Directorate General Of Health Services

National Programme for Prevention and Control of Cancer, Diabetes,Cardiovascular Diseases and Stroke

In India, Non-Communicable Diseases (NCDs) like Cardiovascular Diseases (CVD), Cancer, Chronic Respiratory Diseases, Diabetes are estimated to account for around 60% of all deaths, . The Government of India has been implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) since 2010 up to District level under the National Health Mission. NPCDCS has a focus on awareness generation for behaviour and life-style changes, screening and early diagnosis of persons with high level of risk factors and their referral to appropriate treatment facilities i.e. Community Health Centres and District Hospital for management of non-communicable diseases including cardiovascular diseases. The strengthening of infrastructure for screening, early detection, treatment and referral is also envisaged.

Objectives

Health promotion through behaviour change with involvement of community, civil society, community based organizations, media etc.
Screening at all levels in the health care delivery system from sub-centre and above for early detection of diseases covered under the program including management and follow up.
To build capacity at various levels of health care for prevention, early diagnosis, treatment, rehabilitation, IEC/BCC, operational research and rehabilitation.
To provide logistic 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.

Strategy

The strategies for prevention, control and treatment of NCDs would have following components:

Health promotion awareness generation and promotion of healthy lifestyle
Screening and early detection
Timely affordable and accurate diagnosis
Access to affordable treatment
Rehabilitation

Activities

The package of services would depend on the level of health facility (Sub-centre, PHC, CHC, DH) and may vary from facility to facility. The range of services will include health promotion, psycho-social counselling, outreach activities including screening diseases and their risk factors, management (out-andin-patient), day care services, home based care and palliative care as well as referral for specialized services as needed.

Newer Initiatives:

Population based screening (PBS) for NCDs namely diabetes, hypertension and common cancers (oral, breast and cervix) has been expanded to more than 400 districts. Screening is being provided through trained frontline workers (ASHA & ANM) and suspected cases are referred to Medical Officers at PHC.
Initiation of NCD App for capturing patient wise data and further follow up from PBS districts.
Under Ayushman Bharat, NCDs are included in the spectrum of services being offered at Health and Wellness Centres
Pradhan Mantri National Dialysis Program (PM-NDP) is being implemented in 35 States/UT in 496 Districts.
Prevention, early detection and treatment of rheumatic fever and rheumatic heart diseases.
“National Framework for Joint Tuberculosis-Diabetes collaborative activities” has been developed to articulate a national strategy for ‘bi-directional screening’, early detection and better management of Tuberculosis and Diabetes co-morbidities in India.
National Multi-sectoral Action Plan for prevention and control of NCDs has been developed through series of consultations with various stakeholders including other Ministries / Departments.
Inclusion of prevention and management of Chronic Obstructive Pulmonary Disease (COPD) and Chronic Kidney Disease (CKD) in program.
India Hypertension Management Initiative (in collaboration with ICMR).
Opportunistic screening of common NCDs including Diabetes, Hypertension and Cancer, is being done among the attendees of the India International Trade Fair (IITF) at Pragati Maidan, New Delhi during 14-27 November, every year.

Program infrastructure

Till March, 2020, there are 665 District NCD Cells, 637 District NCD Clinics, 4472 CHC NCD Clinics, 181 Cardiac Care Units and 218 Day Care Units functional in the country.

Pattern of assistance 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 North-Eastern and Hilly States, where the share is 90:10).

For the Cancer component, there is the Tertiary Care Cancer Centers (TCCC) Scheme, which aims at setting up/strengthening of 20 State Cancer Institutes (SCI) and 50 TCCCs for providing comprehensive cancer care in the country. Under the scheme there is provision for giving a ‘one time grant’ of Rs. 120 crore per SCI and Rs. 45 crore per TCCC, to be used for building construction and procurement of equipment, with the Centre to State share in the ratio of 60:40 (except for North-Eastern and Hilly States, where the share is 90:10).

Performance:

Around 6.61 crore persons attended NCD Clinics and were screened for common NCDs like Diabetes, Hypertension, CVDs and common Cancers during 2019-20. More than 1.1 crore population has been covered under Population Based Screening so far. In addition, during outreach activities, 5.6 crore NCD check up were conducted

Medical Officers’ Manual for Prevention and Management of Chronic Kidney Diseases 0