Non Communicable Diseases (NCD) are climbing the rank list and will shortly become the leading cause of death in humans. India is also experiencing such a transition with the rising number of NCD. According to a WHO report, cardiovascular diseases will be the leading cause of death in India by 2020.
But, you don’t have to worry. The government of India has implemented an effective programme with the aim of preventing and controlling NCD.
The central government gives technical and financial support to the state governments in successfully implementing and conducting the popular NCD programme.
This article is about the NCD programme. After reading this article you will be aware of the services offered as part of this programme at the various levels of primary healthcare in India.
What is NCD Control Programme?
Before going into the details of the programme, let’s find out what a NCD is!
As the name suggest, NCDs are a group of diseases which do not spread from person to person. They are results of our own sedentary and modern lifestyle. There is no “infective agent” for the NCD as compared to the communicable diseases. Another big difference is that most of the NCDs causes severe morbidity (usually lifelong) and even mortality by affecting people in all the socio-economic groups.
The common non communicable diseases are :
One of the common feature of these diseases is that early detection is very crucial in the control and treatment. Prevention of these diseases can be done easily by modifying the risk factors. The main preventable risk factors of NCD are tobacco consumption, sedentary lifestyle and unhealthy food habits.
Control of the NCD can only be done by providing proper medical and surgical treatments. But, in a country like India, these preventive and control measures can only be done by implementing a national level health programme. This is where the NCD programme comes into play.
The major objectives of NCD programme are :
- Prevent and control common NCDs through behaviour and life style changes,
- Provide early diagnosis and proper management of common NCDs,
- Provide infrastructure at various levels of health care for prevention, diagnosis and treatment of NCDs,
- Train human resource within the public health setup viz doctors, paramedics and
nursing staff to cope with the increasing burden of NCDs.
The NCD programme provides a spectrum of services extending from simple screening tests to new ultrasound scans based on the infrastructure available at various levels of healthcare.
NCD at grass-root levels
The services offered at sub-centres are basic (yet effective) and includes :
- registering the NCD clients,
- recording blood pressure,
- testing and recording random blood glucose tests (using glucometer),
- recording BMI (body mass index) and
- referral services
Next , we will look at an overview of the NCD programme being conducted at the PHCs (Primary Health Centre)
NCD Clinics at PHC
A fixed day of every week, the OPD (out patient department) at the PHC functions as the NCD clinic. The day fixed for conducting NCD clinic varies from place to place. Contact your nearest primary health centre for further details. Patients can attend these clinics and avail of the following free services :
- Register as part of the programme and get a treatment/follow-up card.
- Check height, weight and BMI
- Test their blood glucose level (random, fasting or post-prandial)
- Check blood pressure
- Test the blood cholesterol level at the laboratory
- Attend health education classes
- Consult the doctor for their routine checkups
- Get medicines for one full months duration (till the next review)
New NCD patient care
Whenever a patient has been newly detected of any of the common NCD, he/she is registered and is given a treatment card/book. This NCD card contains all the vital heath related information about the patient including the blood pressure and blood glucose test values. The patient is given an option to either take treatment from government hospitals or from any other private facility of their choice. The information regarding the type of treatment is also entered in the NCD card.
The patients are encouraged to bring this card/book whenever they visit the health centre for a review or follow-up.
NCD Clinics at higher levels
The quality of the NCD programme conducted at higher levels of healthcare depends mainly on the facilities available at the respective levels.
Hospitals which have USG and X-ray facilities can be used to detect many different types of cancers. Such facilities usually exist at Taluk hospitals, District hospitals and in some Community Health Centres.
ECG (electrocardiogram) test can be done at these higher level public hospitals. It is used to prevent and control cardiovascular diseases.
Thus, at higher levels of healthcare system like in CHC and district hospitals, preventive and control measures of cardiovascular diseases and stroke are also available. This is in addition to the 8 services available at the PHCs.
In addition to conducting clinics at the various levels of healthcare, the NCD programme has provisions to conduct camps at discrete peripheral locations.
Such camps are usually conducted at workplaces, factories, bus stations, railway stations etc. The main aim of the camp is to screen the community for NCD.
Diabetes, hypertension and cardiovascular diseases can be easily screened in such NCD camps. We have conducted almost 18 such camps in the last 3 years. I am planning to write a separate post on my experiences at such an NCD camp later on.
Healthcare in India is easily a topic for a whole day debate. In a county where national health programmes exists for almost all known diseases, the NCD programme stands out because of it’s unique features. The programme gives more priority in early detection and prevention rather than just curative services.
It will cost a person around 1000 rupees for all the basic investigations and one months’s medicine in a private hospital. On the other hand, the same person can avail the above mentioned services and even get medicines completely free of cost at any government hospitals in India, thanks to the NCD programme.
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