Determining the Role of Community Engagement in the Design of Primary Care Models Addressing Non-communicable Diseases

Atul Sharma, Arun Dhananjay Joshi, Nidhi Purohit, Shruti Sharma, Meenal Bhat, Maulik Chokshi, Tushar Mokashi and Arun Nair

Abstract

Non-communicable diseases (NCDs) are a major health concern in India and were estimated to account for 63% of all deaths in 2016, and if left unaddressed, they could cost India approximately US$3.55 trillion in economic losses by 2030. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS) has identified community engagement to enable behaviour change as a top intervention to manage various NCDs. Community engagement initiatives in India are plagued with multiple issues such as a lack of long-term focus, non-clarity on budgets, ineffective programme planning and the absence of visionary leadership and governance. This article attempts to understand the role of community engagement in providing access to NCD awareness and to support action on prevention, screening, diagnosis, treatment and compliance, so that the community is empowered to proactively behave in a way to prevent and manage NCDs effectively and hence reduce the incidence of NCDs. The article is based on research study using a mixed-method approach
in a five-step manner, which included secondary and primary research. After scanning 200 initiatives across the spectrum of community engagement globally, 20 were shortlisted and detailed case studies of the initiatives were analysed and presented. In addition, primary research was pursued to propose recommendations for community engagement across the areas of visioning and planning, leadership and governance, and community involvement. Some guiding principles were recommended to create an environment of shared leadership and collaboration for community engagement, consequently creating greater positive influence on NCD management within the community.

Keywords

Community engagement, non-communicable diseases (NCDs), community involvement, behaviour change

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