Global key policies
Through the guidance of WHO, systems have been put in place to protect people from CVDs. The Millennium Development Goals did not address the impact of non-communicable diseases (NCDs), but fortunately, the 2030 Sustainable Development managed to emphasize the need to treat these disorders including CVDs worldwide. Sustainable Development Goals aim to reduce premature deaths from NCDs by one third by 2030. The United States Centers for Disease Control and Prevention (US- CDCP) in partnership with WHO launched Global Hearts and Initiative driven to prevent and control CVDs. It comprises of MPOWER which is a technical package for tobacco control, HEARTS which is a package sysytem for cardiovascular disease management in primary health care and SHAKE which is a functional package for salt reduction (Global Hearts Initiative working together to beat cardiovascular diseases, n.d.).
National Key Policies
Malaysia has witnessed an increase in NCD and risk factors associated with it in the last two decades. Owing to this national health threat, Malaysian Ministry of Health developed The National Strategic Plan for Non- Communicable Diseases ( NST- NCD) 2010- 2014 and the NCD Prevention 1Malaysia (NCDP- 1M) initiative ( Mustapha et al., 2014). Recently, The Malaysian plan was developed in partnership with the Ministry of Health which focuses on reducing risk factors that leads to the occurs of communicable diseases (CD) and non- communicable diseases (NCDs) through the provision of efficient health care service delivery. This policy also focused on cancer prevention.
Effectiveness or Evaluation of Policies
The Global Hearts Initiative was developed primarily to fight non- communicable disease. Tobacco and alcohol use has been associated with increased cases non- infectious diseases. (Goal 3.: Sustainable Development Knowledge Platform, 2013). MPOWER initiative created by WHO Framework Convention on Tobacco Control (WHO FCTC) developed guidelines for countries to implement and manage tobacco by reducing demand (MPOWER, 2017). Furthermore, MPOWER aims at protecting people from tobacco smoke by pushing for the setting up of smoking zones, rehabilitating addicts to quit tobacco use and warn about dangers of tobacco (Global Health, 2017). Using this initiative, WHO supports governments through MPOWER, SHAKE and HEARTS to manage CVDs in their regions ("World Heart Day 2017", 2017). Since its launch, Global hearts initiatives have been rolled out in various countries with health practitioners being given training and better medical practices to protect individuals from CVDS and help them recover from heart attack and strokes. In February 2008, WHO released demographic data outlining the progress that had been made in the implementation of tobacco control. Additionally, WHO proposed approaches that governments can use to prevent millions of premature deaths ("Tobacco fact sheet," 2017). In its report, WHO found out that only 5% of the worlds population reside in countries where comprehensive smoke-free legislation is enforced, and 40% of the countries allow smoking in public institutions. Additionally, just 6% of the global countries enforced pictorial representation on warnings on tobacco packages ("Smoke-free legislation," 2017). However, tobacco use is a risk factor related to six leading cause of deaths with statistics showing one in every ten deaths of adult deaths. MPOWER uses six strategies which are; monitoring of tobacco use; protecting people from tobacco exposure; offering nicotine replacement and counselling; enforcing warning on smoking hazards on cigarette packs; enforcing banning of tobacco-related advertisements; and raising the prices of tobacco through increasing taxation of tobacco products ("Malaysia Details - Tobacco Control Laws", 2017). The main advantage of this initiative is that it monitors tobacco use and stating prevention policies. Also, It gives guidance on protection of people from tobacco smoke("WHO | Key facts and findings relating to the MPOWER package," 2017).
Malaysia in a quest to control tobacco use among its citizens become part of the WHO Framework on Tobacco Control on 15th December 2005. (Liber, Ross, Omar & Chaloupka, 2017). The Malaysian government, therefore, enforced legislation to control tobacco use. One of the legislation being, stating of smoke-free places. Smoking was banned public places like transport means, workplace, banking halls, and financial institutions, however, smoking was allowed in pubs, casino, and nightclubs and designated smoking areas. Furthermore, laws related to prohibition of tobacco advertising and advertising were enforced, but due to lack of clear interpretation of the statutes, tobacco promotion is still undertaken. Health warning on the use of tobacco is printed on the packaging where it is supposed to cover 50% of the front and 60% of the back. To control tobacco use in Malaysia, the legislation is covered under the Food Act of 1993 where The Control of tobacco Product regulations 2004 was issued under this particular act of 1983. In this bill, laws related to tobacco use and manufacture were stated, for instance, to identify the manufacture of a tobacco product, the telegraphic address or postal address shall be used as the address of the production or the importing company. Furthermore, within this law, any person who goes against the set laws, is liable for prosecution and pay a fine not exceeding ten thousand ringgit or a term not exceeding two years imprisonment or even both (Assunta & Dorotheo, 2015).
