National Programme for Prevention and Control of Cancer

National Programme for Prevention and Control of Cancer, Diabetes, CVDs and Stroke (NPCDCS) STATE NCD CELL, 7 TH FLOOR, AROGYA BHAVAN, ST. GEORGE’S HOSPITAL P. D’MELLO ROAD, FORT, MUMBAI 01 TEL: 022 -2262 3222 / 2027 FAX : E-MAIL: NCD. MUMBAI@GMAIL. COMPOUND, 022 -22642955

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.

Strategy � Health promotion, awareness generation and promotion of healthy lifestyle � Screening and early detection � Timely, affordable and accurate diagnosis � Access to affordable treatment, � Rehabilitation

NCD Programme salient features � Screening of age >30 years individual 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.

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’s ANM in DM screening

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

� Form this year 2014 -15 the programme will be expanded in 5 another districts Nandurbar Osmanabad Parbhani Satara Sindhudurg

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

� 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.

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

� 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

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

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 RHSDH � 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

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

Thank you. .