December 8-10, 2005, Helsinki, Finland
European Conference on Chronic Disease Prevention

Learning from the past - planning for the future


 




MACEDONIAN "CINDI" VISION FOR A CHRONIC DISEASE STRATEGY

- POLITICAL AND PRACTICAL ACHIEVEMENTS, 2001-2005


Background and aim: CINDI Programme in Macedonia began in 2001 with aim to reduce high mortality rate of chronic, noncommunicable disease (NCD) and increased prevalence of lifestyle risk factors in the population as a consequence of rapid political and socio-economic transition. CVD accounted for 57% of all deaths in 2002 and remains the major cause of death. To propose a new effective strategy various preventive programmes for isolated NCD and lifestyle risk factors were critically analyzed. The main aim was to implement an integrated, comprehensive and coordinated approaches with stable intersectoral partnership.


Methods: In the First Draft-Action Plan for CINDI Programme (2002-2007) priority was given to risk reduction on both community and PHC levels (1.pdf.). Also it was proposed rationale use of the existing preventive services in PHC as integral component of health reforms. Macedonian strategy on NCD prevention is focused on the major social determinants: unemployment, poverty and social inequality. Complete strategic quidances in area of capacity building, establishment of national coordination, CINDI Health Monitor System and the recommendations for reduction of lifestyle risk factors are presented on the web site: http://cindi.makedonija.com/.



Results: During the past four years (2001-2005) the following results were reached in chosen priority areas:


1. Lifestyle changes (jpg):


-increased physical activity: Macedonian "Move for Health" Declaration (2) and Programme,
2003 (3.pdf.);


-healthier nutrition: National project for reduction of diet-related NCD risk factors, 2005 (4, 5).


2. Report of "pylot" CINDI Health Monitor survey, 2002 (6, 7).


3. Proposal-Project for establishing the First CINDI Centre in the city of Skopje, 2003 (8).


4. CINDI Programme for Youth, 2004 adopted as state preventive programme in 2005 (9,9a).


5. Educational activities:


-Establishing a new Cathedre for sport medicine at Faculty of Medicine, 2002 (10).


-New topic as a part of the postgraduate study on Public Health in area of physical activity,
2004 (11).


-Training courses (12), lectures (13) and public health education: mass-media campaigns on
10 May, 2003 (14) and 2004 (15, 16), web site (17) and poster, 2004 (18.jpg.).


6. One of the major achievement is the acceptance (19) to join in the European CINDI network on
23.07.2004 by Dr. Aushra Shatchkute, regional adviser (20).


7. New publication with title: The First Macedonian CINDI Vision by Dr. Vera Simovska, national
coordinator.


Conglusion
: Countrywide implementation of the Global strategy on diet, physical activity and health (Puska P, WHO/HQ, Geneve, 2003) is essencial for reduction of NCD and major and sustained improvement in population health, in relatively short-term. National health strategy is urgently needed. The whole CINDI Programme and all the included activities were result of enthusiastic and voluntary work (21).


МАКЕДОНСКА СИНДИ ВИЗИЈА ЗА СТРАТЕГИЈА НА ХРОНИЧНИТЕ БОЛЕСТИ


- ПОЛИТИЧКИ И ПРАКТИЧНИ ДОСТИГНУВАЊА, 2001-2005




Досегашни сознанја и цел: СИНДИ Програмата во Македонија започна во 2001 година со цел да се редуцира високиот морталитет од хроничните незаразни болести (ХНБ) и зголемената преваленција на факторите на ризик поврзани со начинот на живеење на населението како последица на оштрата политичка и социо-економска транзиција.


Кардиоваскуларните болести беа застапени со 57% во вкупниот морталитет во 2002 година и се до денес тие се главната причина за смртта. Со цел да се предложи нова ефективна стратегија, критички беа анализирани различни превентивни програми за пооделни ХНБ и фактори на ризик поврзани со начинот на живеење.


