National Programme for Prevention and Control of Cancer , Diabetes , CVDs and Stroke (NPCDCS)

1. National Programme for Prevention and Control ofCancer, Diabetes, CVDs and Stroke (NPCDCS) State NCD Cell, 7th Floor, ArogyaBhavan, St. George’s Hospital Compound, P.D’Mello Road, Fort, Mumbai 01 Tel: 022-2262 3222 / 2027 FAX : 022-22642955 E-mail: ncd.mumbai@gmail.com

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 yearsindividual 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’sANM 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 ..