Analytical summary - Risk factors for health
The rapid economic transformation of Ethiopia has increasingly been accompanied by changes in dietary and lifestyle behaviour that are contributing to a rising risk of preventable chronic illness. These chronic diseases risk factors include high blood pressure, inadequate intake of fruit and vegetables, overweight or obesity, high concentrations of cholesterol in the blood, physical inactivity and tobacco use.
The leading causes of the major noncommunicable diseases are unhealthy diet and physical inactivity. In the WHO African Region, noncommunicable diseases are projected to account for more than a quarter of all deaths by 2015. It is also estimated that the rate of increase of deaths from chronic diseases in the Region will exceed that from infectious disease, maternal and prenatal conditions, and nutritional deficiencies by more than fourfold in the next 10 years.
The burden on health care due to chronic diseases will therefore be substantial, given the chronic nature of the diseases and the need for long-term and often lifelong treatment. Despite this, there is a lack of a strategy for prevention and control of chronic diseases, for example:
- there is very little research or data on chronic diseases and their risk factors
- poor health management information systems and vital registration systems obscure the disease burden
- there is a lack of comprehensive management of chronic diseases at the health facility or community level
- there is no dedicated unit responsible for chronic diseases at the national or regional level.
In cognizance of these facts, there are currently some promising efforts being undertaken in Ethiopia, such as:
- the development of a national strategy framework
- establishment of a committed and functional national technical working group
- the Health Sector Development Programme IV is addressing chronic disease for the first time
- there have been recent revisions of the health management information system.
However, there are limited resources for chronic diseases. Major threats in the prevention and control of chronic diseases in Ethiopia include:
- unregulated transnational (global) trade, leading to imported products and behaviour;
- proliferation of industrial/commercial food processing and brewery;
- adoption of a western lifestyle (e.g. smoking, alcohol, physical inactivity, refined foods with added salt, sugar and saturated fat).
The way forward
- Implement a programme for the prevention and control of chronic diseases as an integral part of primary health care and the health extension programme.
- Strengthen the diagnostic and clinical management capability of health systems in chronic disease care.
- Promote task shifting to expand accessibility of services for chronic disease prevention and control.
- Formulate and enforce legislation promoting healthy dietary choices, physical activity and restriction of tobacco, alcohol and other addictive substances.
- Integrate programmes population wide and target high-risk individuals to reduce their exposure to risk factors and reduce morbidity, mortality and disability.