A 2012 STEPS survey on NCD risk factors in Tanzania* revealed that 15.9% of Tanzania's population were using tobacco or smoked cigarettes, 26% had high levels of serum cholesterol, 29.3% were taking alcohol, 26% were overweight or obese and less than 5% were eating the recommended amounts of fruits or vegetables. The prevalence of diabetes was 9.1% and hypertension was 25.9%. Without context, these numbers may not say a lot – but we were worried: compared to data gathered in the 80s when only 1% of people were diabetic and 9% were hypertensive, risk factor prevalence had grown.

A long-time focus on communicable disease during the Millennium Development Goals era may have distracted us from an epidemiological transition happening under our noses. But this data, together with the new Sustainable Development Goals, means we have an unprecedented opportunity: If  action is not taken to tackle these major risks for NCDs and combat the burden, the numbers will double by 2030.

Where the Tanzania NCD Alliance comes in

The Tanzania Noncommunicable Diseases Alliance (TANCDA) is a non-governmental organisation (NGO) established in 2012 and acting as an umbrella of four associations: Tanzania Diabetes Association (TDA), Tanzania Cancer Association (TCA), Tanzania Association for Respiratory Diseases and Heart Foundation of Tanzania (HFT). Our main collective objective is preventing the occurrence of NCDs, and improving the welfare of people with NCDs in Tanzania.

VISION: TANCDA envisages a society prevented from and assisted against Noncommunicable Diseases 

MISSION: To prevent the occurrence and improve the welfare of people with Noncommunicable Diseases

Buoyed by the support of the Ministry of Health and global and Danish NCD Alliances, TANCDA started slowly to tackle some of the challenges facing Tanzanians especially lack of on knowledge on NCDs, by conducting awareness activities to different areas including public, schools and the media. One of the successful initiatives TANCDA rolled out was engaging media outlets on combating NCDs. The journalists were trained and then formed the Tanzania Journalist NCD Forum, which is very active via radio, television and newspapers.

We were thrilled when our efforts were recognised as one of 38 initiatives by NCD national and regional alliances around the world on awareness-raising, accountability, advocacy and access, and included in the 2017 NCD Atlas. Our programme for journalists received a Sharjah Award for Excellence in NCD Civil Society Action, for Awareness-raising. The plaque is much treasured and admired, and the award money boosted our capacity to continue with this and similar initiatives. 

Leveraging success in one initiative to support another 

One of TANCDA’s objectives is raising people’s awareness of NCDs by disseminating information about prevention and control. To that end, with prize money from the Excellence Award, TANCDA initiated sensitisation and screening of NCDs to more than 1,200 student teachers between the ages of 20-25 in two colleges in Tanzania (Morogoro and Korogwe teacher’s colleges) in April and May 2018.

The purpose of the teacher education programme was to raise awareness about NCDs and promote healthy behaviours to prevent the onset of these diseases to student teachers, but also the children who these teachers will be instructing in the future. The health education covered diabetes, cancer and cardiovascular diseases, centred on promoting healthy behaviours to reduce obesity, improve diet and nutrition, and increase exercise. The screening focused on height and weight, blood pressure and blood glucose. Additionally, individual education/counselling was offered to all those with diabetes or hypertension, newly diagnosed or known, and all those with a body-mass index outside of the normal range. A physician was available for consultations.

Highlights and observations

We found that the student teachers had:

• Low knowledge of NCDs and their risk factors
• Low prevalence of diabetes
• High prevalence of hypertension (particularly given the student teachers were under 30 year of age); prevalence rate increases to over 40% of the population screened if latest diagnostic criteria is applied!
• Low rates of intake of fruits and vegetables (especially surprising and concerning when fruits are plenty in the regions).

The education sessions we delivered were very helpful as during the education session the tutors were also present and learned about the importance of eating more vegetables and fruits. Since the programme the students of Korogwe Teachers College are now provided with fruit three times a week instead of one day a week! This alone is a success that we are proud of.

What next?

We were surprised that such young people, who have their lives and futures ahead of them and big opportunities to inspire youth with healthy knowledge through their respected roles as teachers, were already showing signs of increased risk of NCDs themselves. But at this young age, it’s not too late! Empowering youth to better understand NCDs and their risk factors is required, such as expanding this initiative countrywide and providing screening to more teachers’ colleges and universities as a means of early diagnosis and to pass on NCDs education to students and families.

By imparting knowledge and skills today, we hope that these student teachers will be ambassadors for healthy change in their communities, ultimately leading to reductions in NCD risk factors. By empowering young people, future leaders, we have an opportunity to change the lives of thousands for the better.

About the Author

Happy Nchimbi has been Project Manager for the Tanzania NCD Alliance since 2013. She holds a Master degree in Health Systems management from Mzumbe University of Tanzania. Bfore joining TANCDA she was a project supervisor at Ifakara Health Institute. During her time with TANCDA she has managed and succeeded to make TANCDA known nationally and internationally by obtaining two awards - Sharjah Award for Excellence in NCD Civil Society Action and the UN Interagency Task Force (UNIATF) award to the Ministry of Health, Community Development, Gender, Elderly and Children, in recognition of its outstanding contribution to achieving NCD-related Sustainable Development Goals. The Ministry was nominated by TANCDA.

Acknowledgements

We acknowledge funding support from the NCD Alliance for this work as part of the Sharjah Award for Excellence in NCD Civil Society Action. We also acknowledge support from the MOHCDGEC, President Office Regional Administrative and Local Government (PORALG), RMO, DMO, College principal Management of Colleges and Hospitals involved, the health care workers who participated in the screening, the mass media organizations and the students for participating.

* What is STEPS?

The STEPwise approach to Surveillance (STEPS) is a simple, standardised method for collecting, analysing and disseminating data in WHO member countries.