Strengthening public health capacity to respond to Myanmar s disease transition Dr. AYE MYA AUNG LECTURER UNIVERSITY OF PUBLIC HEALTH,YANGON
European Commission Project Four year project on Strengthening Public Health capacity to respond to Myanmar s disease transition (2015 to 2019) To enable Myanmar to fill research/ data/policy gaps Health research data and policy analysis are needed to address NCDs in Myanmar
Problem Identification Research gaps in NCDs Evidence based communication gap No prior research addressing the relationship between junk food consumption and childhood obesity Translation of research into PH programs and policies - insufficient Academic role in policy making limited &isolated Policy Gaps regarding NCDs context specific policy school setting No food and beverage policy - Influence school food environment - Students purchases of energy dense foods
Why it is a public health concern? estimated 170 million children - overweight globally prevalence - fastest in LMIC Double Burden: serious risk Myanmar obesity prevalence - 4.27% (M) 8.37% (F) Children and adolescents obese- 7.6% both sexes(ygn) 80% of obese adolescents - obese in adulthood High NCDs risk in adulthood huge morbidity/mortality burden
Death Rates for Non- Communicable Diseases in South East Asia (% of total death-2012) Country (SEA) 2008 2012 Change (2208-2012) Cambodia 47 52 +5 Brunei 82 81-1 Indonesia 63 71 +8 Laos 49 48-1 Malaysia 67 73 +6 Myanmar 40 59 +19 Philippines 62 67 5 Singapore 79 76-3 Thailand 71 71 0 Vietnam 75 74-1 Source WHO Non-communicable diseases country profiles,2014
Related past UPH research findings - Readymade junk food packets - most available food type in schools - Percentage of students eating junk food in both types of school investigated(monastic schools and Basic Education Primary Schools), (62.4%) and (72.9%) Planned research project to address NCDs Consumption of junk foods and obesity among the middle school children in selected schools of Yangon (A case-control study on consumption of junk foods among obese and non- obese middle school children)
Core aim To provide supportive finding in developing Healthy School Food Environment Policy in schools of Myanmar
Healthy School Food Environment Policy Areas -nutritional labelling -irresponsible marketing -Healthy food package -limitation of calories, trans fat, salt and sugar contents of junk foods in school environment Targeted Policy actions - Adopt traffic light food labelling system & inhibit selling red segment foods - prohibit irresponsible marketing of junk foods by giving away toys and other cheap incentives to children - availability of healthy set menu in school canteens - set national guidelines on nutritional contents of foods sold at school canteens (long run)
Strategic Directions Knowledge synthesis Conducting researches translational enough Evidence Academic government engagement Stakeholders awareness, involvement &collaboration Heighten advocacy efforts on Health Impact of junk foods, obesity and NCDs Disease burden, advices and guidelines Communication - Customize message - Anticipated health concerns of childhood obesity and NCDs burden Political Awareness Societal Awareness Decision Making
Policy Development Framework Communication Plan Address the problem Consultation with experts Develop draft policy Other Stakeholders -acceptability -degree of coercion -responsibility Knowledge Synthesis transfer translation Engagement Policy makers(ministerial level) - Inform strongest facts -Objectives of the policy -Intermediate outcome -Feasibility -Acceptability -Distribution of responsibility between diverse stakeholders -How it is synergized with existing program -Coerciveness (tolerated) -Advantages &limitations Built credible evidence - Researches - Literature Reviews (applicable context) Policy Derivatives
Who to engage? Government Union Ministerial level (Education,Health) Regional (Regional Government) Local(School Administrators) Related Departments( FDA, SH, National Nutrition Center, Municipalities, Regional Health Dept.) Consumers Others Students Parents/families/teachers/school staffs Food manufacturers, retailers, food vendors Interested groups( CSO,CBO, Politicians, Activists) Media
Endorsement Ministry of Health (Supportive) Traffic light food labelling system Initiatives Ministry of Education (Ownership) MOH MOE Technical assistance & guidance by FDA, National Nutrition Center Supervision by SH Team Incorporate into existing School Food Safety Program launched by Dept. of FDA Setting policy derivative to establish traffic light food labelling system in schools, work closely with MOH Organize school canteen administrative and supervisory committee for implementation of the policy and sustainability
THANK YOU THANK YOU This project is funded by European Union