The Health department is taking up a new initiative as part of the NCD Control programme to conduct population-based screening for non-communicable diseases (NCDs) and its risk factors, covering the entire State.
The idea is to prepare a Statewide community registry of those above 30 years with NCDs with the support of local self- governments, so that the State has a clear estimation of the actual population suffering from various NCDs.
This initiative is expected to be launched on April 7, World Health Day.
Previous studies
There have been many previous studies done in Kerala to estimate the prevalence of NCDs. A study done by the Achutha Menon Centre for Health Science Studies in 2017, in a representative sample of 12,000 adults in the State, had reported that one out of three people in the State had hypertension, while one in five suffered from diabetes.
A recent study (INDIA DIABETES) by the ICMR and the Indian Institute of Diabetes put the prevalence of diabetes in the State at 24% and that of hypertension at 40%.
The Statewide screening and a community registry will reveal whether the estimated NCD prevalence rate so far in the State is an exaggerated projection or a stark reality.
ASHA workers
The population-based screening programme, as envisaged in the national NCD control programme, utilises the services of ASHA workers, who will visit houses under their jurisdiction and collect details of chronic diseases and risk factors among all above 30 years. ASHA volunteers will be paid an incentive of ₹10 per for every data sheet.
A digital community-based assessment check list has been uploaded in a mobile android app, which will be used by ASHA volunteers for data collection. Blood pressure and blood sugar will be checked by the volunteer herself or people will be gathered in a camp for the purpose.
In the first phase, the project will be initiated in one PHC in every Assembly constituency and in a year, the entire State is expected to be covered.
The survey will thus generate reports of the actual diabetes/hypertension prevalence at panchayat/district and State-level. The disease profiles of panchayats thus generated could be a valuable tool for policy makers as well as local self governments.
Risk factors
While the population screening proposed under the national NCD control programme only talks about screening for diabetes and hypertension, the State has included on its checklist for screening details on risk factors or habits among the population as well as cancers of the oral cavity, cervix and breast.
The health system will follow-up and monitor the patients and patient-support groups will be formed at the ward-level for encouraging treatment compliance and to ensure that there is experience and information sharing.
Primary health centres will have to be primed to ensure appropriate medical management of every person with NCDs according to set treatment protocols, with proper referrals for management of any complications, to prevent complications.
The challenge, however, will be to ensure that patient education and follow-up is regular and systematic so that drug compliance is total and that sufficient control rates are achieved.
