The Grenada National Chronic Non-communicable Disease Commission

by HCC
THE GRENADA NATIONAL CHRONIC NON-COMMUNICABLE DISEASE COMMISSION
COMMISSION PROFILE
Status as at September 2023 Active
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Country Grenada
Name The Grenada National Chronic Non-Communicable Disease Commission
Status as at September 2023 Active
Date of establishment 20 June 2010
Date of first meeting July 2010 (This was the first meeting of the Commission, following more than 10 years as a precursor “National Advisory Committee on CNCD”)
Date of last meeting June 2021
Number of meetings over past 12 months 11
Chairperson’s name Dr. Jane Noel
Title Chair Grenada NNCNCDC
Organisational affiliation -
Duration of tenure -
Summary of steps taken to establish the Commission Identification of key sectors; Cabinet appointment of Members and Chair
Specifically
  • Was there a planning group, (e.g. Task Force, Committee or other “precursor body”) that worked to establish the Commission?
  • If so, does the group still exist?
  • If it does, what is its relationship with the Commission/Coordinating Mechanism?
There was an analogous body that existed with the Ministry of Health (MoH), which consisted primarily of members of the MoH. This group ceased to exist once the Commission was established
Are there recommended profiles or desired characteristics for Commission Chair and Commissioners? Members were appointed on the basis of positions or representations of institutions
Were these applied in selecting the Chair and Commissioners? More or less
If yes, to what extent do the Chair and Commissioners satisfy them? Fully? To a large extent? To some extent? To a large extent
Legal authority/reference Cabinet appointment
Location(sector/entity) St. George’s University (SGU) until June 2016
Mandate/Scope of work No
Terms of reference Yes
Conflict of interest policy Does not exist
Code of ethics Does not exist
Standard operating procedures Do not exist
NNCDC strategic plan/plan of action,br/>Duration of strategy of plan of action Does not exist
Decision-making process (consensus, majority, other) Consensus
Government sector membership and level of representation Ministries of Health, Agriculture, Education; Grenada Food and Nutrition Council; Government Information Service
  • Agriculture
  • Education Drug Control Secretariat (Ministry of Education),
  • Health
  • Social services
  • Ministry of Youth
  • Grenada Food & Nutrition Council
  • Ministry of Culture
  • National Disaster Management Agency
Civil society membership and level of representation Trade union; health NGOs; faith-based organisations; sports groups; women’s groups; college; university; Grenada Nurses’ Association; Grenada Medical Association; Grenada Cancer Society
  • The Connection
  • Grenada Heart Foundation
  • Grenada Trade Union Council
  • Grenada Nurses Association
  • Technical & Allied Workers’ Union
  • Grenada Nurses Association
  • Media Workers’ Association of Grenada (MWAG)
  • Media Workers’ Association of Grenada
  • Grenada Conference of Churches
  • Grenada Faith-based Organizations
  • T.A. Marryshow Community College
Private sector membership and level of representation Private health sector; Grenada Chamber of Industry and Commerce
Ex officio members Chief Medical Officer, Senior Medical Officer, Chief Health Planner, Chief Pharmacist, Chief Nursing Officer
Secretariat exists? If so, please give date of establishment No
Full-time human resources/functions No
Part-time human resources/functions No
Main functions (advisory, accountability, strategic planning, project/programme implementation, other) Advisory
Main areas of interventions for NCDs and NCD risk factors Policy recommendations
Other health issues that the NCD/Wellness Commission /Wellness Coordinating Mechanism addresses All issues related to NCDs
  • Is there integration – structural or functional, with other health-related Commissions, such as HIV Commissions?
  • If so, to what extent? Fully? To a large extent? To some extent?
No
Framework(s) of reference (national policy, strategy or plan; international plans/strategies) Port-of Spain Declaration
Focus of interventions (legislation, taxation, policy development, project/programme development, project/programme implementation, capacity building, surveillance, monitoring and evaluation, other) Policy recommendations
Work groups/subcommittees/task forces and their functions As the occasion arises
Accountability mechanisms (periodicity of monitoring, evaluation, reporting, and to whom; financial accountability mechanisms) Biannual reports to the Minister of Health
Main successes Monthly meetings; production of biannual reports; participation in Caribbean Wellness Day (CWD) activities; discussions of NCD themes; participation in public education activities

