Context: The article highlights the problems that our healthcare system is struggling with and suggest how Doorstep health-care delivery can mitigate the effects of disruption caused by pandemics.

• Even before the start of the pandemic, health experts warn India of a health epidemic – one that involved Non-Communicable Diseases (NCD). During the pandemic, faults in our healthcare system were seen visibly when access to institution-based treatments was severed suddenly. There is a need for states to introspect how to strengthen the healthcare setup to prevent this from happening again.

An initiative of Tamil Nadu (TN)

• TN suffers from a high burden of NCD. The state has very low community control rates for hypertension (7.3%) and diabetes (10.8%). To work on this, it introduced the “Makkalai Thedi Maruthuvam” scheme aimed to take healthcare to the doorsteps of the people.
• It is a community-based scheme to tackle and treat NCDs and to address the crucial issues of prevention and early detection
• It included population-based screening for 18 plus population for 10 common conditions—hypertension, diabetes, oral, cervical and breast cancers, TB, Leprosy, kidney disease, Obstructive Pulmonary Disease and mental health
• Delivery of drugs-hypertension, diabetes to patients above 45 years of age

Impact of NCDs on India

• According to India: Health of Nation’s States report: 55% of the total disease burden in India were caused by NCD in 2016. This burden has been increasing across all states from 1990 to 2016.

Road Ahead

• There is a need to necessitate uninterrupted access to health care services, especially when the correlation between NCDs like hypertension, diabetes etc and Corona was clearly known.
• States should take an example from the TN model and prepare themselves for the upcoming epidemics. They have to ensure that similar disruption will not happen again.