National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke [NPCDCS]

In order to prevent and control major Non-Communicable diseases (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 bottle-necks and accordingly the programme was re-strategised and scaled-up.

The modified strategies are as follows:

 1. Health promotion through behavior change with involvement of community, civil society, community based organizations, media etc.

 2. 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. 

3. 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. 

4. Build capacity at various levels of health care for prevention, early diagnosis, treatment, IEC/BCC, operational research and rehabilitation. 

5. Provide support for diagnosis and cost-effective treatment at primary, secondary and tertiary levels of health care. 

6. Provide support for development of database of NCDs through a robust Surveillance System and to monitor NCD morbidity, mortality and risk factors.

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.

Recent initiatives under NPCDCS 

1. Inclusion of guidelines for prevention and management of Chronic Obstructive Pulmonary Disease (COPD) and Chronic Kidney Disease (CKD) under NPCDCS, to prevent and manage the chronic respiratory and kidney diseases respectively, which are also major causes of death due to NCDs. 

2. For early detection of Diabetes, Hypertension and common Cancers in the community, 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. 

3. Pilot project on ‘Integration of AYUSH with NPCDCS’ has been initiated in six districts in the country. AYUSH facilities and methodologies are being integrated with NPCDCS services for prevention and management of common NCDs, wherein the practice of Yoga is an integral part of the intervention. 

4. Pilot intervention has been initiated for the prevention and control of Rheumatic Fever and Rheumatic Heart Disease under the platforms of NPCDCS and RBSK (Rashtriya Bal Swasthya Karyakram), in three select districts (Gaya - Bihar, Firozabad - Uttar Pradesh and Hoshangabad - Madhya Pradesh). This intervention would be scaled up to other districts in a phased manner. 

Collaboration with National TB Elimination Programme

Another initiative is the integration of Revised National Tuberculosis Control Programme (RNTCP which now has changed to NTEP) with NPCDCS, wherein the “National Framework for Joint Tuberculosis-Diabetes collaborative activities” has been developed to articulate a national strategy for ‘bi-directional screening’, early detection and better management of Tuberculosis and Diabetes comorbidities in India.

Resources

• National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke
• National Framework for Joint TB-Diabetes Collaborative Activities

Assessment