National Annual Review on prevention and control of NCDs

2022

Date: 2022/04/03

District : Matara

Name of the MO-NCD: Dr Sajeewa Kodithuwakku

1
 Basic details
Description of the District
Acute Chronic
District plan and financial allocation
NCD NCD
Extent of area - Square Km District NCD plan (2022) Yes No Yes No
1282.5 Amount allocated to NCD (Rs.) from District
budget (2022)
NCD Allocation as a proportion (%) of
Total District Population district budget (2022

866,488 Human resource, selected infrastructure and transport

facilities (2022)
Whether MO-NCD is  Permanent
permanent/temporary/covering (Mention original
Total number of functioning post if covering)
HLCs - 36 Development officer/MA Yes No
Vehicle assigned to MONCD Yes No
Computers/Laptops Yes No
Internet facilities Yes No
2
 Functioning HLCs
Type of Health Institution Number of Number of HLCs Number of
Health Functioning HLCs
Institutions

PGH  - -   -
DGH  02 02  01
BH  02 02  02
DH 16 16 16 
PMCU  18 17  17
MOH  17 - -
Total  55 36  36 3
Mapping of HLC, PHNO

4
Mapping of Lab Facilities

Lab Facilities
BH - Kamburupitiya
BH - Deniyaya
DH - Akuress
DH - Mawarala
DH - Weligama
DH - Dickwella
DH - Gangodagama
DH -Narawelpita
DH- Morawaka
DH- Urubokka
DH- Deiyandara
DH -Thalla 5
 Essential NCD Drugs Availability in the District
Drugs Availability
Adrenaline tartrate 0.1% Injection 1 ml Ampoule Yes
Yes
Aspirin Tablet 75mg

Yes
Atenolol Tablet 50mg

Yes
Atorvastatin Tablet 10mg and 20mg

Beclomethasone diproprionate – aerosol inhaler – 50mcg metered does,200 dose unit MDI 100 mg Available
Dry powder capsule for Breath induced device
Beclomethasone diproprionate 100mcg DP caps for Breath induced device Out of Stock
Beclomethasone diproprionate 200mcg DP caps for Breath induced device Yes
Out of Stock
Chlorpheniramine maleate (Chlorpheniramine) – injection 10mg in 1 ml Ampoule

Chlorpheniramine Tablet 4mg Yes

Enalapril maleate Tablet 5mg Low Stock
Fluoxetine 20mg Tablet Out of stock
Frusemide – Injection 20mg in 2ml Ampoule Yes
Frusemide Tablet 40mg Out Of Stock 6
 Essential NCD Drugs Availability in the District
Drugs Availability

Glielazide Tablet 40mg and 80mg Low Stock

Glyeeryl trinitrate Tablet 0.5mg sublingual

Yes

Yes
Hydrochlorothiazide Tablet 25mg

Hydrocortisone hemi succinate Injection 100mg Vial

Yes

Losartan Tablet 50mg Low Stock

Metformin Tablet 500mg Low Stock
Nifedipine Slow Release Tablet 20mg Out of Stock
Sal – respiratory solution 0.5% in 15ml vial Yes
Sal 100mcg aerosol inhaler MDI 200 dose unit Yes

Sal 200 mcg DP capsule Yes

T Slow Released tablet 125mg Low Stock
7
Riseperide 2mg Tablet Yes
 Shared Care Cluster System
Number of clusters
No. Apex Hospital Primary Care Institutes

1 BH- Kamburupitiya 11

2 BH- Deniyaya 7

3 DGH- Matara 15

8
 KAMBURUPITIYA CLUSTER
lab
DH Narawelpita 6.8 lab 12.3 Km
Km PMCU Hakmana

MOH-Hakmana MOH-Kamburupitiya
lab m
14.4 K
DH Gangodagama
BH
8.8 Km
Kamburupitiya
PMCU Makadura
MOH-Kirinda Puhulwella
15.4 Km
Km
5K
.6
20.5 Km m
15

