NCD Risk reduction training in India: A Gap analysis
Dr. Arohi Chauhan, MD
Non-communicable diseases (NCDs) have emerged to be an important public health problem in India surpassing the infectious diseases as a major cause of mortality and morbidity.(1) As the infectious diseases are receding as leading contributors to death and disability, Cardiovascular diseases (CVDs), cancers, diabetes and chronic respiratory diseases are becoming major contributors to the burden of disease. Major reasons responsible for this tilt towards the NCDs are the changes in demography, lifestyle and rapid rates of urbanization. NCDs accounts for 61% of the total mortality in India.(2) Risk factors such as physical inactivity, obesity, alcohol and tobacco consumption are responsible for much of the burden of NCDs. Evidence suggests strong linkages between risk factors and development of NCDs. Thus, considering the burden NCDs pose, their management assumes paramount importance.(3)
The National program for prevention and control of Cancer, Diabetes, Cardiovascular disease and Stroke (NPCDCS) in India aims to prevent and control NCDs though behavior and lifestyle changes, providing early diagnosis and management of common NCDs, capacity building of healthcare providers (HCP) as well as establishing palliative and rehabilitative care.(4) HCPs has a vital role in ensuring the appropriate management of all aspects of the health system including NCDs.(5) In India, HCPs are mainly the primary care physicians trained in medical background. Since, reducing many of the risk factors involves behavioral change, HCP himself needs to be trained to acquire the knowledge and skills required to engage patients, motivate them to change, initiate and maintain healthy behaviors to ensure healthy lifestyle.(4) Various studies have observed that the HCPs feels incompetent while addressing NCDs related issues and the education received in the formative years has failed to prepare them for executing such roles on the ground.(3) Thus, training of HCP in order to understand the risk factors for NCDs is imperative.