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22 The Challenge of Non-communicable Diseases and Road Traffic Injuries in Sub-Saharan Africa TABLE 4: Top 15 Risk Factors Ranked by Attributable Burden of Disease for SSA Regions, 2010 Global rank Southern SSA Eastern SSA Central SSA Western SSA 1 High blood pressure 2 6 5 6 2 Tobacco smoking, including second hand smoke 5 7 12 10 3 Alcohol use 1 5 6 5 4 Household air pollution from solid fuels 7 2 2 2 5 Diet low in fruits 8 8 11 13 6 High body mass index (BMI) 3 14 18 15 7 High fasting plasma glucose 6 10 13 11 8 Childhood underweight 9 1 1 1 9 Ambient particulate matter pollution 25 16 14 7 10 Physical inactivity and low physical activity 11 15 15 16 11 Diet high in sodium 13 21 17 18 13 Iron deficiency 10 4 4 4 14 Suboptimal breastfeeding 4 3 3 3 17 Diet low in vegetables 15 23 23 20 19 Drug use 12 19 24 22 23 Intimate partner violence 14 18 20 23 25 Unimproved sanitation 18 9 8 9 29 Vitamin A deficiency 17 11 7 8 31 Zinc deficiency 21 13 10 14 34 Unimproved water source 27 12 9 12 Ranking legend 1-5 6-10 11-15 16-20 21-25 26-30 Source: Authors from [17, 78] Global economic policies in agriculture, trade, investment, and marketing have played a part in changing what people eat, by altering the quantity, type, cost, distribution, and desirability of foods available [84-85]. Globalization gives access to greater food diversity but also convergence towards more homogenous diets (“McDonaldization”). As countries develop, dietary differences between rich and poor are further exacerbated as the latter tend to adopt a poor quality ‘obesogenic’ diet, with ultra-processed products that are typically energy dense and high in unhealthy dietary fat, free sugars, and sodium [86-87]. Fruit and vegetable consumption varies considerably among and within countries but is generally low, with few individuals consuming recommended levels [88]. Dietary diversity is often lacking in many SSA countries. Diets traditionally consist of cereal or root staples with very few micronutrient-rich sources [82]. One study found that a large proportion of young children across a group of countries were exposed to no more than two food groups [89]. Diversion of resources from food production to cash crop exports by African governments, in order
An Overview 23 FIGURE 10: The Double Burden of Under-Nutrition and Overweight in SSA: Share of Recent Mothers Who are Underweight or Overweight (Most Recent Data Available Since 2000) Ethiopia Madagascar Chad Burkina Faso Eritrea Congo Democratic Republic Mozambique Guinea Niger Uganda Mali Benin Malawi Rwanda Zambia Liberia Tanzania Senegal Nigeria Kenya Congo (Brazzaville) Sierra Leone Cameroon Gabon Zimbabwe Ghana Namibia Sao Tome and Principe Lesotho Mauritania Swaziland 0 10 20 30 40 50 % recent mothers Overweight/Obese (BMI>25) Underweight (BMI
Page 1 and 2: The Challenge of Non-Communicable D
Page 3: THE CHALLENGE OF NON-COMMUNICABLE D
Page 7 and 8: TABLE OF CONTENTS Abstract.........
Page 9: List of Tables Table 1: Top 15 Lead
Page 13: LIST OF ACRONYMS AIDS Acquired Immu
Page 16 and 17: 2 The Challenge of Non-communicable
Page 25 and 26: 2. BURDEN OF NCDs AND RTIs This sec
Page 27 and 28: An Overview 13 A Rising Epidemic of
Page 29 and 30: An Overview 15 Types of Disease Ref
Page 31 and 32: An Overview 17 FIGURE 7: ASMR by NC
Page 33 and 34: An Overview 19 For young men, RTI a
Page 35: 3. THE DRIVERS AND DETERMINANTS OF
Page 39 and 40: An Overview 25 TABLE 5: Prevalence
Page 41 and 42: An Overview 27 Life expectancy has
Page 43 and 44: An Overview 29 employ business prac
Page 45 and 46: 4. THE RATIONALE FOR PUBLIC INTERVE
Page 47 and 48: An Overview 33 factors (given that
Page 49 and 50: 5. A COMPREHENSIVE, INTEGRATED APPR
Page 51 and 52: An Overview 37 clarity of vision an
Page 53 and 54: An Overview 39 Tobacco There is str
Page 55 and 56: An Overview 41 into account [255].
Page 57 and 58: An Overview 43 • Secure sustainab
Page 59 and 60: An Overview 45 financing and extern
Page 61 and 62: An Overview 47 percent) - or those
Page 63 and 64: An Overview 49 Several intervention
Page 65 and 66: An Overview 51 BOX 7: Country Respo
Page 67 and 68: An Overview 53 some NCD prevention
Page 69 and 70: An Overview 55 to fragmentation and
Page 71 and 72: An Overview 57 experienced shortfal
Page 73 and 74: An Overview 59 for managing chronic
Page 75 and 76: An Overview 61 In this example, a s
Page 77 and 78: An Overview 63 Guidelines and Quali
Page 79 and 80: An Overview 65 a balance needs to b
Page 81 and 82: An Overview 67 death statistics to
Page 83 and 84: An Overview 69 nations of intervent
Page 85 and 86: “As we start the journey of the n
Page 87 and 88:
REFERENCES 1. The Economist, Africa
Page 89 and 90:
An Overview 75 56. Bukhman, G. and
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An Overview 77 114. BeLue, R., et a
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An Overview 79 168. Stuckler, D., S
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An Overview 81 222. Narayan, K.M.V.
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An Overview 83 278. Catford, J., Im
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An Overview 85 336. O’Brien, M.,
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An Overview 87 390. Beran, D., A. M
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An Overview 89 444. The World Bank,
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MAP IBRD 39854: SUB-SAHARAN AFRICA
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