National Programme for Prevention and Control of Cancer, Diabetes,Cardiovascular Diseases and Stroke
National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)
India is experiencing a rapid health transition with a rising burden of Non-Communicable Diseases (NCD) surpassing the burden of Communicable diseases like water-borne or vector-borne diseases, TB, HIV, etc. The Non-Communicable Diseases like Cardiovascular Diseases (CVD), Cancer, Chronic Respiratory Diseases, Diabetes and other NCDs are estimated to account for around 60% of all deaths, thus making them the leading causes of death. Losses due to premature deaths due to these NCDs are also projected to increase over the years. Therefore, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010 in 100 districts across 21 States, in order to prevent and control the major NCDs. The main focus of the programme is on health promotion, early diagnosis, management and referral of cases, besides strengthening the infrastructure and capacity building.
The main strategies of the programme are as follows:
a) Health promotion through behavior change with involvement of community, civil society, community based organizations, media etc.
b) Outreach Camps are envisaged for opportunistic screening at all levels in the health care delivery system from sub-centre and above for early detection of diabetes, hypertension and common cancers.
c) Management of chronic Non-Communicable diseases, especially Cancer, Diabetes, CVDs and Stroke through early diagnosis, treatment and follow up through setting up of NCD clinics.
d) Build capacity at various levels of health care for prevention, early diagnosis, treatment, IEC/BCC, operational research and rehabilitation.
e) Provide support for diagnosis and cost effective treatment at primary, secondary and tertiary levels of health care.
f) Provide support for development of database of NCDs through a robust Surveillance System and to monitor NCD morbidity, mortality and risk factors.
The funds are being provided to States under NCD Flexi-Pool through State PIPs of respective States/UTs, with the Centre to State share in ratio of 60:40 (except for North-Eastern and Hilly States, where the share is 90:10).
For the Cancer component, there is the Tertiary Care Cancer Centers (TCCC) Scheme, which aims at setting up/strengthening of 20 State Cancer Institutes (SCI) and 50 TCCCs for providing comprehensive cancer care in the country. Under the scheme there is provision for giving a ‘one time grant’ of Rs. 120 crore per SCI and Rs. 45 crore per TCCC, to be used for building construction and procurement of equipment, with the Centre to State share in the ratio of 60:40 (except for North-Eastern and Hilly States, where the share is 90:10).
2.1 Details of Infrastructure established
- For programme management, State NCD Cells have been established in all 36 States/UTs, and District NCD Cells have been established in 390 district headquarters till March 2017.
- Provision has been made under the programme to provide free diagnostic facilities and free drugs for NCD patients attending the NCD clinics at the District and CHC levels. Till March 2017, 388 District NCD Clinics and 2115 CHC NCD Clinics have been established in the country. Also, 133 Cardiac Care Units (CCU) for emergency Cardiac Care and 82 Day Care Centres for cancer chemotherapy have been set up in identified districts.
2.2. Details of NCD screening under the programme:
As per monthly reports received from the State/UTs, the data is compiled at the National NCD Cell. A snapshot of the last three years data on the common NCDs collected in the designated NCD Clinics is as below:
Fig 1: Number of attendees of NCD Clinics diagnosed with common NCDs in the period 2014-15 till 2016-17.
- As per the reports received from States, around 2.24 crore persons attended NCD Clinics and were screened for common NCDs like Diabetes, Hypertension, CVDs and common Cancers during 2016-2017. Among the attendees of NCD Clinics, 9.7 % were diagnosed to be Diabetics, 12.09% were Hypertensive, 0.55% had cardiovascular diseases and 0.17% were patients of common cancers including oral, cervical and breast cancers. After confirmation of diagnosis these persons were either managed in the NCD Clinics or referred to higher facilities. Around 79 lakh persons underwent counselling for health promotion for prevention of NCDs or lifestyle modification for management of NCDs.
- During 2016-2017 around 1.67 crore persons were screened for common NCDs under various outreach activities including health-camps and primary healthcare facility level. Among them, Diabetes was suspected in around 8.4%, Hypertension was suspected in 8.7%, and Common Cancers were suspected in around 0.2% persons screened. They were referred to higher centres for confirmation of diagnosis and management.
3. OTHER INITIATIVES UNDER THE PROGRAMME:
a) For combating common NCDs in the community, a new strategy for Population-based Screening of common NCDs like Diabetes, Hypertension and common Cancers is being initiated under the umbrella of NHM in 100 districts of the country in the first phase. This will utilize the services of the Frontline-workers (ASHA) and Health-staff (Staff Nurse/ANM, etc.) of the existing Primary Healthcare System in screening of NCD risk factors as well as early detection and referral of NCDs. For this, Operational Guidelines have been launched and training of the States has been undertaken.
b) Guidelines for prevention and management of Chronic Obstructive Pulmonary Disease (COPD) and Chronic Kidney Disease (CKD) are being included under the programme to prevent and manage the chronic respiratory and kidney diseases respectively, which are also major causes of death due to NCDs.
c) For comprehensive management of lifestyle related disorders, a pilot project on ‘Integration of AYUSH with NPCDCS’ has been initiated in six districts, namely Bhilwara (Rajasthan), Gaya (Bihar), Surendranagar (Gujarat) under Central Council for Research in Ayurvedic Sciences (CCRAS); Lakhimpur-Kheri (Uttar Pradesh) under Central Council for Research in Unani Medicine (CCRUM); and Krishna (Andhra Pradesh) and Darjeeling (West Bengal) under Central Council for Research in Homeopathy (CCRH). Synergy is being harnessed between the Allopathy system under NPCDCS and the alternative systems of medicine under AYUSH, for prevention and management of ‘lifestyle-related’ common NCDs. Besides health promotion and patient management services at the NCD/Lifestyle Clinics, training on Yoga are also provided through an integrated Yoga programme. The government is planning to expand NPCDCS-AYUSH integration project to more districts of the country.
d) Pilot intervention has been initiated for the prevention and control of Rheumatic Fever and Rheumatic Heart Disease under the platforms of NPCDCS and RBSK (Rashtriya Bal Swasthya Karyakram), in three select districts (Gaya in Bihar, Firozabad in Uttar Pradesh and Hoshangabad in Madhya Pradesh). This intervention is planned to be scaled up to other districts in a phased manner.
e) Another initiative is the integration of RNTCP with NPCDCS, wherein the “National Framework for Joint Tuberculosis-Diabetes collaborative activities” has been developed to articulate a national strategy for ‘bi-directional screening’, early detection and better management of Tuberculosis and Diabetes co-morbidities in India.
f) Opportunistic screening of common NCDs including Diabetes, Hypertension and Cancer, is being done among the attendees of the India International Trade Fair (IITF) at Pragati Maidan, New Delhi during 14-27 November, every year. Besides screening NCDs and lifestyle related risk factors, this initiative also helps to increase awareness about the prevention and control of NCDs. Every year more than 70,000 persons are screened at the IITF and suspected cases of Diabetes, Hypertension and common Cancers are referred to designated hospitals for further management.
Fig 2: Camp for screening of common NCDs at IITF-2016
g) Along with different forms of media, social media is also being used to generate awareness about prevention and control of NCDs. To leverage mobile technology, an application called mDiabetes has been launched to generate awareness, to promote adherence of treatment and to inculcate healthy habits among the masses with special focus on target groups.
Few Photos of NPCDCS facilities:
|District NCD Cell
||Screening for Diabetes and Hypertension in NCD Clinics
|Cardiac Care Unit
||District Cancer Facility
Last Updated On 13/07/2017