1. Surveillance - Development and maintenance of a surveillance system incorporating program monitoring and evaluation components.
Process indicators:
- Development of methodology and tools for a common population-based NCD surveillance system.
- Building technical capacity at various levels.
- Development of methodologies for research on further improvement of the surveillance.
Output indicators:
- Reports and Publications produced.
- Results/materials disseminated to policymakers, public, media, and professional groups.
Outcome indicators:
- Decisions made using surveillance and information generated.
- Number of medial college, district and upazila hospitals regularly contributing to the national facility-based surveillance.
- Number of population sites from which surveillance data are available.2. Health Promotion and Prevention of NCDs - Development of evidence-guided behavior change communication strategy for NCDs, and its implementation at national and community levels.
Process indicators:
- Baseline assessment of knowledge level, practices and perceptions.
- Constitution of multidisciplinary teams consisting of members from the media, public health specialists national program managers, NGOs, community activists, local opinion leaders, etc.
- Development mass media and community intervention details.
- Development of a highly visible behavioral change communication plan incorporating strong social marketing approaches.
- Assessment of community needs. Output indicators:
- Implementation of a highly visible behavior change communication plan incorporating strong social marketing approaches.
- Integration of all chronic NCD domains in the mutually reinforcing plan.
- Number of coalitions built.
- Tools of intervention development.
- Number of surveys done.
Outcome indicators:
- Change in awareness level on NCDs.
- Proportion of motor bikers using helmet.
- Proportion of individuals aware of major NCD risks.
- Proportion of inactive persons.
- Proportion of individuals eating less than 5 servings a day of fruits and vegetables.
- Mean BMI, waist circumference, blood pressure and glucose level.
- Proportion of individuals with obesity, diabetes, and hypertension.
- Proportion of individuals screened for high blood pressure.
- Proportion of people using tobacco.
- Proportion of people with hypertension and diabetes with adequate control.3. Orientation of Health Services - Development and implementation of a sustainable, scientifically valid and resource-sensitive CME program for professional education and involvement of all categories of healthcare providers in the prevention of NCDs and its integration in health services. Process indicators:
- Workshops and consultative deliberations to include the prevention of NCDs in a comprehensive CME program for all categories of healthcare providers.
- Development of sustainable, scientifically valid and resource-sensitive CME programs for training all categories of healthcare providers.
- Development of educational tools that incorporate resource-sensitive risk management and assessment algorithms.
- Inclusion of health promotion and disease prevention theory and practice in medical and paramedical curricula.
Output indicators:
- Number of health professionals with access to course/curricula with modules for health promotion and disease prevention.
- Existence of scientifically valid and resource-sensitive training tools.
- Number of trained professionals.
- Adoption of prevention practices by healthcare providers at community, district, and national health promotion activities.
- Availability of drugs essential for the prevention of NCDs at all levels of healthcare.
- Number of ECG machine and calorimeter with reagents available in upazila health complexes. Outcome indicators:
- Proportion of healthcare providers who screen at-risk individuals for hypertension and diabetes.
- Proportion of healthcare providers who screen for breast cancer.
- Proportion of healthcare providers prescribing drugs which are critical in primary and secondary prevention of NCDs.
- Number of upazila in which community-based mental health services started.
- Number of upazila in which model primary eye care services started.
- Change in awareness and practices of healthcare providers.
- Proportion of upazila health complex having dedicated health promotional activities.4. Legislative and/or regulatory measures - Enactment, amendment and enforcement of laws and regulations in tobacco, mental health, food standards, vehicles (locally manufactured) and road safety.
Process indicators:
- Activities to garner public support for legislation/regulation essential for prevention and control of NCDs.
- Media accounts highlighting the need for legislative and regulatory measures
- Multi-stakeholder dialogue between relevant ministries, economists, multilateral donors and bilateral lending agencies.
- Proposals to legislators for enacting/amending law(s).
- Establishment of task forces and working groups to support parliamentary committees.
- Legislative and/of regulatory measures relating to training of drivers/licensing.
Output indicators:
- Development of national standards and guidelines for care and treatment of mentally ill patients.
- Number of community-based mental health services established.
- Mental Health Ordinance enacted.
- Food standard legislation enacted.
- Vehicle safety law enacted.
- Amendment of tobacco control law.
Outcome indicators:
- New relevant legislation/regulations appeared mental health, food standards, vehicles (locally manufactured) and road safety.
- Amendment of existing laws such as tobacco control law.
- Legislation/regulations enforced
- Public consumer support for legislation/regulations
- Decline in per capita consumption of tobacco.5. Research - Policy and operational research of local relevance in order to examine tobacco tax policies, marketing and advertising strategies. Operational research in controlling road traffic injury. Periodic research on burden of NCDs and their risk factor levels.
Process indicators:
- Development of tools and course to enhance research skills.
- Training courses on epidemiology and prevention of NCDs to enhance skills.
Output indicators:
- Publications prepared through acquisition of data.
- Information provided to media.
- Presentations and seminars for public, health professionals and policy makers.
Outcome indicators:
- publications in the form of reports, articles and infobases on NCDs available.
- Research information used for decision-making.
- Feedback of information to health authorities.