Policy initiatives

Public education

Advocacy

Success factors Excellent Chair, committed members, appropriate meeting facility, diversity of discussion topics

Commitment and dedication of a few members of NCNCDC

Specifically
  • Were there any successes due mainly to the participation of non-health sectors in the Commission?
  • If yes, please summarize, highlighting the role played by the non-health sector(s)
Yes
Ministry of Agriculture, faith-based organisations, trade union movements, and business representations all participated in activities recommended by the Commission, e.g. CWD
Main challenges Inconsistent attendance at meetings by some members; lack of secretariat
  • Lack of financing
  • Lack of appreciation by MOH and Government generally
  • Lack of Respect
  • Lack of inclusion in decision-making
How were these challenges overcome?
Specifically:
  • Did changes in administration disrupt the Commission’s functioning?
  • If yes, what were these changes and their effects?
  • If no, how was continuity of function maintained? What steps were taken?
No.
Briefing the new Minister on the existence of the Commission.
Inviting the new PS and Minister to a meeting of the Commission
  • Inclusion in decision-making
  • Greater respect
Partnerships, technical cooperation (TC) – please summarize partners and relevant TC areas None
Main source(s) of funding and approximate percentage of funding from each source None
Indicative annual budget (USD) None
Resource mobilisation, main areas The NNCDC has its own resources. The NCNCDC mobilizes funds from various sources and has to date been able to receive two small grants from the private sector. It has recently sent in an application for another source of funds to engage in training workshops and product development. The NNCDC is currently mobilizing resources for its “Good Food” initiative.
Mechanisms for sustainability Dedication of membership

The GRD NCNCD Commission meets monthly, but has no dedicated technical or professional staff of its own, no strategic plan, no specific budget, and limited access to Cabinet. However, it has easy access to the Minister of Health, and the Chief Medical Officer and a Senior Medical Officer are members of the Commission. Despite its challenges, the Commission has been extremely productive, and St. George’s University, the entity from which the former Commission Chair came, provided a well-resourced meeting venue and administrative support.

The critical importance of strong leadership is evident in the success of this Commission; the former Chair demonstrated unwavering commitment, despite significant competing priorities, facilitating smooth transitions from one political administration to another. The Commission produces and submits biannual reports.

This Commission has catalysed trade unions, churches, media, and public and private employers to celebrate Caribbean Wellness Day annually, with resource mobilisation undertaken by relevant sectors for the implementation of activities. Public education activities included a series of twice weekly radio programmes on NCDs and three public consultations. However, key challenges of the GRD NCNCDC, as with many others, are limitations in human and financial resources.

NNCDC ADVOCACY WORK
Status as at December 2021 Active
MENTAL HEALTH
Develop and implement a comprehensive mental health plan that complies with international human rights instruments,
includes allocated human and financial resources, and undergoes regular monitoring against indicators or targets for implementation
-
Decriminalize suicide, suicide attempts and other acts of self-harm -
Increase public awareness about mental health and how to stop discrimination through campaigns that involve
individuals living with mental disorders and psychosocial disabilities
-
Introduce brief interventions for hazardous substance use -
Advocate with other sectors such as housing, education, social welfare etc for the support of people with mental disorders
and psychosocial disabilities
-
YOUTH ENGAGEMENT
Does the NNCDC structure include a position for a youth representative? -
Is the NNCDC connected to other organizations that prioritize youth engagement? Yes: T.A. Marryshow Community College
Has the NNCDC utilized social media campaigns to target youth? -
5 NCD RISK FACTORS

