NPCDCS

 

India is experiencing a rapid health transition with a rising burden of Non Communicable Diseases (NCDs). According to a WHO report (2002), cardiovascular diseases (CVDs) will be the largest cause of death and disability in India by 2020. Overall, NCDs are emerging as the leading cause of deaths in India accounting for over 42% of all deaths (Registrar General of India). NCDs cause significant morbidity and mortality both in urban and rural population, with considerable loss in potentially productive years (aged 35–64 years) of life.


It is estimated that the overall prevalence of diabetes, hypertension, Ischemic Heart Diseases (IHD) and Stroke is 62.47, 159.46, 37.00 and 1.54 respectively per 1000 population of India. There are an estimated 25 Lakh cancer cases in India. According to the National Commission on Macroeconomics & Health (NCMH) Report (2005), the Crude Incidence Rate (CIR) for Cervix cancer, Breast cancer and Oral cancer is 21.3, 17.1 and 11.8 (among both men and women) per 100,000 populations respectively.


The main preventable risk factors for NCDs are tobacco consumption; poor dietary habits, sedentary life style, stress etc. National Family Health Survey III (2005-06), reported that the prevalence of current tobacco use was 57•0 % among men and 10.8% among women. Over 8 lakh deaths occur every year due to diseases associated with tobacco use. The cancer registry data reveals that 48% of cancers in males and 20% in females are tobacco related and are totally avoidable. Common cancers caused by smoking tobacco are lung, larynx, pharynx and oesophagus, while cancers of the mouth, tongue and lip are due to chewing and smoking tobacco.


States have already initiated some of the activities for prevention and control of non communicable diseases (NCDs) especially cancer, diabetes, CVDs and stroke. The Central Govt. proposes to supplement their efforts by providing technical and financial support through National Program for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS). The NPCDCS program has two components viz. (i) Cancer & (ii) Diabetes, CVDs 3 & Stroke. These two components have been integrated at different levels as far as possible for optimal utilization of the resources. The activities at State, Districts, CHC and Sub Centre level have been planned under the programme and will be closely monitored through NCD cell at different levels. The Government of India launched a flagship programme called the NRHM in 2005 with the objective of expanding access to quality health care to rural populations by undertaking architectural corrections in the institutional mechanism for health care delivery. The crucial strategies under NRHM have been the integration of Family Welfare and National Disease Control Programmes under an umbrella approach for optimization of resources and manpower; strengthening of outreach services by incorporation of village health worker called ASHA; efforts for communitization of services through formation of Health and Sanitation Committees at village, block and district level; registering Rogi Kalyan Samities for improving hospital management; strengthening and upgrading the public health infrastructure to Indian Public Health Standards (IPHS); and consolidation of the District Level Programme Management Unit through the induction of professionals. The NPCDCS aims at integration of NCD interventions in the NRHM framework for optimization of scarce resources and provision of seamless services to the end customer / patients as also for ensuring long term sustainability of interventions. Thus, the institutionalization of NPCDCS at district level within the District Health Society, sharing administrative and financial structure of NRHM becomes a crucial programme strategy for NPCDCS. The NCD cell at various levels will ensure implementation and supervision of the programme activities related to health promotion, early diagnosis, treatment and referral, and further facilitates partnership with laboratories for early diagnosis in the private sector. Simultaneously, it will attempt to create a wider knowledge base in the community for effective prevention, detection, referrals and treatment strategies through convergence with the ongoing interventions of National Rural Health Mission (NRHM), National Tobacco Control Programme (NTCP), and National Programme for Health Care of Elderly (NPHCE) etc.and build a strong monitoring and evaluation system through the public health infrastructure.