Need of a New Frontline Health Functionary Dedicated to Non-Communicable Diseases in India

Abstract

Majority of global deaths are attributed to noncommunicable diseases (NCDs). Along with the ageing population, burden of non-communicable diseases is also rising. India shares more than two-third of the total deaths due to NCDs in the South-East Asia Region (SEAR) of WHO. Since the awareness level about the chronic diseases and their risk factors is still limited in the low and middle income countries, it is expected that the health education based primary prevention interventions could be as successful as the first generation community oriented primary care (COPC) models. Community health workers (CHWs) are central to the primary health care approach towards health care utilization in India but do they have sufficient training.The first step in primary prevention of cardiovascular diseases is to identify individuals at high cardiovascular risk. A number of methods have been devised to calculate individual risks based on risk factor levels. Under NPCDCS in India, there is a three tier structure of NCD Clinic at block, district and state level. At the village level in Subcentre, only opportunistic screening is being done to those who visit the subcentre and are above 30 years of age. There is no provision of active screening of non-communicable diseases and their risk factors under the programme. There is no dedicated health worker at thegrassroot level for the NCDs. Thus the authors envisages that there is a direneed for the provision of new band of community based health functionary dedicated to control the burden of NCDs.

Leveraging role of non-physician health workers in prevention and control of non-communicable diseases in India

“…Boosting the role of nurses, female health workers, ASHA workers, community health workers, etc., could save 2.5 million lives or more per year. [ 8 ] A systematic review conducted by Joshi R and researchers on task-shifting responsibilities related NCD management in developing countries reported that the tasks performed by NPHW evidently lead to better health outcomes. [ 9 ] NCD-related primary health care services can be effectively delivered by this workforce especially in understaffed and resource strained regions.…”

“…On the same lines, WHO and other International and national health agencies have advocated involvement of these workers in management of various NCDs so as to ensure access to essential health services. [ 8 9 ] In response to the NCD burden, National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) was launched by Indian Government which directs at integration of NCD interventions at primary level through active involvement of NPHWs such as nurses, auxiliary nurse midwife, male health worker, ASHA workers, and community health workers. [ 5 ] These workers are the frontline healthcare providers who are primarily responsible for providing healthcare services to needy.…”

Mobile technology to give a resource-based knowledge management advantage to community health nurses in an emerging economies context

“… Information shapes knowledge, which in turn is a driver of health-related change (WHO, 2016).  Need of a New Frontline Health Functionary for Non-Communicable Diseases in India (Gupta et al, 2017).  Technology has emerged as an opportunity for KM (Kalnad et al, 2017).…”

“… The importance of receivers responding to signalers about the effectiveness of their signals (Gupta et al, 2017).  Service -centred organisation (Vargo and Lusch, 2017)  "Perfect information" (Stiglitz, 2000).…”

“…This is evidenced by the limited understanding of the Ministry of Health and Family Welfare (MoHFW) about the nature of medical knowledge flow, the types of KM tools suitable to disseminate breast health information and the barriers to enablers of KM (Chib, 2010; Nicolini et al , 2008). Observers have also witnessed a less than substantive investment in educational resources as to normalise breast self-examination or technological innovations to assist prevention activities (Gupta et al , 2017).…”