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Country/JA: Bulgaria flag Bulgaria
Action type: Policy initiative

Problem: Multiple major risk factors (tobacco use, alcohol use, unhealthy diet, low physical activity) for disease, including cancers, need to be actively addressed to improve population health.

Objective: To implement a program of activities/initiatives to reduce the impact of these major risk factors at both population and individual levels and a program of annual screening for three cancers (breast, cervical, colorectal).

Implementation status: Ongoing policy initiative

Key Contextual Factors

  • The collaborative activities were planned base on the experience of the Countrywide Integrated Noncommunicable Disease Intervention (CINDI) project, which ended in 2010, fully supported by the Ministry of Health.
  • The National Programme for Prevention of Non-Communicable Diseases (NPPNCDs) provides the overarching framework to tackle non-communicable disease (NCD) risk factors and promote early prevention.
  • Individual and population strategies are embedded within the NPPNCDs. It is funded from the national budget.

Key Components/Steps

  • Coordinated by the National Center of Public Health and Analyses (NCPHA), the program is a collaborative approach between the Ministry of Health, the Regional Health Inspectorates (RHIs), targeting all 28 regions within the country, and different non-governmental organizations.
  • The program follows strict planned activities for addressing behavioral risk factors and performing annual screening for breast, cervical and/or colorectal cancers.
  • The activities are performed by the RHIs, the NCPHA and all municipalities within the country, with the assistance of medical specialists for screening activities.
  • The Programme includes timeframes for implementation and target indicators, monitoring and evaluation frameworks.

Main Impacts / Added Value

  • NPPNCDs is a comprehensive programme that aims to target the whole population (also addressing school settings as well as inequality issues).
  • It includes two major surveys on behavioral risk factors (2014 and 2020) which monitor and assess the progress of the programme.
  • Cancer prevention campaigns within the country aim to provide more knowledge and awareness to the public as well as screening for specific cancer sites on an annual basis.
  • The programme is the only nationwide campaign that performs screening activities in all 28 regions (there is no national cancer strategy/plan).

Lessons Learned

  • Strong intersectoral collaboration is needed
  • Political commitment to obtain resources and support for effective activities is important
  • Good organizational capacity and infrastructure is important
  • Social support among different communities is important

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References and Documentation

Contact

  • Institution/organization: National Center of Public Health and Analyses
  • Department/lead: Prof. Plamen Dimitrov
  • E-mail: p.dimitrov@ncpha.government.bg
  • Telephone: 0035928056430