Dr Deepak Patkar
Director, Professional Services, Nanavati Super Speciality Hospital

Establishment of efficient referral systems, sustained monitoring of patients with adherence to global clinical protocols, maintaining health records of past and present patients, treatment services through provision of subsidised options like state health insurance, essential support services and last but not the least enhanced synergies between policymakers and private sector players remain the key challenge areas in the smooth implementation for screening programmes across India. In order to make screening programmes for various diseases a successful endeavour, the Government needs to allocate enhanced funds for public healthcare. For a country the size of India with diverse demographic profiles and disease histories, increased funds for the healthcare sector can go a long way in ensuring a healthy and disease-free existence for its people. Providing training to health workers to provide first-stage treatment procedures and create a base-pool of primary health professionals at the village, town and city level should be given priority in the national health guidelines. Private sectors may indeed play a very important role in this regard and we suggest that the national policies should incorporate guidelines for them, as well with regard to the screening programme. With Governments support, screening can be carried out in these sectors at a subsidised rate, making them available to even a greater population. We also need to standardise the screening techniques and protocols.

Realising the need to tackle the ever-growing menace of non-communicable diseases (NCDs), the Government of India announced the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2008. The broader contours of the scheme were to be implemented in one district of seven states in India. Providing critical support to other national health programmes like the National Rural Health Mission (NRHM) and the National Programme for the Health Care of the Elderly (NPHCE), schemes like NPCDCS have made a positive attempt to plug the gaps in different stages of identifying and providing effective treatment methods for NCDs. The Government has formulated an NCD service package to be implemented at different levels by the public health system. Starting from the community healthcare centre at rural levels, the package would also be implemented at district hospitals and hospitals providing tertiary care facilities. NPCDCS has also identified screening camps as a core ution area of its agenda.

Dr Mukesh Batra
Founder and Chairman, Dr Batras Group of Companies

 In India, the lack of awareness for screening of diseases has been evident in the way we view healthcare, most of it stems from educational and behavioural factors to cultural and economic considerations. Low awareness on screening procedures, lack of easy availability and cost of screening, and lack of skilled healthcare professionals and appropriate infrastructure are some of the major reasons India lacks in screening and early detection of diseases. At the Government level, one needs to put in place screening programmes and communicate the benefits of early detection. The screening procedure must be cheap, easy, and acceptable and available to all individual. The Government should identify standardised protocols, ranging from screening to diagnosis of individuals to ensure the spread of diseases is controlled. The Government should bring in a seamless integration between screening to consultation and then prevention, and this is possible only when we have skilled caregivers and healthcare professionals in place.

Increase in non-communicable diseases (NCDs) causes a huge economic burden, especially for a country like us as we have the largest youth population in size currently. The rapid spread of NCDs points at two key challenges India faces, i.e. double burden of infectious and chronic diseases due to malnutrition and on the other hand obesity due to change in lifestyle . These two factors weaken the health systems that are already compromised. To address NCDs, one must ensure that service delivery, human resources, medicines and technology, information systems, financing and governance work synergistically. In the absence of any of these pillars, India would further suffer. The most important task currently is to fix the limited and poorly distributed health force in India and ensure skilled healthcare professionals are available and accessible to all. Standard protocols for screening and diagnosis are followed and awareness about early detection is provided. Awareness on public health and healthy lifestyle has to be brought in at an early age, so as to achieve healthier India.