In April 2016, Singapore’s Ministry of Health (MOH) declared War on Diabetes. The declaration came about due to the increasing number of Singaporeans who were reported to suffer from diabetes or were at risk of developing it.

During a National Health Survey conducted in 2010, 1 in 9 residents or 11.3% of Singaporeans aged between 18 and 69 years were reported to be diabetic. Six years onwards, when the War on Diabetes was announced, the Health Ministry mentioned that 400,000 Singaporeans were currently suffering from the disease while 1 in 3 residents were at a lifetime risk of developing it.

Following this declaration, MOH announced that it would adopt a multi-pronged and comprehensive strategy to tackle the disease on five fronts: Prevent, Screen, Control, Understand and Do your part.

It has been about a year since the ministry first promulgated the campaign and declared war on diabetes. This two-part article sought to update healthcare providers in Singapore on some of the initiatives that have been implemented by the Health Ministry on the first two fronts – Prevent and Screen. Under the ‘Prevent’ front, the ministry sought to promote healthy living at a young age to avert or delay the onset and progression of diabetes.

1. NurtureSG taskforce

To work towards this strategy, an inter-agency NurtureSG taskforce was formed in 2016 to help formulate the NurtureSG Plan. This plan, which aims to enhance health among the young, would look into the current health issues and negative trends, work towards reinforcing health promotion efforts at schools and institutions and bringing health promotion beyond the school environment into the families and the community.

The taskforce also sought to establish some key performance indicators in tackling obesity at schools – through nutrition, inculcation of good eating habits, provision of healthier food choices at schools as well as targeting physical activity.

2. Public Consultation

The NurtureSG taskforce proceeded to conduct a public consultation exercise from April to June 2016. The exercise consolidated the views of more than 900 Singaporeans (including parents, students, teachers and caregivers) through focus discussions, online platforms and face-to-face surveys.

Dr Lam also hosted a Facebook chat to garner more views. Following the public consultation, the taskforce updated parliament that members of public identified the lack of physical activity. They would also appreciate the provision of more affordable and accessible healthy food options both in schools and outside schools.

3. Pre-schools

We could witness some of the above recommendations when NurtureSG taskforce’s announced that its recommendations would be implemented in schools in February 2017. The pre-schoolers will get at least one hour of physical activity daily in school.

This is an increase from the current allocated 30 minutes. Pre-schools would also be required to serve a wider variety of food groups and cut out on sugary drinks and deep-fried food.

4. Primary, secondary schools, junior colleges and centralised institutes

Meanwhile, the older students would receive more opportunities for “unstructured play” beyond physical education lessons and the formal curriculum time lessons. Schools will also make available facilities and sports equipment for students during those times. Additionally, healthier food and drink options for students in canteen would be implemented across the board from the primary schools to secondary schools, junior colleges and centralised institutions.

5. Tertiary institutions

For students at the tertiary level, the Health Promotion Board (HPB) would engage students to serve as in-house instructors for their fellow students. As instructors, these students would conduct activities like mass aerobics workouts and adventure-based classes. The canteens at these institutions of higher learning (IHLs) would also be urged to serve healthier meals by the financial year 2019.

6. Mental health and sleep

Besides physical health, the area of mental health is also not overlooked. Both Ministry of Education (MOE) and Health Promotion Board (HPB) established peer support structures in mainstream schools and institutions of higher learning. The trained students would be better able to identify signs of mental stress among their peers. Tote Board has also participated in this initiative by apportioning S$10 million funding for ideas that would help achieve better mental well-being and resilience among young Singaporeans.

There also efforts made to improve sleep health. During a Student Health Survey (2012-2013), it was reported that 50% of students from secondary schools, junior college and ITEs had about seven hours of sleep per day. Meanwhile, about one-third of the students had less than five-and-a-half hours of sleep. This is insufficient considering that youths aged 14 to 17 are recommended to sleep for eight to ten hours. To tackle this problem the Health Promotion Board would also step-up on public education on area of sleep health. MOE would also educate students about the importance of sleep health and good practices. MIMS

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