A countrywide approach to the control of non-communicable diseases--the Singapore experience.
BACKGROUND
Many developed and developing countries are grappling with recent epidemics of non-communicable diseases and how to effectively control them. Singapore as a small, compact and highly urbanized country has similarly experienced a rapid increase in its chronic disease load and has adopted a national approach to control them.


METHODS
This paper traces the strategies taken in the 80s and the 90s to control non-communicable diseases and evaluates the effectiveness of the two approaches.


RESULTS
In the 80s, the control programme was largely a Ministry of Health responsibility using a persuasive approach to reach out to the target groups. This produced some results through the lowering of hypertension and cholesterol. For the 90s, the approach was one of leadership by government working with relevant agencies to reach out to all relevant sectors in the population. This National Healthy Lifestyle Programme was given top political support. The integrated and comprehensive approach used showed some improvements in health and gave the direction where efforts should be channelled.


CONCLUSIONS
The countrywide approach taken in Singapore for the control of non-communicable diseases illustrates a model where a national framework was adopted, harnessing health promotion and disease prevention and involving personal responsibility as a key success factor. This rides on a well-developed continuum of healthcare which aims to become an integrated and seamless one.
Emmanuel
S C
SC
National Healthcare Group Polyclinics, 11 Jalan Tan Tock Seng, Level 6, Singapore 308433.
Lam
S L
SL
Chew
S K
SK
Tan
B Y
BY
D002908:Chronic Disease; D003140:Communicable Disease Control / Q000458:organization & administration*; D015438:Health Behavior; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*; D015397:Program Evaluation; D012846:Singapore; D013997:Time Factors