding, abdominal pain

Early detection:
• Annual digital rectal examination starting at age 40
Prostate Cancer
• Symptoms of urethral outflow obstruction
• Urinary frequency, nocturia, post void dribbling

Early detection:
• Digital rectal examination
• Prostate Specific Antigen (PSA) determination
Lung Cancer
• Persons with long history of smoking, chronic cough or nagging
cough, history of weight loss

Early detection:
• Chest x—ray every 6mos.
• Sputum cytology
 COPD
• Cough
• Sputum production
• Dyspnea upon exertion
• Spirometry is done to determine
degree of obstruction
 Asthma
• The hallmark of asthma is
demonstration of reversibility of
airway obstruction
• Spirometry and Peak expiratory
flow rate (PEFR)
 05
Roles of Public Health
Nurse
1. Advisor
2. Provision of direct services
3. Facilitation of support groups
4. Health education
5. Distribution of medication
6. Rehabilitation services
7. Monitoring of clients
8. Linking clients with the health system
9. Capacity building (Peer Educator)
10. Administration
Assisting smokers to quit

ASK
ADVISE
ASSIST
ARRANGE
FOLLOW UP
Provide a smoke free
environment
 Stress Management Techniques
1. Excise your stressors.
2. Tweak your work environment.
3. Know when it’s time to replace rumination with a try-out. 
4. Take mini-breaks. 
5. Take micro-breaks. 
6. Nip anger well before you explode. 
7. Do stress-reducing recreations. 
8. Ritualize. 
9. Restrain rushing.
10. Try to live by The Serenity Prayer. 
11. Accept humankind's fallibility. 
12. Don’t look back. 
Thanks!