Главна цел беше да се имплементира еден интегриран, сеопфатен и координиран пристап со взаемна, стабилна интерсекторска соработка.


Методи:
Приоритет, во првиот Нацрт-Акционен план за Програмата СИНДИ (2002-2007) беше даден на редукција на ризикот како на ниво на заедницата, така и на ниво на примарната здравствена заштита (ПЗЗ) (1.pdf.). Воедно беше предложена рационална примена на постојните превентивни служби во ПЗЗ како интегрална компонента на здравствените реформи. Македонската стратегија за превенција на ХНБ е фокусирана на големите социјални детерминанти: невработеноста, сиромаштијата и социјалната нееднаквост. Севкупните стратешки препораки во домен на градење на националните капацитети, утврдување на националната координација, "СИНДИ Health Monitor" системот и препораки за редукција на ризик факторите поврзани со начинот на живеење на населението се прикажани на веб-страницата: http://www.cindi.mkedonija.com/


Резултати
: Во одбраните приоритетни области беа постигнати следните резултати во изминатите четири горини (2001-2005):

1. Промени во начинот на живеење (jpg):


- зголемена физичка активност: Македонска Декларација "Движење за здравје" (2) и
Програма, 2003 (3.pdf.).


- рационална исхрана: Национален проект за редукција на ризик-факторите за ХНБ
поврзани со исхраната, 2005. (4, 5).


2. Извештај за "пилот" истражување "СИНДИ Health Monitor", 2002 (6, 7).


3. Предлог-проект за поставување на првиот СИНДИ Центар во градот Скопје, 2003 (8).


4. СИНДИ Програма за млади, 2004 прифатена во рамките на државните превентивни
програми во 2005 (9, 9a).


5. Едукативни активности:


- Отварање нова катедра по спортска медицина на Медицнскиот факултет во Скопје,
2002 (10).


- Ново поглавје од областа на физичката активност како дел од постдипломските
студии по Јавно здравство, 2004 (11).


- Тренинг курсеви (12), предавања (13) и јавно-здравствени едукативни мас-медиумски
кампањи на 10 мај 2003 (14) и 2004 (15, 16), веб страница:www.cindi.makedonija.com (17)
и постер, 2004 (18.jpg.).


6. Едно од големите достигнувања е прифаќање на апликацијата (19) за зачленување
на Македонија во Европската СИНДИ мрежа на 23.07.2004, од регионалниот адвизор,
Dr. Aushra Shatchkute (20).


7. Нова публикација под наслов: Првата Македонска СИНДИ визија, од националниот
координатор Dr. sci. med.Вера Симовска.


Заклучок:
Имплементација на Глобалната стратегија за исхрана, физичка активност и здравје (Puska P, WHO/HQ, Geneva, 2003) ширум земјата е есенцијална за редукција на ХНБ и значајно подобрување на здравјето на населението во релативно краток период. Ургентно е потребна национална стратегија во здравството. Целосната СИНДИ Програма и сите вклучени активности беа резултат на ентузијазам и волонтерска работа (21).



Preferred form of presentation*:
Oral presentation
 
Poster presentation
yes

Presentation Topic:
Main theme: (pick one from the list above)*:
Integration and Partnership
Specific topic (pick one from the list above)*:
Diet and physical activity, New NCD strategy





CV Simovska Vera/biografy

doc pdf

HEPA MACEDONIA 2007



National Public Health Organization for the promotion of

Health-Enhancing Physical Activity  HEPA  Macedonia

 

 

  General  information:

 

  Title: National Public Health Organization for the promotion of Health-Enhancing Physical  Activity HEPA Macedonia

  Adress: Kozara  68/II, 1000 Skopje, Macedonia

  Phone: +389 2 323 9698;  +389 2 322 5402

  E-mail: hepa@makedonija.com

  Web site: www.nosmoking.cjb.net,  www.mango.org.mk

  Status of the organization: National Public Health (NGO, not for profit), 

  Member of  the WHO HEPA Europe and collaborating partner of Public Health Institute for   Sports Medicine in Macedonia

  Contact person: Vera Simovska, MD., PhD, President

 

    Background:

     National Public Health Organization for the Promotion of  Health - Enhancing  Physical  Activity HEPA Macedonia is  established  on 11 October 2005.

