The Department of Health’s Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2013-2010 (2013) is essential reading for patients, health care professionals and service related industries.

It contains 10 targets to be met by 2020

1) ↓ by at least 25% the relative premature mortality(under 60 years of age) from NCDs;
2) ↓ by 20% tobacco use;
3) ↓ by 20% the relative per capita consumption of alcohol;
4) ↓ mean population intake of salt to <5 grams/day;
5) ↓ by 10% the percentage of people who are obese and/or overweight;
6) ↑ the prevalence of physical activity (defined as 150 minutes of moderate-intensity physical activity per week, or equivalent) by 10% .
7) ↓ the prevalence of people with raised BP by 20% (through lifestyle and medication).
8) Every women with sexually transmitted diseases to be screened for cervical cancer every 5 years if no STD every women to have 3 screens in a lifetime (and as per policy for women who are HIV/AIDS positive).
9) ↑ the percentage of people controlled for hypertension, diabetes and asthma by 30% in sentinel sites;
10) ↑ the number of people screened and treated for mental disorder by 30%.

However, of concern is the perception created in the report that civil society only plays a role in the primary prevention of illness and focuses on risk factors (page 38). Admittedly it is the section entitled Role of Civil Society in Promoting Health highlights the civil society role in primary prevention. However, it NGO civil society role is not outlined any where else.

“It is necessary for the public to mobilise for better health through active advocacy and social mobilisation and responsible bodies that are protected from commercial influence have a very important role in promoting population health. Partnerships between government and civil society organisations can contribute considerably to improving health. Where possible joint campaigns can be run, however the independence of CSOs should be maintained for an effective advocacy role. CSOs can assist in ensuring that public policies and practices are in the public interest.

Social mobilisation is essential for addressing the risk factors of NCDs. People must be encouraged to take ownership of their behaviours and choices and the environment should be supportive and enable people to make healthy choices. There should be a process of enabling people to increase their control over the determinants of health and thereby improve their health. CSOs can help people organise and empower people with knowledge to make informed decisions. Awareness campaigns and community education are necessary to improve health literacy and keep people informed of healthier options and / or dangerous practices”

I don’t think any of us have a problem with the statements above. However, the quote is the only reference to civil society at any point in the document. The implication is that that is the only PRIMARY PREVENTION in which civil society organisations are involved. .
Primary prevention    (Aka primary prophylaxis)  is aimed at stopping the onset of an illness such as asthma OR diabetes  in healthy people For example preventing prenatal sensitisation to smoke, large antismoking campaigns. Interventions are introduced before the onset of the disease and are designed to reduce its incidence

Secondary prevention and tertiary prevent involves  those health interventions aimed at onset or mild or even severe forms of illness to reduce its impact or to prevent exacerbations. For excelent article on the levels of prevention read The Language of Prevention.

Does your organisation provide more than preventive care like screening, treatment, palliative care?  We would love to hear from you[email protected]