Africa CDC eager to extract lessons from the project and extend them to other AU member states
Photo: Mekonnen Teshome Evidences from studies prove that non-communicable diseases (NCD) risk factors related to reproductive and maternal morbidities worsen the risk of maternal mortality, stillbirth, and neonatal death.
According to the study titled Non-communicable Diseases and Reproductive Health in Sub-Saharan Africa: Bridging the Policy-Implementation Gaps, the Sub-Saharan Africa region has experienced an epidemiological transition to NCDs in the last two decades.
Despite the high prevalence of deadly non-communicable diseases, the Ethiopian Public Health Institute (EPHI) asserts that the majority of risk behaviours for NCDs and reproductive health-associated morbidity and mortality are preventable, particularly through awareness and positive behavioural changes such as adopting a healthy lifestyle and engaging in physical exercise.
“Around 80 per cent of all NCD deaths occur in low and middle-income countries. NCDs account for almost 65 per cent of women’s deaths globally, and the majority of these deaths occur in LMICs and are premature. In recent years, NCDs among women of reproductive age have doubled in many African countries,” the study states.
As a response, EPHI and the Norwegian Institute of Public Health (NIPH) are collaborating on a four-year prevention health project aimed at reducing the risk of NCDs among Ethiopian women and their children, launched in Addis Ababa. The programme, funded by Horizon Europe and named “ENABLE” (Enabling Environments for NCD Risk Reduction in Ethiopia), focuses on preventing NCDs by promoting positive behavioural change among pregnant women and their children. The announcement was made jointly by EPHI and NIPH on February 6, 2024 in Addis Ababa.
A 2022 study by Jimma University, one of the project implemention partners, supports previous research, revealing that 10.3 per cent of pregnant women were affected by cardiovascular diseases, with a relatively high proportion of rheumatic heart disease observed.
Medical evidence indicates that common NCDs affecting pregnancy include cardiovascular disease, hypertension, diabetes, cancer, mental health disorders, thyroid disease and multiple sclerosis.
Dr Getachew Tollera, deputy director-general of the Ethiopian Public Health Institute, highlighted in his keynote address at the kick-off of the “ENABLE” project that the programme aimed to create a level playing field for preventing NCDs by promoting three key interventions: Healthy nutrition, physical exercise, and protecting the target groups from exposure to pollution and a toxic environment.
Dr Tollera emphasised that the project would raise awareness among the target group, especially in children under five, pregnant and lactating women, to reduce NCD risk factors.
“The programme is expected to result in multiple positive impacts, including improving the health of pregnant women and children, building the capacity of health workers, enhancing health systems in the target locations, as well as fostering collaboration and partnerships across national and global actors,” Dr Masresha Tessema, EPHI’s Food and Nutrition Research Director and principal investigator of the project, underscored.
He pointed out that the project aligns with Ethiopia’s NCD prevention strategy and follows evidence-based approaches to generate necessary data and evidence for effective interventions in the future.
There were a total of 700,000 deaths in Ethiopia, according to The World Health Organization's Non-communicable Diseases Country Profiles 2018. Of this, 39 per cent attributed to non-communicable diseases, 12 per cent to injuries and 49 per cent to communicable, maternal, perinatal and nutritional conditions, while other NCDs account for the remaining shares.
Eleni Papadopoulou, principal investigator of the project and a researcher from the Norwegian Institute of Public Health (NIPH), highlighted the core objective of enhancing the knowledge and awareness of participants, developing capacities and skills of health workers, and promoting positive behavioural changes among pregnant women and their babies.
Eleni emphasised that the project aims to ensure that public policy decisions are evidence-based and context-specific, compiling new sets of data and experiences during the four-year implementation.
Adelard Kakunze, Non-communicable Diseases and Mental Health Expert at the Africa Centres for Disease Control and Prevention (Africa CDC), stated that ENABLE is a groundbreaking project, and its best practices can be replicated in other African countries and areas of the continent’s health system.
“Africa CDC is keen to work together with EPHI and NIPH and to use and share the good experiences and the evidence gathered in this particular project for the benefit of other African countries.”
Kakunze emphasised the need for digitisation of health systems and projects like this to make them evidence-based, utilising the collected data and evidence in the realisation of the projects.
Horizon Europe funds the four-year ENABLE project (2023-2027) to reduce NCD risks among the target groups in urban environments, specifically in the cities where the project is being implemented: Addis Ababa, Adama, Harar, and Jimma.
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