TOBACCO USE
Reduced affordability of tobacco products by increasing tobacco excise taxes and prices -
Protect people from tobacco smoke by creating, by law, implementing completely smoke-free environments in all indoor workplaces, public places, and public transport -
Warn individuals of the dangers of tobacco and tobacco smoke through effective health warnings and mass media campaigns -
Implement and enforce bans on all forms of tobacco advertising, promotion, and sponsorship -
Ban the sale of tobacco to minors NA
Support plain packaging and pictorial health warnings on cigarette packages -
Implement measures to minimize illicit trade in tobacco products -
Assess the usage and impact of e-cigarettes, and develop appropriate control measures if indicated, including through legislation and regulations for tobacco control -
PHYSICAL INACTIVITY
Raise public awareness of physical inactivity through mass media public spaces and other programmes Promoting/Currently Promoting:
Develop population-based, age-specific guidelines on physical activity. -
Advocate for the design of public spaces that are supportive of physical activity. -
UNHEALTHY DIET
Reduce salt intake and salt content of food Promoted/Currently Promoting:
  • Now More than Ever: Better Labels, Better Choices, Better Health: in collaboration with other CSOs in the Caribbean. The aim of this campaign was to raise awareness about the impact of childhood overweight and obesity and the regional NCD epidemic, while promoting children’s right to nutritious foods and mobilising public and policymaker support for the adoption of the octagon shaped warning labels on the front of packaged foods as the best way to help Caribbean citizens identify products that are high in sugars, fats and salt. Campaign Duration: March 15th-April 30th, 2021. https://fb.watch/9mvnP5zYQ-/
  • Now More Than Ever: We Need to Protect Our Children Campaign: which seeks promote the overall health and well-being of children and young people and build support for healthy environments with a focus on increased access to nutritious foods.
Replace trans fats with unsaturated fat -
Raise public awareness of unhealthy diet through mass media and other programmes Promoted/Currently Promoting:
  • Now More than Ever: Better Labels, Better Choices, Better Health: in collaboration with other CSOs in the Caribbean. The aim of this campaign was to raise awareness about the impact of childhood overweight and obesity and the regional NCD epidemic, while promoting children’s right to nutritious foods and mobilising public and policymaker support for the adoption of the octagon shaped warning labels on the front of packaged foods as the best way to help Caribbean citizens identify products that are high in sugars, fats and salt. Campaign Duration: March 15th-April 30th, 2021. https://fb.watch/9mvnP5zYQ-/
  • Now More Than Ever: We Need to Protect Our Children Campaign: which seeks promote the overall health and well-being of children and young people and build support for healthy environments with a focus on increased access to nutritious foods.
Place taxes on sugar sweetened beverages Promoted/Currently Promoting:
  • Ban of Sodas and Sugary Snacks in Schools: In order to reduce sugar consumption and lower rates of overweight and obesity among youth in Grenada, a ban on sales of carbonated beverages and sweet snacks in schools was announced, effective January 1, 2020.
Implement nutritional labelling policies which promote consumption of healthier foods and beverages Promoted/Currently Promoting:
  • Now More than Ever: Better Labels, Better Choices, Better Health: in collaboration with other CSOs in the Caribbean. The aim of this campaign was to raise awareness about the impact of childhood overweight and obesity and the regional NCD epidemic, while promoting children’s right to nutritious foods and mobilising public and policymaker support for the adoption of the octagon shaped warning labels on the front of packaged foods as the best way to help Caribbean citizens identify products that are high in sugars, fats and salt. Campaign Duration: March 15th-April 30th, 2021. https://fb.watch/9mvnP5zYQ-/
Develop and implement school policies which restrict the availability of unhealthy foods and beverages within schools and their surroundings Promoted/Currently Promoting:
  • Ban of Sodas and Sugary Snacks in Schools: In order to reduce sugar consumption and lower rates of overweight and obesity among youth in Grenada, a ban on sales of carbonated beverages and sweet snacks in schools was announced, effective January 1, 2020.
HARMFUL USE OF ALCOHOL
Raise excise taxes on alcoholic beverages -
Regulate commercial and public availability of alcohol -
Enforce restrictions or bans on alcohol promotion and advertising -
Collaborate with NGOs and Ministry of Transport to educate the public on the harmful use of alcohol -
Advocate for the introduction of breathalyser testing -
AIR POLLUTION
Improve housing conditions and ensure access to clean energy sources for indoor cooking, heating and lighting -
Create awareness and develop appropriate strategies to reduce exposure to second-hand tobacco smoke in households -
Phase out health-harmful subsidies for fossil fuels and polluting industries and introduce penalties for polluters and/or taxes on pollution -
Include air quality measures in urban, rural and transport planning at city, regional and national level, including measures to encourage modal shift and active mobility, noting the additional benefits to health, wellbeing, and reduction of health inequalities -
Adopt and strictly enforce emissions standards for all pollutants in all relevant sectors, including industry, energy, transport, waste, and agricultures -
Grenada National NCD Commission Hosts 1-day Retreat to Revitalise the Commission and Chart a Strategic Path Forward