     The aim  was  to develop the steps to implement national policy, startegy and programme on the key health determinant, physical activity in accordance to the new EU Health Strategy (2007-2016).

     In  February  2006  HEPA  Macedonia  was  accepted  as  “temporary” member by the Steering Committee of  the WHO HEPA EUROPE until confirmation by the network at 2nd Annual meeting on 14 June in Tampere, Finland (www.euro.who.int/hepa). Also it,s is a member of the World  Move for Health” network as well as member of Research project and network  of European Union for “Action and Physical Activity on Aging”- EUNAAPA (www.eunaapa.org).

       There  is  a  need for quick action to implement this strategy associated with the implementation of the WHO Resolution WHA 57.16 on ”Health Promotion and Healthy Lifestyle” and WHA 57.17 on “Global Srategy on Diet, Physical Activity and Health” as well as with the A/RES/58/5 on “Sport as a means to promote Education, Health, Development and Peace”.

 

  The vision and main goals

   People in Macedonia should enjoy to achieve better health through increasing  physical  activity. To  strengthen  and  support  efforts  and  actions  that increase participation  and  improve  the  conditions  favourable to  a healthy  lifestyle, in  particular  with respect  to  health - enhancing physical  activity (HEPA). To initiate national approache and network for physical activity  promotion, inter-ministerial and -sectoral approache and a general framework for physical activity promotion policy.

 

    Main  activities: 

 1. To promote health through PA using population-based approach.              

 2. To support the formulation of  National strategy and programme for the promotion of  health-

     enhancing physical activity - ”HEPA  Programme”:
       - the main objective is to reduce major chronic disease morbidity/mortality
       - the intermediate objectives are to reduce the population levels of biological risk  factors for

         chronic disease by introduction changes in the lifestyle: increased PA, balanced nutrition

         and  smoking  cessation. 

3.  To formulate organizational structure and establishement a national network.
4.  To strengthen cooperation, partnership and collaboration with other relevant programmes,

     sectors, NGOs e.t.c  in promotion of HEPA.

5.  In addition to provide the background for the identification and development of  an overiew 

     of relevant HEPA Action Plan for implementation of HEPA programme in Macedonia

6.  To prepare annual work programme for the main planned activities and events      
7.  To establish specific outcomes, monitoring and evaluation, and deliverables
     for  HEPA Europe.

 

Start of  health promotion through physical activity within  the National programme  for chronic disease prevention – CINDI in  Macedonia (2001-2005)

 September  2001- National PA startegy is initiated as part of CINDI conceptual model:

     - the  health promotion and NCD prevention dimensions of the PA strategy.

2001-2002  Formulation of  Action Plan for development and implementation of  Programme for the promotion of physical activity within the contex of the first CINDI Draft-Plan of Action in Macedonia, 2002-2007.  Action Plan is based on:

      -  the best scientific evidence on health, social and  economic  benefit of  PA

      -  intersectoral  and  multidisciplinary

2001 - Planning  CINDI coordinative centre in Skopje with an information base  and     organization structure for implementation of  the CINDI programme.

2001 - Realised “pylot“ CINDI Health Monitor survey on demonstration level;

         - Planning a national register for NCD risk factors focused on PA

2001 - Planning seminar/lecture in Skopje:

           Modern aspects of NCD primary prevention: programmed PA and dietary  interventions

2002 - Initiation of preventive interventions and national quidelines for reduction of lifestyle risk 

           factors: decreased physical activity and unbalanced nutrition.

