5-Apr-2022: Update on National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke
The Department of Health & Family Welfare, Government of India, provides technical and financial support to the States/UTs under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), as part of National Health Mission (NHM), based on the proposals received from the States/UTs and subject to the resource envelope. The programme focusses on strengthening infrastructure, equipment, human resource development, health promotion & awareness generation for prevention, early diagnosis, management and referral to an appropriate level of healthcare facility for treatment of the Non-Communicable Diseases (NCDs). Under NPCDCS, 682 District NCD Clinics, 191 District Cardiac Care Units, and 5408 Community Health Center NCD Clinics has been set up.
A population-based initiative for prevention, control and screening for common NCDs i.e., diabetes, hypertension and common cancers (oral, breast and cervical) has been rolled out in the country under NHM and also as a part of Comprehensive Primary Health Care. Under the initiative, persons more than 30 years of age are targeted for their screening. Screening of these common NCDs is an integral part of service delivery under Ayushman Bharat – Health and Wellness Centres. A total of 7,04,631 Accredited Social Health Activist (ASHAs), 2,19,113 Auxiliary Nurse Midwife (ANM)/Multipurpose Workers (MPW), 28,912 staff nurses, 76,567 Community Health Officers (CHOs) and 29,648 Medical Officers (MOs) have been trained on universal screening of common NCDs
Preventive aspect of NCDs is strengthened under Comprehensive Primary Health Care through Ayushman Bharat Health Wellness Centre scheme, by promotion of wellness activities and targeted communication at the community level. Other initiatives for increasing public awareness about NCDs and for promotion of healthy lifestyle includes observation of National and International Health Day and use of print, electronic and social media for community awareness. Furthermore, healthy eating is also promoted through FSSAI. Fit India movement is implemented by Ministry of Youth Affairs and Sports, and various Yoga related activities are carried out by Ministry of AYUSH. In addition, NPCDCS gives financial support under NHM for awareness generation (IEC) activities for NCDs by the States/UTs as per their Programme Implementation Plans (PIPs).
Further, the Fifteenth Finance Commission (FC-XV) recommends grant to states for Rs. 16,377 crores in Rural Sub Health Centres & Rural Primary Health Centres (PHCs) and Rs. 2,095 crores in Urban PHCs to provide support for diagnostic infrastructure with the vision of providing Comprehensive Primary Health Care close to the community.
12-Jun-2019: A meeting to review the status of National Programme for prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and strokes (NPCDCS) was held recently.
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.
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-and in-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 checkup were conducted.
30-Mar-2022: Union Minister Dr Jitendra Singh says, NIDAN Kendras established at five Government hospitals in four states for treating genetic disorders
Union Minister of State (Independent Charge) Science & Technology; Minister of State (Independent Charge) Earth Sciences; MoS PMO, Personnel, Public Grievances, Pensions, Atomic Energy and Space, Dr Jitendra Singh said that the Department of Biotechnology started the Unique Methods for Management of Inherited Disorders (UMMID) initiative to address the burden of genetic disorders in the country. One of the components of the UMMID initiative is establishing NIDAN Kendra (National Inherited Disorders Administration Kendras) for providing clinical care broadly encompassing the activities of prenatal testing for genetic disorders, new-born screening for relatively common treatable genetic metabolic disorders, and genetic counselling of pregnant mothers carrying fetuses with high risk of genetic disorders.
In a written reply to a question in the Lok Sabha today, Dr Jitendra Singh said, in the pilot phase of the UMMID initiative, NIDAN Kendras have been established at five Government hospitals spread in four states of the country. In the next phase of the UMMID initiative, the NIDAN Kendras are being expanded to institutes in different states including Bihar, and these will be in Government Hospitals including AIIMS depending upon capacity.
The Minister also informed that clinician training is one of the components of the UMMID initiative which envisages supporting establishment of training centres for providing training to the clinicians working in Government hospitals in Biochemical Genetics, Cytogenetics, Molecular Genetics, Clinical Genetics and Comprehensive clinical care. At present, six training centres are being supported for providing training to clinicians.
23-Sep-2019: Government launches ‘UMMID’ initiative to tackle inherited genetic diseases of new born babies.
The Union Minister for Science & Technology, Earth Sciences and Health & Family Welfare, Dr. Harsh Vardhan launched UMMID (Unique Methods of Management and treatment of Inherited Disorders) initiative and inaugurated NIDAN (National Inherited Diseases Administration) Kendras, which is being supported by Department of Biotechnology (DBT), M/o Science and Technology.
The Minister for Science & Technology brought attention to the issue of ensuring proper treatment to children and creation of awareness amongst the masses and urged upon all to dwell more into finding solutions. With the program being implemented at government hospitals, people who cannot afford expensive care for genetic disorders will be benefited. He further emphasized on the use of cutting edge scientific technology and molecular medicine for extending Universal Health Coverage for all.
Taking into account that congenital and hereditary genetic diseases are becoming a significant health burden in India, and realizing the need for adequate and effective genetic testing and counselling services. DBT has started the UMMID Initiative which is designed on the concept of ‘Prevention is better than Cure’. In India’s urban areas, congenital malformations and genetic disorders are the third most common cause of mortality in newborns. With a very large population and high birth rate, and consanguineous marriage favored in many communities, prevalence of genetic disorders is high in India, the UMMID initiative aims (i) to establish NIDAN Kendras to provide counselling, prenatal testing and diagnosis, management, and multidisciplinary care in Government Hospitals wherein the influx of patients is more, (ii) to produce skilled clinicians in Human Genetics, and (iii) to undertake screening of pregnant women and new born babies for inherited genetic diseases in hospitals at aspirational districts.