PMCU-Kirinda Puhulwella
lab DH Ruhunugama

lab DH Akuressa
DH Deiyandara DH Mawarala

MOH-Mulatiyana PMCU-Maramba MOH-Athuraliya

MOH-Akuressa
 DENIYAYA CLUSTER
lab
lab
24.3 km 26.2 km

DH Morawaka
PMCU Rotumba

BH Deniyaya 31
m Km
lab 27 .7 k

14
8.3 Km Km
13.6 Km
PMCU Derangala

DH
Urubokka

PMCU PMCU
Pallegama Beralapanathara
PMCU Kotapola
 DGH MATARA CLUSTER
PMCU-
lab 19.7km lab Kirinda
DH Weligama 18Km
Puhulwella
DH Dickwella 19km 6.2Km PMCU-
lab
Thihagoda
10.4km
DH Thalalla 12.6Km PMCU-
lab
Yatiyana
DH Urugamuwa 20.2km
DGH Matara 15.5Km PMCU-
Thelijjawila
7.8km
16.3km
11.5km 6.7km
6.6km
14.2km
PMCU -Galbokka PMCU-Mirissa PMCU-Kekanadura
PMCU-Kapugama
PMCU-Devinuwara
22.2km PMCU-Denipitiya

PMCU -Midigama
 Best Practices
HR related activities Training related activities
• Physical Activity programmes at • Traning on New HLC Data base.
PMCUs. • Traning Programme on Clinical & self
• Mobile NCD Screning Clinics. breast examination.
• Health Education Programmes.

12
 Best Practices

Essential NCD medicines Essential laboratory investigations

13
HLC services

14
 Percentage of eligible participants ≥35 y screened, 2022
No 31,068 screened out of the target population 346,400
% of eligible participants screened out of the target population – 8.97%

Male=10,355 ( 6%) Female= 20,713 (12%)

% of Males screened out of Eligible Males % of females screened out of eligible females
Screened To be screened Screened To be screened

10%
6%

2.23%
% of males screened out of
94%
total eligible males
screened
90%
97.77%
15
 Percentage of eligible participants SCREENED, 2022 by HLC
45.00

40.11
40.00

35.00

30.00

25.82
25.00

20.07 19.52
20.00
17.45 17.01
15.95
14.71
15.00
13.02 12.73 13.05
12.17
11.75 11.83
10.22 10.72 11.34
10.00
8.17 11.51 9.04 9.13
7.70
6.17 5.47 5.71 5.26
5.00 4.08 4.72 4.29 4.12
2.11 2.46 2.21
2.33 0.98 0.89
0.00
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Overall District Information on screening activities
2022
Number Percentage

Oral examination
Breast examination (Females)
Identification of CVD risk 20% or more

• Referred for any condition -

Number Percentage

Medical clinic
Specialist clinic
WWC
Dental clinic

17
 Trends in Screening
3.50%

0.0318
3.00%

2.50%

2.07%
2.00% 1.85%
0.0186
1.50%

1.02% 1.00%
1.00%

0.50%
0.30% 0.36%
0.20%
0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021Q4 2022 Q1 2022 Q2 2022 Q3 2022Q4