2003 -“Move  for  Health  2003 Initiative  Around  the  World”

           The  first  step  was  made  in  collaboration  with the WHO Department  for NCD    

           prevention  and  health  promotion (Puska P, WHO/HQ, Geneva 2003).

2003 - Establishing a national coordination with Executiv Counsil  Move for Health  within 

           Macedonian CINDI Programme.

           The  website  was  developed  “Macedonia on the Move”

2004 - Mass  media campaign  Move for Health-Active Youth”.

           The Macedonian  Move for Health  Declaration was adopted.

 

            Ongoing  activities  on  national  level, 2005-2006

2005 - Establishing a National Public Health Organization  HEPA  MACEDONIA

2006 - Member of  the” WHO HEPA Europe” and “ World Move for Health”

2006 - WHO “Quit &  Win”  Programme for smoking cessation with  title: “Tobacco-Free Sport and  Physical Activity” -   http://www.nosmoking.cjb.net  (http://www.quitandwin.org).

2006 – Member of the European network and research project for “Action and Physical Activity on Aging” – EUNAAPA (www.eunaapa.org)

 

Main activities of HEPA Macedonia National Public Health Organization for

the promotion of  Health-Enhancing Physical Activity

Research:

          Effects of applied programmed PA at children, youth and adult population

          Efficacy of PA on reduction on diet-related risk factors for chronic diseases

          Researches in area of public health

            - health promotion through PA and healthier nutrition

            - monitoring and evaluation of outcomes

Health promotion in general:

          Healthy lifestyle

          Skills for health

Promotion of physical/sports activity:

          On population and individual levels

          On national, regional and local level in Macedonia

Teaching/advocacy 2006

  - Continuing doctoral education (CME)  accredited  by  Faculty of Medicine, Macedonian 
     Medical  Association and  Doctor Chamber of the Republic of Macedonia.   
     Participants: 230 physicians from different branche of medicine.
  - Traening seminars, workshops  and courses.
  -  Mass-media  campaigns:  “Move for Health” and  “Quit & Win”
  -  Policy and strategy documents – Initiation for PA  Strategy/Programme
  - Statute for transformation of Sports medicine institutions countrywide
  - Strategy for Sport-decentralization of sport in Macedonia
  - Legislation (Low for Sport)
  - Recommendations and guidelines

 

    Continuing doctoral education (CME) -  2006

Workshop: “New  way of presenting of the recommendations for physical activity and  their application  in the preventive-therapeutic programmes focused on obesity”.

            Simovska V. HEPA Macedonia. Public Health Institute of Sports Medicine.

            Skopje, 31 May 2006 - www.lkm.org.mk.

Professional-scientific meeting: “Non-pharmacological combined therapeutic treatment

            at obese  population”. Simovska V. HEPA Macedonia.

            Faculty  of  Medicine, Clinic  for  pediatric  disorders,  Skopje, 21 April 2006.

           The First Annual HEPA  Macedonian Conference, Public Health Institute of Sports 

            Medicine, Skopje, 26 December 2006.

 

     T o p i c s:

-   Vision and goals of HEPA Macedonia-National Public Health Organization for the Promotion

    of  Health-Enhancing Physical Activity. Simovska V., HEPA Macedonia.                                                                                                                                    

-   Dietotherapy in individuals with  overweight and obesity - startegies in treatment    

    of obesity. Simovska V, Public Health Institute for Sports Medicine, Skopje.

-   Anthropometric,s  characterisitics in patients with M. Cushing.

    Stratovska-Subevska S., MD., PhD., Faculty of Medicine. Clinic of  Endocrinology, Skopje                                                                                       

-   Annual Report of HEPA Macedonia 2006         

-   Annual HEPA Macedonian Work Programme 2007: Developing National HEPA  Programme.

    

Skopje, 1 June 2007                                               Prim dr Vera Simovska, MD., PhD.

                                                                      President of National Public Health Organization  

                                                                  for the promotion of Health-Enhancing Physical Activity



CV Simovska Vera/biografy

doc pdf