**10.1 Neglected causes of cardiovascular diseases and their causes**

Neglected CVDs in SSA are endomyocardial fibrosis, congenital heart diseases, and rheumatic heart disease [26]. Rheumatic fever affects children in low resource settings where poverty is rife, overcrowding and poor sanitary conditions and limited access to health care services. Rhematic heart disease can be prevented by preventing streptococcal infections or treating them early when they occur [27].

Congenital heart disease: Genes and environmental factors are associated with congenital heart diseases. Maternal health is critical particularly during the first trimester [28]. New-born heart health is affected by maternal health during pregnancy and the environmental conditions in which the mother lives. Causes of endomyocardial fibrosis are virus infections and toxic insults among others [29, 30]. See **Table 1** below.

It is important to point out that social determinants of health are alluded to in the national development plan 2030 [31]. The realisation and implementation of these policies however, remain a challenge.


**9**

**Figure 2.**

security etc.

*Poverty Is Not Poverty: The Reality on the Ground Including the Rural-Urban Divide…*

2020. This includes population and individual based strategies.

• Legislation for reduction of sodium in processed foods [32]

• Detection, treatment and control of cardiovascular disease risk [25]

• Emphasis -assertive treatment, targeting antihypertensive and statin treatment

• Training of nurses (lest we forget) on correct measurement and aggressive management of NCDs, active detection, prevention, control of cardio-vascular

Both the population based and individual based strategies above, are focussing mainly on treatment rather than prevention. Why wait for the population to fall sick? Simple, cost effective and culturally adapted behaviour and educational

Health of the population should be protected- a central tenet of public health. The health care in SA is hospicentric rather than preventive and promotive. Only 10% of health expenditure is spent on promotive health? The system seems to foster

Step 3: Health gives us access to everything else in the society, education, jobs,

Step 1: Health is an asset -acknowledgement and identification of that).

• Taxation of sugar sweetened beverages [32] and alcohol

diseases to avert expenses on hospitalizations [25].

the idea that people should get ill first before being assisted.

**11.1 Population based strategies to prevent NCDs**

• Tightening of anti-tobacco regulations [25]

**11.2. Individual level strategies (crucial)**

guidelines [25]

**12. Public health lip service?**

interventions rather needed (**Figure 2**) [23].

Step 2: Health needs to be preserved.

*We are waiting for people to fall sick as depicted below.*

**11. South African plans to decrease NCD related premature mortality**

SA has plans to decrease NCD related premature mortality by 25% by end of

*DOI: http://dx.doi.org/10.5772/intechopen.95901*

**Table 1.** *Neglected causes of cardiovascular diseases and their causes.* *Poverty Is Not Poverty: The Reality on the Ground Including the Rural-Urban Divide… DOI: http://dx.doi.org/10.5772/intechopen.95901*
