Non-communicable diseases (NCDs) are a group of diseases that are not contagious and characterized by both chronicity and close relation to social and public factors. NCDs develop as a result of the common risk factors such as tobacco smoking, alcohol abuse, unhealthy diet and physical inactivity. They cause a great disease burden and are the leading cause of premature mortality in most countries. The four main NCDs are: cardiovascular disease, cancer, chronic obstructive pulmonary disease and diabetes.

Worldwide 60% of deaths are due to NCDs. As a result of the current trends, it is expected that by 2030 the annual number of deaths from NCDs will increase by 35% while in the next 20 years the number of deaths from infectious diseases is expected to decline. According to the calculations, 80% of the cases of coronary heart disease (ischemic heart disease) and cerebrovascular disease is caused by aforementioned behavioral risk factors.

As in many countries, in Azerbaijan NCDs are the largest disease burden and the leading cause of premature mortality. For year 2011, 80% of reported deaths in Azerbaijan was due to cardiovascular diseases, cancer, respiratory system diseases, injuries, poisoning/other consequences of external causes, (poor) nutrition, metabolic disorders and diseases of the endocrine system including diabetes.

The Ministry of Health of Republic of Azerbaijan conducted a number of research on NCDs including the "Case Analysis on NCDs” (2008), "Analysis of the economic impact of NCDs" (2009), "A Global Youth Tobacco Survey" (GYTS-2011), "National Survey on NCD Risk Factors” (2011). The research have revealed that NCDs are the primary cause of morbidity and mortality in Azerbaijan.

Achieving comprehensive coverage by NCD prevention and control services is a priority area fo healthcare system at all levels. Despite healthcare services attempts to eliminate NCDs impact on human health, proper knowledge and skills of healthcare providers, in particular at primary healthcare level, still play a key role in addressing these challenges.

Public Health and Reforms Centre of the Ministry of Health (PHRC) with the support of the World Health Organization has implemented a project on strengthening of NCD risk factors prevention at primary health care in order to improve effective communication skills of health personnel, particularly primary health care physicians, to deepen their knowledge on basic non-communicable diseases and their risk factors, to advance patient consultation skills on healthy behavior, to manage health education recommendations for population when they visit clinics, to enhance patients’ ability to take care of their health regularly.

The project goal was to improve primary healthcare physicians’ skills on prevention of non-communicable diseases risk factors among the population. Baku City Main Healthcare Department of the Ministry of Health provided all required opportunities for PHRC staff on the project implementation. The project was implemented in three stages.

At the first stage, in October 2014, to identify their knowledge in prevention of NCDs and risk factors, physicians of ten hospitals (polyclinics) were surveyed. The survey helped to assess

performance of medical personnel who are in direct contact with population. A questionnaire consisting of 43 question items was used in the research and was anonymous. 40 physicians of ten hospitals in different administrative areas/districts of Baku city participated in the survey. According to the survey findings, in average only 37% of physicians demonstrated adequate level of knowledge and skills on basic non-communicable diseases and their risk factors, healthy behavior and healthy lifestyle, preventive care, early diagnosis and patient education.

The survey findings were then analysed and utilized while developing a training manual. Recommendations developed on the basis of the survey results were taken into account both in the manual and training materials considered for PHC providers.

On the second phase of the project a series of trainings on NCDs and risk factors prevention was held with participation of an international expert. Each training session was provided for one (representative) physician from each of the 20 polyclinics (total 40) in Baku. The training sessions were held on 4 and 7 November 2014. In total, 40 primary health care physicians attended the training.

During the training sessions general information on the project, the project objectives and the shareholder/actors were introduced to the participants. PHRC developed training materials were distributed to each participant: presentations, manuals, clinical protocols ("Clinical protocol on prevention of cardiovascular diseases" and "Clinical protocol on smoking cessation"), a number of visual materials (booklets, brochures, posters) for physicians and patients. The basic training materials were distributed to doctors in both printed and electronic forms (CD-ROM).

At the training such issues as a role of primary healthcare physicians in NCD's prevention, patient’s visit structure (anamnesis, physical examination, internal organs revision, treatment plan, and preventive measures on risk reduction), consulting on prevention of NCD risk factors in accordance with a person's age and sex were introduced. A special attention was paid to the issues of mammography, colonoscopy, body weight reduction, nutrition (poor nutrition), behavior change strategies, and etc. The training was highly appreciated by the participants and at the end a plan for future project activities was discussed.

At the final stage of the project the 40 doctors who had completed the training, jointly with the PHRC project staff, conducted trainings for other doctors in their clinics. It is expected that these training will have a positive impact on NCDs risk factors prevention among thousands of primary healthcare patients.