Three Promising Practices for Management of NCDs in India
by Deepti Mathur, Senior Manager, Knowledge Management, PSI/India
Dr. Ritu Rana, General Manager, Non Communicable Diseases, PSI/India
Dr. Heather White, Technical Advisor for Non-Communicable Diseases, PSI
Common non-communicable diseases (NCDs), like diabetes and hypertension, are silent killers that plague a large percentage of the workforce and reduce productivity globally, posing a threat to the development of nearly any economy. NCDs account for over 38 million deaths every year, roughly 68% of the global deaths annually. In India, nearly one out of every ten persons aged 18 years and above has raised blood glucose, and 69.2 million people were diabetic in 2015.
To combat this growing epidemic, PSI/India and local partners work to prevent, detect and reduce the risk for type 2 diabetes and high blood pressure in Haryana State and Andhra Pradesh through Project Uday (meaning uprise). Eli Lilly & Company supports the consortium of local partners, which includes both the Public Health Foundation of India (PHFI) and Project Hope.
Eli Lilly & Company and The Confederation of Indian Industries hosted its annual NCD Summit where a diverse group of stakeholders from the public sector, civil society, state government, and medical community shared promising practices in diabetes care and management. PSI/India led the group in developing a white paper on promising practices in management of NCDs in India.
Recommendations culled from insights from 14 NGOs on their NCD interventions and practices as other conference events brought out three critical themes with the potential to alter the face of NCDs. These all seem to be particularly true for evolving countries with rapid urbanization, changing lifestyle, and low health budgets — emerged from this experience-sharing platform. These are:
- Utilizing existing frontline health workers for NCDs for follow-up, educating patients and creating networks for enabling self-care. For example, at Municipal Corporation of Greater Mumbai (MCGM), which provides primary NCD care through 174 dispensaries, the dispensaries usually provide medicine for managing diabetes for two weeks. If a patient does not return for follow-up, the dispensary shares a list of such patients with the doctor at the Health Post, who shares this with the Community Health Volunteer (CHV). The CHVs then seek out these patients during their routine work, thereby reducing the number of patients falling off of treatment. Similarly, the Kerala government surveyed tobacco and alcohol use in the community, utilizing Kudumbashree workers, and educated the community on the health hazards of tobacco and alcohol through the State Poverty Eradication Mission. Though only working in a few districts, this project was deemed a great success in utilizing existing frontline health workers.
- Integrating services: An effective mechanism of combating NCDs is early diagnosis, which can be done by opportunistic screening of patients who come for other related health concerns in maternal health, HIV/AIDS and tuberculosis. Thus, a formal agreement between various national programs, which make it mandatory to refer patients to related services, is very useful in catching patients early. In Kerala’s Revised National TB Control Programme, which includes diabetes screening, whenever a person comes with symptoms in the Tuberculosis Centre they are also screened for diabetes and HIV. The same process is followed for diabetic patients at NCD clinics, those who have a cough are referred to a sputum microscopy centre for testing sputum.
Simple, effective measures exist for addressing these common diseases. It will be important to understand how such strategies can be put into effect at a national level. Collaboration and partnership will be key to winning the battle against NCDs.
Banner photo: © Population Services International / Photo by: Gurmeet SapalFebruary 16, 2017