Non-communicable diseases (NCD) are causing mortality across the globe. NCDs are also known as chronic diseases that exist for a long duration and are the result of a combination of genetic, physiological, environmental and behavioral factors. The various types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.
As part of its commitment to decrease premature mortality from NCDs, the Government of India reorganized the NCD control program in 2016 with WHO- Global NCD action plan 2013-2020 and introduced screening for the common NCDs. Detection, screening, and treatment of NCDs, as well as palliative care, are the key components of the NCD control program.
A pan India screening program is initiated for males and females aged 30 years and above for hypertension, diabetes and oral cancer at the nearest community clinics and screening of females for breast and cervical cancer at the next levels of health service delivery [primary health centers (PHC) and district hospitals].
There are many challenges to implement this program at the sub-centers as they are understaffed poorly equipped and patients hardly visit. For many the health centers are very far, inadequate transport facilities, high travel costs and loss of wages are major barriers for the rural population to seek preventive health services at the PHCs (primary health center).
In India, a female CHW known as Accredited Social Health Activist or ASHA works as an interface between the community and the primary health care. Each ASHA is identified from a village and she has a target population of 1,000 to cover. They are well-recognized to deliver different preventive health care services at the doorsteps of people. She gets awarded a performance-based incentive for promoting universal immunization, and other healthcare programs.
Different parameters in NCD screening like Body Mass Index (BMI), Random Blood Sugar (RBS), Blood pressure (BP) can be monitored and recorded. Regular monitoring and screening help in early detection of the diseases for common NCDs (hypertension, diabetes, and breast, cervical and oral cancers) at home by trained CHWs in a rural setting. Patients who turned positive are taken for further evaluation.
These diseases are caused by forces that include rapid unplanned urbanization, globalization of unhealthy lifestyles and population aging. Unhealthy diets and poor physical activity may show up in people as raised blood pressure, increased blood glucose, elevated blood lipids and obesity. These are called metabolic risk factors that lead to cardiovascular disease, the leading NCD in terms of premature deaths.