As a part of this initiative, in the first phase, five NIDAN Kendras have been established to provide comprehensive clinical care.
Training Centres at Madras Medical Mission- Chennai; SGPGIMS- Lucknow; CDFD – Hyderabad; AIIMS- New Delhi; MAMC- New Delhi; NIIH- Mumbai and CMC Vellore have been supported to provide training in Biochemical Genetics, Cytogenetics, Molecular Genetics, and Clinical Genetics to the clinicians from government hospitals. Screening of 10,000 pregnant women and 5000 new born babies per year for inherited genetic diseases will be taken up at the following seven aspirational districts.
The department is planning to expand the program and establish more Nidan Kendras in other parts of the country, train more clinicians in clinical genetics and cover more aspirational districts for screening of pregnant women and new born babies for inherited genetic diseases to provide comprehensive clinical care, in the next phase under this UMMID initiative.
The Government of India has launched the National Health Policy, 2017 aiming to shift focus from “sick-care” to “wellness”. UMMID initiative shall work towards achieving wellness by promoting prevention of genetic diseases.
25-Mar-2022: Government Steps Towards Ensuring New-Born Care
Under the National Health Mission, based on the proposals submitted by States/ Union Territories in the Annual Programme Implementation Plans (PIPs), support is provided for establishing Neonatal Intensive Care Units (NICUs) / Sick New-born Care Units (SNCUs) at Medical College and District Hospital level, New-born Stabilization Units (NBSUs) at First Referral Units (FRUs)/ Community Health Centres (CHCs) level for care of sick and small babies.
Under National Health Mission, ASHAs are performing following activities for childcare:
- Conducting home visits as per scheduled visit under Home Based New-born Care and Home-Based Care of Young Children (HBYC) program to improve childcare practices and to identify sick new-born and young children in the community for referral to nearest health facilities for management.
- Mobilize eligible new-borns and children to immunization sessions and support Auxiliary Nurse Midwives (ANMs) in conducting regular immunization.
- Identify houses with 0 to 5 years old children and distribute Oral Rehydration Solution (ORS) packets and Zinc tablets and educate mothers on preparation of ORS.
- Increase awareness among families and community members on early identification of childhood pneumonia and also refer severe cases to the nearest health facility in coordination with ANMs.
- Distribute Iron and Folic Acid (IFA) syrup to mothers of children 6 to 59 months of age and also ensure IFA supplementation twice in a week to prevent anaemia in children.
- Identify sick children with Severe Acute Malnutrition (SAM) in coordination with Anganwadi workers and ANMs for referral to Nutrition Rehabilitation Centres (NRCs).
- Promote early initiation of breastfeeding, exclusive breastfeeding for first six months among infants and appropriate Infant and Young Child Feeding (IYCF) practices.
The Ministry of Health and Family Welfare (MoHFW) is supporting all States/UTs in implementation of Reproductive, Maternal, New-born, Child, Adolescent health and Nutrition (RMNCAH+N) strategy under National Health Mission (NHM) based on the Annual Programme Implementation Plan (APIP) submitted by States/ UTs to reduce Infant Mortality Rate. The details of interventions are given below.
Interventions for improving Infant Mortality Rate (IMR):
- Facility Based New-born Care: Sick New-born Care Units (SNCUs) are established at District Hospital and Medical College level, New-born Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick and small babies.
- Community Based care of New-born and Young Children: Under Home Based New-born Care (HBNC) and Home-Based Care of Young Children (HBYC) program, home visits are performed by ASHAs to improve child rearing practices and to identify sick new-born and young children in the community.
- Mothers’ Absolute Affection (MAA): Early initiation and exclusive breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted under Mothers’ Absolute Affection (MAA).
- Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative implemented since 2019 for reduction of childhood morbidity and mortality due to Pneumonia.
- Universal Immunization Programme (UIP) is implemented to provide vaccination to children against life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningitis caused by Haemophilus Influenzae B. The Rotavirus vaccination has also been rolled out in the country for prevention of Rota-viral diarrhoea. Pneumococcal Conjugate Vaccine (PCV) has been introduced in all the States and UTs.
- Rashtriya Bal Swasthya Karyakaram (RBSK): Children from 0 to 18 years of age are screened for 30 health conditions (i.e. Diseases, Deficiencies, Defects and Developmental delay) under Rashtriya Bal Swasthya Karyakaram (RBSK) to improve child survival. District Early Intervention Centres (DEICs) at district health facility level are established for confirmation and management of children screened under RBSK.
- Nutrition Rehabilitation Centres (NRCs) are set up at public health facilities to treat and manage the children with Severe Acute Malnutrition (SAM) admitted with medical complications.
- Intensified Diarrhoea Control Fortnight / Defeat Diarrhoea (D2) initiative implemented for promoting ORS and Zinc use and for reducing diarrhoeal deaths.
- Anaemia Mukt Bharat (AMB) strategy as a part of POSHAN Abhiyan aims to strengthen the existing mechanisms and foster newer strategies to tackle anaemia which include testing & treatment of anaemia in school going adolescents & pregnant women, addressing non-nutritional causes of anaemia and a comprehensive communication strategy.
- Capacity Building: Several capacity building programs of health care providers are taken up for improving maternal and child survival and health outcomes.