Table 1 Multifaceted and multi-institutional framework for chronic disease prevention

Policy

Targeting specific chronic diseases or risk factors (e.g smoking, alcohol)

Fiscal

Taxes on food, alcohol or tobacco. Subsidies on exercise equipment.

South Africa on tobacco; Zambia on soft drinks[1]

Industry and private businesses

Working with food industry to lower fat or sugar content of products

Mauritius and the food industry[8]

International collaboration

Building intellectual, technical and financial capacity through partnerships

Mauritius and Tanzania on the InterHealth Project[8]

Mass media

Public health education via radio, television and newspapers targeting communities or the nation

South Africa and the Coronary Risk Factor Study[9]

Voluntary/advocacy organisations

Public education, patient support, lobbying by special interest groups.

Institutions (schools, workplace, churches)

Institution-based interventions on diet, physical activity and smoking

Primary healthcare

Routine advice given by doctors and nurses on major risk factors; quality of care; community outreach services.

South Africa and the Coronary Risk Factor Study[9]

Behavioural interventions

Tobacco cessation, increased physical activity and dietary change and promotion of weight loss

Pharmacological interventions

Pharmacological interventions for high risk individuals: e.g combination of aspirin, beta-blockers, angiotensin converting enzyme inhibitors and statins can reduce the risk of recurrent myocardial infarction by 75% [1].