Though there is a rising burden of diseases like cancers, cardiovascular diseases, diabetes and respiratory diseases in India, there is a lack of systematic ongoing surveillance system for non-communicable diseases.
A new review article by the Indian Council of Medical Research – National Institute of NCD Epidemiology (ICMR-NINE) published in International Journal of non-communicable diseases stated that a well-defined policy for institutionalising NCD surveillance with well-defined objectives, standard methods, definitions, risk factors, health conditions and health system response is the need of the hour.
NCD burden in India is huge with the WHO estimating that NCDs account for 68 per cent of all deaths in India and of them 55 per cent deaths occur before individuals attain 70 years. High prevalence of NCDs is responsible for significant long-term out-of-pocket and high hospitalisation expenditures, mostly borne by individuals and their families.
“Although the country has demonstrated capacity in conducting surveys, registries and risk factor assessments, there has been no cohesive linking of such information to action and evaluation to complete the surveillance cycle. Many of the surveys do not reflect state or district-level patterns that can enable better health planning,” the study said.
The review analysed the recent National NCD Monitoring Survey, 2017-2018 (NNMS) which established the baseline national estimates for monitoring progress of reduction of NCD risk factors and evaluation of the health system towards attainment of the national NCD targets and indicators.
However, the pediatric age group less than 15 years old is not included in these surveys, amounting to a huge knowledge gap on NCDs among children.
While the state level surveys focused on cancers, cardiovascular diseases, diabetes and respiratory diseases, they ignored mental health, injuries, gastrointestinal, rheumatological, hematological diseases, or risk factors like air pollution.
The review cited the example of Health and Demographic Surveillance System (HDSS) which described NCD risk factor burden.
Though HDSS have enabled exploration of research questions, there has been limited experience of use of research data for programmatic action and policy linkage, the study pointed out and underscored that while there were standalone activities that described different dimensions of NCD risk factors and morbidity, they were not linked to notable interventions to reduce the burden of diseases.
ICMR suggested that the digitised records of patient and family health records, hospital records, insurance and surveys may be linked through unique Ayushman Bharat Health Account (ABHA) and a governance framework for data to enhance NCD surveillance.
