nal Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPC
PROGRAMME BACKGROUND
India is experiencing a rapid health transition with a rising burden of Non-Communicable Diseases (NCD) surpassing the
burden of Communicable diseases like water-borne or vectorborne diseases, TB, HIV, etc. The Non-Communicable
Diseases like Cardiovascular diseases, Cancer, Chronic Respiratory Diseases, Diabetes, etc. are estimated to account
for around 60% of all deaths. NCDs cause considerable loss in potentially productive years of life. Losses due to
premature deaths related to heart diseases, stroke and Diabetes are also projected to increase over the years.
In order to prevent and control major NCDs, the National Programme for Prevention and Control of Cancer, Diabetes,
Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010 with focus on strengthening infrastructure,
human resource development, health promotion, early diagnosis, management and referral.
Under NPCDCS, NCD Cells are being established at National, State and District levels for programme management,
and NCD Clinics are being set up at District and CHC levels, to provide services for early diagnosis, treatment and
follow-up for common NCDs. Provision has been made under the programme to provide free diagnostic facilities and
drugs for patients attending the NCD clinics. Cardiac Care Units (CCU) are also being set up in identified districts for
providing facilities for emergency Cardiac Care. Day Care Centres at the identified districts are setup to provide facilities
for Cancer care.
During the period 2010-2012, the programme was implemented in 100 districts across 21 States. Review of the initial
phase of programme implementation helped to identify the bottlenecks and accordingly the programme was
re-strategised and scaled-up. The programme aims to cover the entire country by March 2017.
MODIFIED STRATEGIES
- Health promotion through behavior change with involvement of community, civil society, community based
organizations, media etc.
- Outreach Camps are envisaged for 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.
- Management of chronic Non-Communicable diseases, especially Cancer, Diabetes, CVDs and Stroke through early
diagnosis, treatment and follow up through setting up of NCD clinics.
- Build capacity at various levels of health care for prevention, early diagnosis, treatment, IEC/BCC, operational research
nal Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPC
and rehabilitation.
- Provide support for diagnosis and cost effective treatment at primary, secondary and tertiary levels of health care.
- Provide support for development of database of NCDs through a robust Surveillance System and to monitor NCD
morbidity, mortality and risk factors.
Total cost of the programme for period 2012-2017 is Rs. 8,096 crore (share of Government of India is Rs. 6,535 crore
and that of State Governments is Rs. 1,561 crore). The funds are being provided to the States under NCD Flexi-Pool
through State PIPs of respective States/UTs, with the Centre to State share in ratio of 60:40 (except for NE and Hilly
States, where the share is 90:10).
For the Cancer component, there is the Tertiary Care Cancer Centers (TCCC) scheme, which aims at setting
up/strengthening of 20 State Cancer Institutes (SCI) and 50 TCCCs for providing comprehensive cancer care in the
country. Under the scheme there is provision for giving a one time grant of Rs. 120 crore per SCI and Rs. 45 crore per
TCCC, to be used for building construction and procurement of equipment, with the Centre to State share in the ratio of
60:40 (except for North-Eastern and Hilly States, where the share is 90:10).
PROGRAMME PERFORMANCE
As on March 2016, the programme is under implementation in all 36 States/UTs. A total of 298 District NCD Cells and
293 District NCD Clinics have been established in the country. Also, there are 103 functional Cardiac Care Units for
emergency cardiac care and 64 Day-Care Centres for Cancer care at the District levels in the country.
During 2015-2016, more than 1.29 crore persons have been screened in the designated NCD Clinics. Among these
NCD Clinic attendees, around 8% were diagnosed to be Diabetics and 12% were Hypertensives. Also, around 90,000
persons were diagnosed to be suffering from Cardiovascular diseases and over 13,000 persons were detected to be
having common Cancers (including Oral, Cervical and Breast Cancers) among them. During 2015-2016, around 96 lakh
persons were screened under various outreach activities for common NCDs (in Camps and PHC/SC), and they were
referred to higher Centres for diagnosis and management.
RECENT INITIATIVES UNDER NPCDCS
- Inclusion of guidelines for prevention and management of Chronic Obstructive Pulmonary Disease (COPD) and
nal Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPC
Chronic Kidney Disease (CKD) under NPCDCS, to prevent and manage the chronic respiratory and kidney diseases
respectively.
- Guidelines are being issued to the States for initiating Population-based Screening of common NCDs utilising the
services of the Frontline-workers and Health-workers under the existing Primary Healthcare System.
- Pilot project on Integration of AYUSH with NPCDCS has been initiated in six districts. AYUSH facilities and
methodologies are being integrated with NPCDCS services for prevention and management of common NCDs,
including Yoga as an integral part.
- Pilot intervention for the prevention and control of Rheumatic Fever and Rheumatic Heart Disease under the platforms
of NPCDCS and RBSK in Gaya (Bihar), Firozabad (Uttar Pradesh) and Hoshangabad (Madhya Pradesh). It will be
scaled up to other districts.
- Integration of RNTCP with NPCDCS through the National Framework for Joint Tuberculosis-Diabetes collaborative
activities for bi-directional screening and better management of comorbidities.