National Programme for Prevention and Control of NCDs in Maharashtra

1. National Programme for Prevention and Control of Cancer, Diabetes, CVDs and Stroke (NPCDCS) S T A T E N C D C E L L , 7T HF L O O R , A R O G Y A B H A V A N , S T . G E O R G E ’ S H O S P I T A L C O M P O U N D , P . D ’ M E L L O R O A D , F O R T , M U M B A I 0 1 T E L : 0 2 2 - 2 2 6 2 3 2 2 2 / 2 0 2 7 E - M A I L : N C D . M U M B A I @ G M A I L . C O M F A X : 0 2 2 - 2 2 6 4 2 9 5 5

2. Programme Objective  Health promotion through behavior change with involvement of community, civil society, community based organizations, media etc.  Opportunistic screening at all levels in the health care delivery system from sub-centre and above for early detection of diabetes, hypertension and common cancers. Outreach camps are also envisaged.  To prevent and control chronic Non-Communicable diseases, especially Cancer, Diabetes, CVDs and Stroke.  To build capacity at various levels of health care for prevention, early diagnosis, treatment, IEC/BCC, operational research and rehabilitation.  To support for diagnosis and cost effective treatment at primary, secondary and tertiary levels of health care.  To support for development of database of NCDs through Surveillance System and to monitor NCD morbidity and mortality and risk factors.

3. Strategy  Health promotion, awareness generation and promotion of healthy lifestyle  Screening and early detection  Timely, affordable and accurate diagnosis  Access to affordable treatment,  Rehabilitation

4. NCD Programme salient features  Screening of age >30 years individual for Diabetes and Hypertension  The screening should be both Hospital and Community based  The Community based screening - by health worker at Subcentre both Male and Female  The Hospital based screening - by staff appointed under the programme at DH & CHC  Strengthening of District ICU for Cardiac care  Opportunistic screening of common cancers (Cervix, Breast and Oral) at DH and CHC level  Curative services should be made available from PHC and above  Health promotion and Counselling services available from PHC and above.

5. What is achieved  The programme was started in 6 districts of Maharashtra. (Amravati, Bhandara, Chandrapur, Gadchiroli, Wardha and Washim)  In 2013-14 we screened 21.16 lack individuals for DM & HT form 6 NCD districts  The confirmed DM patients were 94,401 – (P-4.46%)  The confirmed HT patients were 1,64,085 – (P-7.75%)  The confirmed patients of Common Cancers were – 946  Started 71 NCD clinics in 6 NCD districts  Develop a treatment protocol of DM & HT for PHC Medical officers  Develop Cancer related IEC material and distributed to the health facilities of 6 NCD districts  Training PHC medical officers for DM & HT management CHC/PHC Medical officers in cancer screening and early diagnosis Subcentre’s ANM in DM screening   

6. Issues in implementation  Lack of coordination between DHO & CS  No review of programme from DHO or PHC Medical officer  Screening coverage is a problem  Duplication of reporting  Lack of ownership to the programme  Though horizontal programme, treated as a vertical programme  Availability of Specialist, MBBS doctors is a problem

7.  Form this year 2014-15 the programme will be expanded in 5 another districts  Nandurbar  Osmanabad  Parbhani  Satara  Sindhudurg

8. Major Tasks for new districts  Recruitment of man-power  Formal training of HT & DM screening to health workers  Programme sensitization in the existing health system  Initiation of Screening  To make medicine available for DM/HT/CVD management at DH & CHC  To make medicine available for DM/HT management at PHC as per the treatment protocol

9.  For the recruitment process the advertisement will be published from state level  Application will be submitted at District level  The recruitment process of District Epidemiologist, Programme Co-ordinator and Finance Consultant will be done at state level, rest will be at CS level.

10. For new district Additional HR to be recruited  At District level  District NCD Cell  District Epidemiologist/ Public Health Specialist – 1.  District Programme Coordinator – 1.  Finance cum Logistics Consultant – 1.  Data Entry Operator – 1.  District NCD clinic  General Physician – 1  GNM – 2  Physiotherapist – 1  Counsellor – 1  Technician – 1  Data Entry Operator – 1

11.  CCU / Day Care Facility  Specialist – 1  GNM – 4  CHC NCD clinic  General Physician / Doctor – 1  GNM – 1  Counsellor – 1  Technician – 1  Data Entry Operator – 1

12. Focus Points for Deputy Director  Regular review of NCD programme progress in each and every meeting of CS and DHO.  Monthly review meeting with District Programme Officer and Finance cum Logistic Officer.  Co-ordination in establishment of linkages between District Hospital and Tertiary Care Centers

13. Focus Points for Civil Surgeon  To make available sufficient space for NCD cell, Clinic and sitting arrangement for NCD staff, patients etc. at Dist. Hospital and RH\SDH  Appointment of qualified staff as per requirement and guidelines  Regular Medical Superintendent review in every meeting.  Proper utilization of fund as per guidelines.  Implementation of programme in co-operation with DHO.  Strengthening of Lab, CCU, Geriatric services, Oncology services etc. at DH and CHC  Awareness about NCD in public

14. Focus Points for District Health Officer  Co-operation and Co-ordination with Civil Surgeon in implementation of NCD activities.  Review of THO and MO for the progress of NCD programme.  Asked Medical officers to take the review of NCD programme  Regular data collection and maintenance of all NCD activities.(Data regarding suspected and confirm patients)  Proper utilization of fund as per guidelines.  Awareness in public about various NCDs

15. Thank you ..