Proposed Health Improvement Initiatives
To control tobacco use and protect the population from exposure to tobacco, various initiatives can be put in place. For Instance WHO initiated the MPOWER initiative to help in control and regulation on the same. Therefore it is upon each county to enforce the laws stated by the MPOWER initiative in trying to reduce CVDs shortly. The Comprehensive tobacco control efforts save peoples lives, improve health, and reduce healthcare related problems, CDC recommends investments in comprehensive worldwide tobacco control program. Intensive efforts are continuously been implemented across the world to improve the quality of services in relation to delivery of health care services. The use evaluation well-structured methods to identify improvement initiatives that work well before applying them across a broad range of contexts. The chosen evaluation methods need to provide an understanding on how the initiative performed in a certain demography and how it can be improved in the future to provide improved health (Parry et al., 2013). Governments interventions to prevent initiation of tobacco use, promote tobacco termination, eliminate exposure to shared smoke, and identify and eliminate differences;
Mass-education to increase awareness of the health effects of smoking and the adverse impact of sharing smoke exposure, promote tobacco reduction, and discourage tobacco use promotions. Mass media campaigns have been used to promote quitting of tobacco use and strategies such as posters, social media posting and discussion forums are used as part of comprehensive tobacco control initiatives to inform about the harmful effects of smoking. This kind of media campaigns discussions can help individuals change their smoking attitudes and beliefs, increase quitting plans and quit attempts, and reduce adult smoking prevalence (Durkin et al., 2012). Jurisdictions should aim for high reach and consistent exposure over time with preference towards negative health effects messages.
Termination interferences that expand insurance coverage for cessation treatments and use of these medications, make tobacco rehabilitation centers efficient and part of healthcare service provision in clinical care, and increase stopping capacity of tobacco users;
Surveys to attitudes, behaviors, and health outcomes to assess program efficiency and influence over time; and
Expanding the infrastructure, administration, and management to achieve the targets needed to sustain program efficiency and productivity and foster collaboration among governments and local institutions.
For instance, Minnesota initiated a program The State Health Improvement Partnership (SHIP) which focused on creating a healthier community by expanding opportunities for active living, healthy eating and tobacco-free living among citizens (State Community Health, 2017).
Impacts of partnership working
A partnership forms a collaborative relationship between two or more parties based on trust, impartiality and mutual understanding of their deeds for the achievement of a stated goal. Partnerships involve a lot of risks, as well as benefits for it, consists of a lot of accountability regarding delivery of services. For an organization to be successful, the parties need to coordinate, communicate and cooperate with right structure communication channels. ("WHO | APPS definition of partnership," 2017)
A partnership approach stipulated on co-operation and collaboration between all relevant providers will have adverse benefits in the delivery of services. These include which include removal of communication and service distribution barriers to progressing towards steadying restoration providing more consistent comprehensive care. Additionally, the partnership will help in streamlining access to a range of training, education and employment opportunities for stakeholders in a related field for the success of the community.
A partnership is working offer practical support between working professionals in streamlining efficiency in service delivery. It includes training and designing of useful frameworks (Glasby & Dickinson). Additionally, partnership working increases borrowing capacity of an institution ("Partnership advantages and disadvantages - Business Tasmania," 2017)
Partnership working like any other partnership has its limitations. Partnership working has a higher risk of breaking up of already established networks, and the risk of cost-cutting on efficient provision of public health services (Taylor-Robinson et al., 2017). Another limitation the lack of clarity regarding variances in mission and regulations, specific allocation of responsibilities, competence regarding workforce and working approach (Widmark, Sandahl, Piuva & Bergman, 2017)
Durkin, S., Brennan, E., & Wakefield, M. (2012). Mass media campaigns to promote smoking cessation among adults: an integrative review. Tobacco control, 21(2), 127-138.
Silent Ischemia and Ischemic Heart Disease. (2017). Heart.org. Retrieved 1 December 2017, from http://www.heart.org/HEARTORG/Conditions/HeartAttack/TreatmentofaHeartAttack/Silent-Ischemia-and-Ischemic-Heart-Disease_UCM_434092_Article.jsp
Cardiovascular diseases (CVDs). (2017). World Health Organization. Retrieved 1 December 2017, from http://www.who.int/cardiovascular_diseases/en/
Who we are, what we do. (2017). World Health Organization. Retrieved 1 December 2017, from http://www.who.int/about/en/
Working together to beat cardiovascular disease. (2017) (pp. 2-6). Retrieved from https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwj0-qii6OnXAhXIyRQKHbwdCO4QFggnMAA&url=http%3A%2F%2Fwww.who.int%2Fcardiovascular_diseases%2Fglobal-hearts%2FGHI_Brochure.pdf&usg=AOvVaw2ma7vwFf0vtIMoohQ03qX2
Mustapha, F. I., Omar, Z. A., Mihat, O., Noh, K. M., Hassan, N., Bakar, R. A., ... & Rahman, L. A. (2014). Addressing non-communicable diseases in Malaysia: an integrative process of systems and community. BMC Public Health, 14(Suppl 2), S4.
Goal 3 .:. Sustainable Development Knowledge Platform. (2017). Sustainabledevelopment.un.org. Retrieved 1 December 2017, from https://sustainabledevelopment.un.org/sdg3MPOWER....
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