In 2008, out of the 57 million global deaths, 36 million deaths, or 63%, were due to NCDs, principally cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. In India, the estimated deaths due to NCDs in 2008 were 5.3 million (World Health Organization – NCD Country Profiles, 2011). The overall prevalence of diabetes, hypertension, Ischemic Heart Diseases (IHD) and stroke in India is 62.47, 159.46, 37.00 and 1.54 respectively per 1000 population. (Indian council for Medical Research, 2006).
The NPCDCS aims at integration of NCD interventions in the NRHM framework for optimization of scarce resources and provision of seamless services to the end customer / patients as also for ensuring long term sustainability of interventions.
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.
The package of services would depend on the level of health facility. The range of services will include health promotion, psycho-social counselling, management (out-and-in-patient), day care services, home based care and palliative care as well as referral for specialized services as needed. Linkages of District Hospitals to private laboratories and NGOs will help to provide the additional components of continuum of care and support for outreach services. The district may be linked to tertiary cancer care health facilities for providing comprehensive and advanced secondary care.
The services under the programme would be integrated below district level and will be integral part of existing primary health care delivery system, and vertical at district and above as more specialized health care are needed both for cancer component and diabetes, CVD, and stroke.
Expected Outcomes:
The programmes and interventions would establish a comprehensive sustainable system for reducing rapid rise of NCDs, disability as well as deaths due to NCDs.
Broadly, following outcomes are expected at the end of the 12th Plan:
- Early detection and timely treatment leading to increase in cure rate and survival.
- Reduction in exposure to risk factors, life style changes leading to reduction in NCDs.
- Improved mental health and better quality of life.
- Reduction in prevalence of physical disabilities including blindness and deafness.
- Providing user friendly health services to the elderly population of the country.
- Reduction in deaths and disability due to trauma, burns and disasters.
- Reduction in out-of-pocket expenditure on management of NCDs and thereby preventing catastrophic implication on affected individual.
Changing Diabetes Barometer
There are 18 surveyors who are trained in diabetes management, diabetic foot care, collection of anthropometric parameters, diet, exercise etc. 11018 patients were counseled and 288 IEC activities were conducted.
The Diabetes Registry Cell has registered 10567 patients with Diabetes mellitus in Diabetes Registry software November 2013.
World Diabetic Day is commemorated every year on 14th November at different places of Goa to create awareness activity as part of IEC.
Goa Cancer Registry
Since incidence of Cancers in Goa contributes to sizeable mortality, Goa Cancer Registry was inaugurated on 2nd January 2009 to register the patients with Cancer and to analyze the same to conclude on the pre disposing factors as well as to assess the disease load in the state and till December 2013, 4765 cases have been registered under Cancer registry where in the data has been collected from Goa Medical College, and from different peripheral units of Goa. The study till date has shown high prevalence of Breast Cancer, Oral Cavity Cancers and of reproductive organs of female.
In view of breast cancer on the rise amongst female community two Mammography vans have been procured conducting camps at Dona Paula, Margao, Vasco, Mapusa, Ponda, Canacona, Valpoi, Curchorem, Pernem, Bicholim, Shiroda, Sanquelim, Sanguem and Siolim screening 2344 females.
Government Hospitals as well as Private Hospitals have been recognized to get the Patients suffering from Cancer registered in Goa Cancer Registry. All Municipal Councils and Panchayats have been requested to send number of deaths occurring due to cancers within their jurisdiction to respective Health Centres since it has been realize that there might be some data that is missed or remains unreported.