The modern-day healthcare industry has adopted various advancements to enhance its offerings, be it innovation, high-tech Infrastructure or quality healthcare. But challenges like scarcity of doctors, inadequate medicines, unawareness and lack of knowledge of emerging diseases are still major issues to be addressed, writes Rajbala of Elets News Network (ENN).
In the last decade, the advancements being witnessed in our day-to-day lifestyle have also brought significant changes in the disease patterns of people. There is a belief that it has turned not just a national but global health threat, leading to non-communicable diseases (NCDs).
The NCDs which involve cardiovascular diseases (CVDs), chronic diseases, cancer, diabetes, etc have become a big challenge these days. It needs to be addressed immediately, specifically in rural India where a large segment is constrained in many ways due to limited awareness.
“Quality of health services, infrastructure, trained HR and development of transparent healthcare system will be given a major push for which the government has already initiated various programmes” says Gaurav Dahiya, Managing Director, National Health Mission, Gujarat.
In the modern era, the role of ICT in the field of medical science is immense, says Vishal Chauhan, Commissioner-cum- Secretary Healthcare, Human Services and Family Welfare Department, Government of Sikkim. “ In Sikkim, we are utilising ICT for timely reporting and monitoring of health programmes through Health Management Information System (HMIS) under National Health Mission.”
Moreover, NCDs affect individuals over a long period of time causing a financial challenge as well.
An estimated 40 million people die annually due to a NCD, which amounts to 70% of all global deaths, and 17 million people die before the age of 70, according to the World Health Organisation, which adds that NCDs are increasing significantly in low- and middle-income countries: 87% of premature deaths occur in low- and middle-income countries. Together, cardiovascular diseases (CVDs), cancer, respiratory diseases and diabetes mellitus account for 81% of all deaths in NCDs. It is expected that the global burden of NCDs will increase by 17% by 2025.
Motivation, appreciation and incentives are the three key mantras that can bring major or drastic changes in any project, says Joy Chakraborty, Chief Operating Officer, P D Hinduja Hospital, adding: “The same applies for creating a culture of innovation in our country. Indian brains have time and again proved themselves being most innovative in various fields, irrespective of the place where they are in the world.”
According to a Global Burden of Disease study, the cardiovascular disease has been one of the foremost NCD killers in 2015, with more than 400 million individuals living with CVD and nearly 18 million CVD deaths worldwide.
Risk Factors of NCDs
Underlying socioeconomic, cultural, political and environmental determinants like globalisation, unplanned urbanisation leads to common modifiable risk factors like unhealthy diet, physical inactivity and tobacco use and unmodifiable risk factors like age and heredity.
Intermediate risk factors like raised blood pressure, high blood glucose, abnormal blood lipids and obesity increases the risk of NCDs such as heart diseases, stroke, cancer, chronic respiratory diseases, mental health and diabetes.
As mentioned, NCDs are caused largely by four modifiable risk factors: tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. Interestingly, 80% of the premature CVD can be prevented through action against these four behavioural factors, according to reports released by WHO.
In India, nearly 61% of deaths now happen due to emerging non- communicable diseases and over 23% are at a risk of premature death, as per reports released by WHO.
Initiatives to Curb Non-Communicable Diseases (NCDs)
The development of NCDs has led to a tensed atmosphere in different parts of the country. It has become extremely important to deal with it in an efficient as well as planned way while overcoming other challenges as well.
The State Health Departments are presently running the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) programmes in their respective States. Under this, door- to-door screening of diseases like diabetes, HTN, common cancer and investigation and treatment of non- communicable diseases is done for early detection of such diseases.
The programme aims to cover 200 districts nationwide by 2018. In addition to that, the Central Government has also started schemes to set up cancer centres across the country.
While 31 such hospitals have already been built under the programme, 49 more are in the pipeline by 2020, according to reports.
Meanwhile, suspected cases of NCDs are investigated and, if required, a proper treatment is given from primary to tertiary level.
The Central Government proposes its efforts by offering efficient technical as well as financial support through NPCDCS programmes. For close monitoring of programmes, the Government has implemented NCD cells at various levels to ensure proper implementation and supervision of the programme related to treatment, screening, availability of medicines, etc.
To control NCDs at larger level, the State health departments are attempting to create a wider knowledge base in the community for early prevention, detection, referrals and treatment strategies through convergence with executed interventions of the National Rural Health Mission (NRHM), National Tobacco Control Programme (NTCP), and National Programme for Health Care of Elderly (NPHCE).
According to Dr Mohan Singh, Mission Director, National Health Mission, Jammu and Kashmir, “To provide equitable and quality primary healthcare services to the urban population with a special focus on slum and vulnerable sections of the society, we seek to improve the health status by facilitating their access to quality primary healthcare.”
Identified indicators related to SDGs targets and their projections/likely achievements (Premature Mortality)
In a bid to combat NCDs, there is need for our healthcare industry has to accelerate and empowered to overcome the challenges and lessen the increasing burden of NCDs in the country.
Digital guidance or consultation is not fully functional in many parts of the country due to which a large chunk of public faces hardship.
Online presence or consultation about NCDs and its long-term impact on health can help control the rising rate of NCD patients. Also, this could control the disease at primary level. With integrated management and strong monitoring system, healthcare services can be made accessible.
Availability of specialist doctors is one of the major challenges in India. It means we still need to groom our healthcare industry despite of huge integration of technology. It is therefore recommended that the medical education in small or big institutions must be given a major push.
Due attention is required for implementation of these programmes in remote areas and underprivileged population in the urban areas. For India, having committed to global indicators and goals to address NCDs and risk factors by 2025, a mission approach is required for effective implementation of programmes.
To-do list to prevent NCDs:
- Banning smoking in public places is recommended to prevent smoking and to promote smoking cessation
- Increased availability and types of school playground spaces and equipment for exercise activity and sports are recommended
- Consideration of physical activity when planning new landscaping/ buildings or towns is recommendedElimination of industrially produced trans fats is recommended.
- Drink-driving countermeasures are recommended such as lowered blood alcohol concentration limits and “zero tolerance”, random breath testing and sobriety check points.
- Measures to support and empower primary care to adopt effective approaches to prevent and reduce harmful use of alcohol are recommended
- Awareness and enforcement of the programmes initiated
Population-based NCD screening is much needed to control disease at the initial level. Moreover, the Government has planned to integrate NCD screening software to track and maintain the patient’s data and execute further plans.
Another major step, which is already being implemented, is counselling about this big threat which could burden the country socially as well as economically. The State governments have started providing counselling programmes in schools, colleges, rural and urban parts of the country.
The government has ensured to enhance the medical education to overcome scarcity of doctors and clinicians at primary as well as tertiary level. In accordance to that, medical institutions have been set up, additional medical courses have been started, and internship programmes have been enhanced with additional healthcare courses.
Major step of the Health Department is that it has already started providing door-to- door screenings, investigation and evaluation of the initiated programmes, and free of cost treatments to the patients.
There is a strong scientific guidance both for clinical practice and for decision makers to combat the growing global threat of non- communicable diseases. A further reduction in the use of tobacco, supporting regular physical activity and healthy food choices and limiting the use of alcohol will have a significant impact on population health. It is time to join hands and create public awareness about NCDs towards realising the dream of ensuring a better healthcare system exists in the country.