18
RISK FACTORS

19
 Overall District Information on risk factors in 2022

Behavioral Risk Factors

Male Female Total

n % n % n %

Physical inactivity
1584 14.25 3206 14.43% 4790 14.37%

Tobacco
2567 23.09% 37 0.17% 2604 7.81%

Betel chewing(with or without 3236 29.11% 2278 10.26% 5514 16.54%

tobacco)
Alcohol consumption
3857 34.70% 20 0.09% 3877 11.63%

20
Overall District Information on risk factors in 2022

Intermediate risk factors

Male Female Total

n % n % n %

Overweight
2252 20.28% 5725 26.75% 7977 23.93%

Obesity
512 4.61% 2024 9.46% 2536 7.64%

High BP
3335 30.32% 6190 28.30% 39525 28.58%

High Blood Sugar

1447 13.42% 3040 14.08% 4487 13.46%

High total cholesterol

1292 12.31% 3206 15.39% 4498 13.49%

21
RISK FACTOR TRENDS

22
 Tobacco Smoking (Total) Trend
12.00%

10.24%
10.00% 9.50%
0.0859
8.11%
8.00%
7.24% 7.59% 0.0725
0.0715
6.27%
6.00%

4.00%

2.00%

0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022 Q4

23
 Tobacco Smoking (Males) Trend
30.00%
26.44% 26.59%
25.55%
25.00%
22.16% 22.25% 0.2179 0.2127
20.72% 19.88%
20.00%

15.00%

10.00%

5.00%

0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022Q4

24
Chewing betel (with tobacco or arecanut) Trend
30.00%

25.00% 24.26%

20.00%
19.76%
17.57% 0.1676
15.00% 13.95% 13.71% 0.1433
12.54% 12.91%
10.00%

5.00%

0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022 Q4

25
 Alcohol use (Total) Trend
18.00%

16.00% 15.64%
14.76%
0.1396
14.00%
12.63%
11.00% 0.1173
12.00% 0.1121
10.00%
9.82% 9.68%
8.00%

6.00%

4.00%

2.00%

0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022 Q4

26
 Alcohol use (Males) Trend
50.00%

45.00%
42.94% 42.16%
40.00%
38.41%
0.343 0.3447
35.00% 34.45%
32.46%
30.00% 29.61% 28.92%
25.00%

20.00%

15.00%

10.00%

5.00%

0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022 Q4

27
 Overweight Trend
30.00%
27.51%
25.61% 25.64% 25.85% 25.05%
25.00%
23.07% 0.2382 0.2373
22.56%
20.00%

15.00%

10.00%

5.00%

0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022Q4

28
 Obese Trend
10.00%
8.83%
9.00% 8.49%
7.98%
8.00% 7.64%
7.08% 0.0727 0.0713
7.00%
6.84% 6.85%
6.00%

5.00%

4.00%

3.00%

2.00%

1.00%

0.00%
1 2 3 4 5 6 7 8 9

2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022 Q4

29
 High Blood Pressure Trend
35.00%

29.96% 0.3011
30.00%
27.36% 27.06% 0.2802
25.00%
22.02% 21.09% 20.46%
20.00%
16.67%
15.00%

10.00%

5.00%

0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022 Q4

30
 High Blood Sugar Trend
16.00%

14.00% 13.12% 13.49%

12.00%

10.00% 9.61%
8.66% 0.087
7.97% 0.0747 0.0799
8.00%
6.58%
6.00%

4.00%

2.00%

0.00%
1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022 Q4

31
 High Cholesterol Trend
30.00%
28.00% 26.63%
26.00%
25.76%
24.00%
22.00%
21.70%
20.17% 19.41%
20.00% 17.97%
18.00%
16.00%
14.00% 13.27%
12.00% 0.1091
10.00% 0.087
8.00%
6.00%
4.00%
2.00%
0.00%
1 2 3 4 5 6 7 8 9

2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021Q4 2022 Q1 2022 Q2 2022 Q3 2022

Q4

32
 CVD risk >20% Trend
0.0372

3.12%

2.26% 2.26% 2.33%

1.85% 1.96% 0.0183
1.41%

1 2 3 4 5 6 7 8 9
2020 Q4 2021 Q1 2021 Q2 2021 Q3 2021 Q4 2022 Q1 2022 Q2 2022 Q3 2022 Q4
 Title of the intervention
• Problem addressed………………………………………….
…………………………………………………………………………..
• Objective of the intervention

……………………………………………..
• Date of commencement…………………………………
• Stakeholders involved
Health ………………………….
………………………….
…………………………..
Non- health ………………………….
……………………………..
…………………………….. 34
 Key problems identified
3 Main problems

1)Lack of gluco meter strips.

2) Lack of Male Participatance.

3)Lack of Awareness of NCDS.

35
 Planning the intervention
Activities planned Responsibility Timeframe

36
Implementation

37
Implementation

38
Implementation

39
 Current status of the intervention
• NCD screening Awareness Programs in state Sector.

40
Challenges faced in the process

41
42