Wednesday, December 14, 2011

India implements NCDs control measures

Under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke Programme (NPCDCS) launched earlier by the Indian Ministry of Health several initiatives have been taken over the last two years. Efforts have been made to implement various programmes for prevention and control of NCDs, and even provide financial help to patients unable to bear the cost of treatment.

Free Treatment for Cancer Patients

As per the latest estimates projected by National Cancer Registry Programme of Indian Council of Medical Research, the prevalence of cancer in the country is about 27 lakhs. The incidence of new cancer cases every year in the country is about 11 lakhs.

Treatment of Cancer, wherever available in the Government health care delivery system is mostly subsidized. Under Rashtriya Arogya Nidhi, funds are given to states illness assistance funds/ societies to provide assistance to all 'below poverty-line' patients suffering from life threatening diseases. The quantum of support is upto Rs. 1.5 lakhs per case.

Under the same scheme, Ministry gives grants to revolving funds of hospitals under control of Ministry of Health and Family Welfare to provide financial assistance upto Rs. 1 lakh in each case to patients suffering from lifethreatening diseases.

Further, under the same scheme, the Health Ministry directly gives financial assistance in cases where assistance sought is more than Rs. 1.5 lakh in each case. However this assistance is available only for 'below poverty-line' patients taking treatment in Government hospitals.

Under the Indian government's Health Minister’s Cancer Patient Fund, entire fund is distributed to 27 Regional Cancer Centres for providing assistance to  cancer patients falling under 'below povertline,  taking treatments, in each case Rs.1 lakh.

In addition, financial assistance is given to poor indigent patients, maximum upto Rs. 50,000 each case, from Health Minister’s discretionary grant to defray a part of the expenditure on hospitalization/treatment in government hospitals in cases where free medical facility is not available.

During the current year of 2011, about 2202 cancer patients have been provided financial assistance by this Ministry. Among those receiving support, about 241 cancer patients have been recommended by the Members of Parliament during the year 2011-12, for financial assistance for their treatment.

Working Group on NCDs Burden

The working group on Non-Communicable Diseases set up by the Planning Commission for the 12th Plan, recommended development of twenty state cancer institutes as Centre of Excellence, besides three National Cancer Institutes.

NCDs Prevention and Control

In July 2010, 100 districts selected for launching “National Programme for Prevention & Control of Cancer, Diabetes, CVD and Stroke (NPCDCS)” and the “National Programme for Health Care of Elderly (NPHCE)”  (Total cost: Rs.1230 crores):
  • A Cardiac Care Unit at a cost of Rs. 1.5 crores will be established at 100 district hospitals.
  • NCD clinic will be established at 100 district hospitals and 700 Community Health Centres (CHCs) for diagnosis and management of Cardiovascular Diseases (CVD), Diabetes & Stroke.
  •  For life saving drugs, Rs. 50,000 will be provided to each district hospital in 100 districts.
  •  Opportunistic Screening for diabetes and high blood pressure will be provided to all persons above 30 years, including pregnant women of all age groups at 20,000 Sub-Centres.
  • Home based care will be provided for bed ridden cases in 100 districts.
  • Support will be provided for contractual manpower and equipment at 100 district hospitals & 700 CHCs for management of NCDs including health promotion activities.
  • Screening for Hypertension and Diabetes in Urban Slums was initiated in 7 Metro Cities in 2010 (Delhi, Mumbai, Kolkata, Chennai, Bangalore, Hyderabad and Ahmedabad)
  • Glucometer Strips and Lancets procured under the national programme distributed to States for the purpose of Screening – Rs. 10.51 crores (Cost of a Glucometer Strip approximately Rs.10 at present).
  • School health survey has been initiated in selected districts, which includes screening for childhood (juvenile) diabetes.

Cancer: New initiatives during last two years

  • Common diagnostic services, basic surgery, chemotherapy and palliative care for cancer cases will made available at 100 district hospitals.
  • Support for Chemotherapy drugs will be provided for 100 patients at each district hospital at a cost of Rs. 1.00 crore per annum.
  • Day care Chemotherapy facilities will be established at 100 district hospitals.
  • Facility for laboratory investigations including Mammography will be provided at 100 district hospitals and, if not available, this can be outsourced at government rates.
  • Home based palliative care will be provided for chronic, debilitating and progressive cancer patients at 100 districts.
  • Support will be provided for contractual manpower and equipment for management of cancer cases at the 100 district hospitals.
  • Sixty five centres will be strengthened as Tertiary Cancer Centres (TCCs) to provide comprehensive cancer care services at a cost of Rs. 6.00 crores each.

Tobacco Control

In the year 2009-2010, the Global Adult Tobacco Survey India (GATS India) was conducted for systematically monitoring adult tobacco use (smoking and smokeless) and tracking key tobacco control indicators.

One of the largest surveys of this kind in the world, it was carried out in all the States and 2 UT’s of Chandigarh & Puducherry.

The entire survey was funded by the Government of India and was conducted by Indian Institute of Population Science (IIPS), Mumbai in technical collaboration with WHO and CDC, Atlanta, USA. The results were published in October, 2010.

The survey revealed that more than one-third of adults (35%) use tobacco in some or the other. Among them, 21% adults use only smokeless tobacco, 9% use only smoke and 5% use smoke as well as smokeless tobacco.

The prevalence of overall tobacco use among males is 48% and among females is 20%. Nearly 2 in 5 adults (38%) in rural areas and 1 in 4 adults (25%) in urban areas use tobacco in some form. The extent of use of smokeless tobacco products among males (33%) is higher than among females (18%).

 The results of the survey are being used to formulate policies aimed at mainstreaming tobacco control strategies with other national health programmes, within the overall framework of the National Rural Health Mission (NRHM).

The GATS India initiative will strengthen the Ministry’s efforts to prevent any further increase in the prevalence of tobacco use, especially among the vulnerable groups such as youth, children and females.

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