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. Consequently, 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. A meeting to review the status of NPCDCS was held recently.

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Objectives of NPCDCS:

• Health promotion through behavior change with involvement of community, civil society, community based organizations, media etc.
• 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. Outreach camps are also envisaged.
• To prevent and control chronic Non-Communicable diseases, especially Cancer, Diabetes, CVDs and Stroke.
• To build capacity at various levels of health care for prevention, early diagnosis, treatment, IEC/BCC, operational research and rehabilitation.
• To support for diagnosis and cost effective treatment at primary, secondary and tertiary levels of health care.
• To support for development of database of NCDs through Surveillance System and to monitor NCD morbidity and mortality and risk factors.

Key features of NPCDCS:

Health promotion, awareness generation and promotion of healthy lifestyle:

• Given that the major determinants to hypertension, obesity, high blood glucose and high blood lipid levels are unhealthy diet, physical inactivity, stress and consumption of tobacco and alcohol, awareness will be generated in the community to promote healthy life style habits.
• For such awareness generation and community education, various strategies will be devised /formulated for behavior change and communication by inter personal communication (IPC), involvement of various categories of mass media, civil society, community based organization, panchayats/local bodies, other government departments and private sector.
• The focus of health promotion activities will be on:
  • Increased intake of healthy foods
  • Salt reduction
  • Increased physical activity/regular exercise
  • Avoidance of tobacco and alcohol
  • Reduction of obesity
  • Stress management
  • Awareness about warning signs of cancer etc.
  • Regular health check-up
• Screening and early detection:
  • Screening and early detection of non-communicable diseases especially diabetes, high blood pressure and common cancers would be an important component.
  • The suspected cases will be referred to higher health facilities for further diagnosis and treatment.
  • Common cancers (breast, cervical and oral), diabetes and high blood pressure screening of target population (age 30 years and above,) will be conducted either through opportunistic and/or camp approach at different levels of health facilities and also in urban slums of large cities.
  • The screening of the urban slum population would be carried out by the local government/municipalities in cities with population of more than 1 million.
  • The ANMs will be trained for conducting screening so that the same can be also conducted at sub centre level. Each district will be linked to nearby tertiary cancer care (TCC) facilities to provide referral and outreach services. The suspected cases will be referred to District Hospital and tertiary cancer care (TCC) facilities.
• Timely, affordable and accurate diagnosis.
• Access to affordable treatment.
• Establishment/Strengthening of Health infrastructure
  • Community health centers and district hospitals would be supported for prevention, early detection and management of Cancer, Diabetes, Cardiovascular Diseases and Stroke.
  • Support would be provided for establishing NCD clinics and strengthening laboratory at Community health centers and district hospitals.
  • Financial support for the essential contractual staff such as doctors and nurses at these units would also be provided under the programme.
• Human Resource development:
  • Under NPCDCS, health professionals and health care providers at various levels of health care would be trained for health promotion, NCD prevention, early detection and management of Cancer, Diabetes, CVDs and Stroke.
• Miscellaneous services:
  • Financial support would be provided to district and CHC/FRU/PHC for procurement of screening devices, essential drugs, consumables, transport of referral cases as per the details annexed for treatment of Cancer, Diabetes, CVDs and Stroke.

Conclusion:

The NCDs disproportionately affect the poor, impoverish families, and place a growing burden on health care systems. A majority of cancers and CVDs can be prevented and treated if diagnosed at an early stage. The NPCDCS is a step in the right direction.