BACKGROUND

Ø  Noncommunicable diseases (NCDs), including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide. Almost three quarters of all NCD deaths, and 82% of the 16 million people who died prematurely, or before reaching 70 years of age, occur in low- and middle-income countries.

Ø  Noncommunicable diseases (NCDs) contribute to around 5.87 million deaths that account for 60 % of all deaths in India. India shares more than two-third of the total deaths due to NCDs in the South-East Asia Region (SEAR) of WHO.

Ø  India is experiencing a rapid health transition with a rising burden of Non-Communicable Diseases (NCD) surpassing the burden of Communicable diseases like water-borne or vector borne diseases, TB, HIV, etc. Cardiovascular diseases (coronary heart disease, stroke, and hypertension) contribute to 45% of all NCD deaths followed by chronic respiratory disease (22 %), cancers (12 %) and diabetes (3%).

Ø  In Bihar Prevalence of Hypertension among individuals aged 15 years and above is 17.15% and prevalence of Diabetes is among individuals aged 15 years and above is 14.45%.

Ø  In order to prevent and control major NCDs, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010 with focus on strengthening infrastructure, human resource development, health promotion, early diagnosis, management and referral. 

Ø  Under NPCDCS, NCD Cells are established at State and District levels for programme management, and NCD Clinics are set up at almost all District and CHC levels, to provide services for early diagnosis, treatment and follow-up for common NCDs. Provision has been made under the programme to provide free diagnostic facilities and drugs for patients attending the NCD clinics. Cardiac Care Units (CCU) are also set up in identified districts for providing facilities for emergency Cardiac Care. Set up of Day Care Centres at the identified districts are under process to provide facilities for Cancer care. 

Ø  State Cancer Institute is being set up at Indira Gandhi Institute of Medical Science, Patna. 

Ø  India Hypertension Control Initiative (IHCI) is being implemented in 05 identified districts (Vaishali, Muzaffarpur, Purnea, Rohtas and Jamui). 

Ø  Pilot Project for Rheumatic Heart Disease/Rheumatic Fever is being implemented in Gaya district under Ministry of AYUSH, Govt. of India. 

Ø  During the period 2010-2011, the programme was implemented in 02 districts Rohtas and Vaishali as Pliot Project in the state. Review of the initial phase of programme implementation helped to identify the bottlenecks and accordingly the programme was re-strategised and scaled-up for 04 more districts in 2011-12. While in 2013-14, 13 more districts, in 2014-15, 04 more districts, in 2015-16, 01 more district and in 2016-17, 14 more districts were added under this programme. Now, it is successfully being run in all 38 districts through NCD Cells & NCD Clinics and 212 functional CHC NCD Clinics. 

Ø  Population Based Mass Screening for NCDs (Diabetes, Hypertension and Common Cancers of Oral, Breast & Cervix) was stated in 05 districts in 2017-18. In 2018-19, 19 more districts were added, while in 2019-20 all 38 districts were covered. Now, it is being implemented at all functional 6434 Health Sub-Centres/Additional Primary Health Centres-Health & Wellness Centres including other than Health & Wellness Centres. 

Guidelines

·         The Programme is being run & implemented as per the Standard Operating Procedure (SoP) for running of NCD Cell & NCD Clinics at various levels.

·         Treatment Protocols for Diabetes and Hypertension are displayed at all District & CHC level NCD Clinics.

·         Drawing & Disbursing power is given to all NCDOs under NPCDCS as the joint signatory with the concerned ACMOs.

·         New Operational Guideline of NPCDCS (attached)

·         New ASHA Training Module  (attached)

·          NCD Training Module for Community Health Workers  (attached)

·    NCD Training Module for ANM in (attached)

·         Medical Officer Training Module  (attached)

·         NPCDCS Programme Managers Manual (attached)

·         Operational Guidelines for Prevention, Screening and Control of Common NCDs (attached)

·         Operational Framework : Management of Common Cancers (attached)

·         Guidelines for Prevention and Management of Stroke (attached)

·         Handbook for Counsellors reducing risk factors for NCDs (attached)

·         Health Worker Manual Booklet (attached)

·         Operational Manual for Screening of Common Cancers (attached)

·         Monitoring Checklist for NCD Clinic (attached)

·         Monitoring Checklist of Training Assessment (attached)

·         Financial Guidelines for ASHA (NCD) Residential Training (attached)

·         Guidelines for filling & digitisation of CBAC Form & Family Folder (attached)

·         CBAC (Community Based Assessment Checklist) Form & Family Folder, Individual Health Card, Patient Referral Card, NCD Register (attached)

·         NPCDCS monthly reporting formats  i.e. 1 for Sub-Centre, 2 for PHC, 3A (CHC & SDH) & 3B (compiled of 1 & 2 at CHC), 4 for District NCD Clinic, 5A for compiled CHC & SDH and District NCD Clinic at District level, 5B for compiled all 3B at District level) with guidelines (attached)

·         Drug & Equipment Management Guidelines (attached)

·         Package of Services provide under NPCDCS (attached)

·         Indicative list of Drugs for Common NCDs (attached)

IEC Materials

i) IEC materials for various types of Non-Communicable Diseases such as Hypertension, Diabetes, Oral Cancer, Breast Cancer, Cervix Cancer, Heart Disease, Rheumatic Heart Disease, Stroke 

ii) IEC materials for Treatment Protocols of Diabetes and Hypertension 

Diabetes Protocol: https://drive.google.com/file/d/1RbiLyFAqBEvj-xfPoBNkfUhSRC0HFZQ4/view?usp=sharing

Hypertension Protocol: https://drive.google.com/file/d/1P_yfSgGw9zWuajPbQ_wIMJHGvgb9M7HS/view?usp=sharing

iii) Audio/Video Clips for awareness generation on NCDs such as Hypertension, Diabetes, Cancer, CKD, COPD, Oral & Breast Self Examination 

Achievement

i) NPCDCS programme is being implemented and monitored through NCD Cells set up at the State & District level.

ii) NCD Clinics are run at the District, CHC & SDH level for Opportunistic Screening and necessary treatment, referral (if any found suspected) and follow up with providing of at least one month free drugs to the patients identified for Diabetes and Hypertension.

iii) Counseling and Physiotherapy services are provided at all District NCD Clinics.

iv) Population Based Mass Screening is done for common NCDs (Diabetes, Hypertension and Common Cancers i.e. Oral, Breast & Cervix) through home visit by ASHA in her catchment area at the Health Sub-Centre/APHC-HWC level. Data of every household and information of every individual's risk factor for NCDs over 30 years of age are captured and filled in Family Folder & CBAC Form respectively by the ASHA for further screening of the same by the concerned ANM. The persons having risk factor of score >4 are referred to higher institutions for further diagnosis and treatment. Follow up is done by the ASHA/ANM at the interval of every six month.

Events / News

Important letters

Important letter issued from NCD Cell, SHSB