On Saturday February 3rd, 2018 the Grenada National NCD Commission (NNCDC) held a 1-day retreat to revise the NNCDC Terms of Reference and to produce a 2-year action plan to guide their work in support of the Grenada National Action Plan for the Prevention of Chronic Non Communicable Diseases.

The retreat was led by NNCDC Chair Dr. Damian Greaves who assumed the post in 2017 following, interim Chair Dr. Sonia Nixon, NCD Focal point who assumed the position after the departure of the previous longstanding Chair, Dr. Omowale Amuleru-Marshall. The retreat was held at the St. George’s University, where the commission has had its home for many years. SGU Provost Dr. Joseph Childers underscored the institution’s support and commitment to the NNCDC in his opening remarks.

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Grenada NNCDC Observership

(Left to right) Dr. Damian Greaves, Chair of the Grenada NNCDC, Dr. Joseph Childers, Provost at St. George’s University, , The Hon. Nickolas Steele, Minister for Health, Social Security and International Business, Grenada and Sir Trevor Hassell, HCC President & Chair of the Barbados National Commission on CNCDs

Barbados National NCD Commission Hosts the National Chronic Non-Communicable Disease Commission of Grenada

The HCC and partners have been continuing their work in the region aimed at supporting the multisectoral response through the strengthening National NCD Commissions (NNCDCs) or their equivalents.  On January 11-12, 2018 Dr. Damian Greaves, Chair Grenada NNCDC and Dr. Sonia Nixon, Senior Medical Officer of Health for NCDs, Grenada and past interim NNCDC chair, visited Barbados for a 2 day site visit/observership with the Barbados National NCD Commission.

‘This session for us over the last 2 days has been totally engaging and eye opening. I am leaving very ‘buoyed up’ and highly motivated.’ Dr. Damian Greaves, Chair  of the Grenada NNCDC.

‘I am very grateful to HCC and the Barbados NNCDC.  This experience can only enhance the forward movement of the commission.’ Dr. Sonia Nixon, Senior Medical Officer of Health for NCDs.

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The Grenada NNCDC team

The Grenada NNCDC team meets with members of the Barbados NNCDC, including Denise Carter Taylor, Dr Arthur Phillips, Sheena Edwards and Donna Carter, whilst participating in the PAHO NCD update webinar, led by Dr Tomo Kanda, mental health and NCD advisor

Grenada NNCDC Strengthening Mission

The collaboration between the Commonwealth Secretariat (COMSEC) and the Healthy Caribbean Coalition (HCC) aimed at establishing or strengthening National NCD Commissions in the Caribbean continued with a mission to Grenada 3-4 October 2016. As part of the technical cooperation (TC) being undertaken through this collaboration, HCC consultant Dr. Beverley Barnett visited the country to hold discussions with Ministry of Health officials and the Grenada National Chronic Non-communicable Disease Commission (NCNCDC), and provide guidance for enhancing the functioning of the Commission.

The objectives of the mission also included determining future TC needs of the NCNCDC and obtaining feedback on the draft Framework for the Establishment and Strengthening of National NCD Commissions: Towards a More Effective Multisectoral Response to NCDs, Part II (the Implementation Framework, IF).

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Grenada NNCDC Strengthening

L to R: Dr. George Mitchell, CMO; Dr. Bev. Barnett, HCC Consultant; Hon. Nikolas Steele, Minister of Health and International Business, Grenada; Dr. Sonia Nixon, NCD Focal Point and Interim NCNCDC Chair.