Burden of non communicable diseases in India: Setting priority for action.

Non-communicable diseases (NCDs) are defined as diseases of long duration, and are generally slow in progression. NCDs are replacing communicable diseases, maternal and child health as well as malnutrition as the leading cause of death. Non-communicable diseases are the leading cause of death in the world, responsible for 63% deaths worldwide in 2008. NCDs accounts for 53 percent of deaths in India. Based on available evidence cardiovascular diseases (24 percent), chronic respiratory diseases (11 percent), cancer (6 percent) and diabetes (2 percent) are the leading cause of mortality in India. Treatment cost is almost double for NCDs as compared to other conditions and illnesses. Burden of non-communicable diseases and resultants mortality is expected to increase unless massive efforts are made to prevent and control NCDs and their risk factors. India could develop a strategy for reducing out of pocket expenditure. Underlying determinants of NCDs mainly exist in non-health sectors, such as agriculture, urban development, education and trade. Inter-sectoral collaboration is therefore essential to create an enabling environment. Government of India had launched various vertical programmes such as National Cancer Control Programmes, National Tobacco Control Programme, National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS) etc. Strong surveillance, monitoring and evaluation system is required for successful implementation of the programmes. Public health facilities should be strengthened for providing services of screening; early diagnosis and treatment within the public health care delivery system. Efforts need to be done on implementing the clinical standards and guidelines developed under the Indian Public Health Standards (IPHS), and integrating NCD training into training curricula of health workforce.

Assessing Indian public health standards for community health centers: A case study with special reference to essential newborn care services.

The main objective of the study is to identify the availability of infrastructure facility, human resources, investigative services, and facility based newborn care services with respect to Indian Public Health Standards (IPHS) at community health centers (CHC) of Bharatpur District of Rajasthan State. Data were collected from service providers at CHC through well structured questionnaire at thirteen CHCs situated at Bharatpur District of Rajasthan State. It was found that infrastructure facilities were available in almost all the CHCs, but shortage of manpower especially specialists was observed. Availability of investigative services was found quite satisfactory except ECG. It was also observed that none of the CHCs have fully equipped facility based newborn care services (including newborn corner and newborn care stabilization unit). As per IPHS suggested in the revised draft (2010) important deficiencies were revealed in the studied CHCs of Bharatpur district and by additional inputs such as recruiting staff, improving infrastructure facilities, CHCs can be upgraded.