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 vectorborne diseases, TB, HIV, etc. The Non-Communicable Diseases like cardiovascular diseases, Cancer, Chronic Respiratory Diseases, Diabetes, etc. are estimated to account for around 60% of all deaths. 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.
Leading causes of DALYs 2016 in the state (India: Health of the Nation’s States The India State-Level Disease Burden Initiative –Report 2017) are:
Ischemic heart disease [11.0%]
Diabetes [4.1%]
COPD [4.1%]
Stroke [4.0%]
Road injuries [2.8%]
Falls [2.7%]
Depressive disorders [2.3%]
Chronic kidney disease [2.3%]In order to prevent and control major NCDs, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched with focus on strengthening infrastructure, human resource development, health promotion, early diagnosis, management and referral. Under NPCDCS, NCD Cells are being established at State and District levels for programme management, and NCD Clinics are being set up at District and CHC levels, to provide services for early diagnosis, treatment and follow-up for common NCDs. Provision has been made under the programme to provide free diagnostic facilities and drugs for patients attending the NCD clinics. Cardiac Care Units (CCU) is set up in Hospicio Hospital for providing facilities for emergency Cardiac Care. Day Care Centres facilitities available at Goa Medical College & Hospital for Cancer care. Palliative Care OPD is set up at Hospicio Hospital, Margao. The modified strategies are as follows:
Health promotion through behavior change with involvement of community, civil society, community based organizations, media etc.
Outreach Camps are envisaged for 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.
Management of chronic Non-Communicable diseases, especially Cancer, Diabetes, CVDs and Stroke through early diagnosis, treatment and follow up through setting up of NCD clinics.
Build capacity at various levels of health care for prevention, early diagnosis, treatment, IEC/BCC, operational research and rehabilitation.
Provide support for diagnosis and cost effective treatment at primary, secondary and tertiary levels of health care. Provide support for development of database of NCDs through a robust Surveillance System and to monitor NCD morbidity, mortality and risk factors.