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, Cancer, Chronic Respiratory Diseases, Diabetes and other NCDs are estimated to account for 63% of all deaths, thus making them the leading causes of death. NCDs cause considerable loss in potentially productive years of life. Losses due to premature deaths related to heart diseases, stroke and diabetes are also projected to increase over the years.
In order to prevent and control major NCDs, Government of India has implemented the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in all States across the country with the focus on strengthening of infrastructure, development of human resource, emphasis on health promotion, population based screening (age 30 years & above) early diagnosis, management and referral. For activities up to district level and below under NPCDCS, States are given financial support under the umbrella of NHM. 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 NE and Hilly States, where the share is 90:10).
Broad Activities permissible under NCD flexi-pool for NPCDCS are as follows:
During the year 2022-23 (up to 30/09/2022): 696 District NCD Cells, 707 District NCD Clinics, 193 District Cardiac Care Units, 268 District Day Care Centre for cancer patients, 5541 CHC NCD Clinics are established.
Population based prevention and control, screening and management initiative for common NCDs (Diabetes, Hypertension and cancer viz. Oral, Breast and Cervical Cancer) is being implemented as a part of comprehensive primary health care under Health Wellness Centre in National Health Mission (NHM). Under this initiative, persons more than 30 years of age are targeted. Prevention, control & screening services are being provided through trained frontline workers (ASHA, ANM & MPWs), and the referral support and continuity of care is ensured though PHC, CHC, District Hospitals and other tertiary care institutions. PBS can help in better management of diseases by the way of early stage of detection, follow up, treatment adherence. It will also generate awareness on the risk factors of NCDs. The initiative has linkages with NPCDCS and Tertiary care institutions like SCIs and TCCCs.
Training Modules have been developed for training of various categories of health staff viz. Nurses, ANMs, ASHAs and MOs. About 7.19 lakhs ASHAs, 2.25 lakhs ANM/Multi-Purpose Workers, 80,418 Community Health Officers, 29,076 Staff Nurses and 29,632 Medical Officers have been trained.
Software has been developed in collaboration with MoHFW, Tata Trusts and Dell Technologies for implementation of PBS for prevention, control, Screening and management of the population-based screening of common NCDs. It has tablet/mobile based application for ASHA/ANM and web based software for PHC, CHC and DH level facilities. National level training of trainers for software was conducted in April, 2018, followed by state level training. Till 20 January 2023: trained 1,08,714 Health Professionals on NCD Application across Pan India, total enrolment (30+) through NCD application is 26.23 crore and 14.40 crore were screened and their record maintained in NCD application (including State sending aggregate data through API).
