Harshal Tukaram Pandve*
Department of Community Medicine, Smt. Kashibai Navale Medical College, Narhe, Pune, Maharashtra, India
Received date: August 25, 2012; Accepted date: August 26, 2012; Published date: August 28, 2012
Citation: Pandve HT (2012) Non-Communicable Diseases: Challenges, Solution and Initiatives in India. J Community Med Health Educ 2:e108. doi: 10.4172/2161-0711.1000e108
Copyright: © 2012 Pandve HT. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Chronic non-communicable diseases are assuming increasing importance among the adult population in both developed and developing countries. The prevalence of non-communicable disease is showing an upward trend in most countries and India is not an exception. For one reason, life expectancy is increasing in India and greater number of people is living to older ages and at greater risk to chronic diseases like diabetes mellitus. For another, the life-styles and behavioral patterns of people are changing rapidly, these being favorable to onset of non-communicable diseases. The impact of chronic diseases on the lives of people is serious when measured in terms of mortality, morbidity, disablement, economic loss of country.
In last few decades India had gone through rapid socio-economic growth. This period also witnessed rapid health related change with rising burden of non-communicable diseases. In India an estimated 2.27 million people died due to Ischemic Heart Diseases (IHD) during 1990, and according to projections the number of deaths due to IHD was to increase from 1.17 million in 1990 to 1.59 million in 2000 and 2.03 million by 2010 . In one study, the prevalence of IHD among adults (based on clinical and ECG criteria) was estimated as 96.7 per 1000 in urban population [2,1]. In India, cardiovascular diseases are ranked third based on the overall burden of disease, the other two being infectious and parasitic diseases and unintentional injuries. In India, deaths from coronary heart disease rose from 1.17 million in 1990 to 1.59 million in 2000 and are expected to rise to 2.03 million in 2010 [3,2]. In India the prevalence of diabetes mellitus in adults was found to be 2.4% in rural and 4.0 to 11.6% in urban dwellers [1,3]. High frequencies of impaired glucose tolerance, shown by those studies, ranging from 3.6 to 9.0%, indicate the potential for further rise in prevalence of diabetes mellitus in the coming decades . There were an estimated 37.76 million diabetics in India in 2004; 21.4 million in urban areas and 16.36 million in rural areas. Diabetes was estimated to be responsible for 109 thousand deaths, 1157 thousand years of life lost and 2263 thousand Disability-Adjusted-Life Years (DALYs) during 2004 .
The countries like Singapore also had undergone rapid socioeconomic development like India. Singapore also faced the major problem of chronic non-communicable diseases in early phases of socio-economic development. In 1991, a national committee was appointed to review the national health plan for the 1990s, and one of the key recommendations emphasized health promotion and disease prevention. This was followed by the National Healthy Lifestyle Programme in 1992, which adopted a multisectoral approach involving government ministries and organizations, health professionals, employers, unions, and community organizations. These sectors worked together to provide information, skills training, and the social and physical environment necessary to encourage healthy living by Singaporeans. The programme included extensive use of the mass media to promote healthy lifestyles, legislative measures to discourage smoking, and widespread school, workplace, and community health promotion programmes. The programmes emphasized healthy diets, regular physical exercise, and measures to discourage smoking. In 1992, the Ministry of Health also conducted the first National Health Survey (NHS), a population based cross-sectional survey to measure the prevalence of diabetes mellitus, hypertension, obesity, smoking, physical inactivity, and hypercholesterolaemia-all cardiovascular disease risk factors. In 1998, six years after the launch of the National Healthy Lifestyle Programme, a second NHS was conducted to determine whether the risk factors in the population had changed. The 1998 results suggest that the National Healthy Lifestyle Programme significantly decreased regular smoking and increased regular exercise over 1992 levels and stabilized the prevalence of obesity and diabetes mellitus. The intervention had mixed results after six years. Successful strategies have been continued and strengthened . Similar type of healthy life style programmes were also adopted by Finland and Mauritius [7,8]. Similar kind of Healthy Lifestyle Programme is required in India to fight with the ever increasing problem of noncommunicable diseases like cardiovascular diseases and diabetes mellitus. The examples of Singapore and Mauritius have got much importance because the Healthy Lifestyle Programmes are highly successful in these countries with Indian origin populations. The main focus is on communicable diseases which are still the major problems for India; country should also provide some attention to noncommunicable diseases which are the future problems for the country.
In response to ever-rising burden of cardiovascular diseases and Diabetes in India, at national level Government of India has undertaken some actions in various National health programmes and projects [9,10]. The governmental efforts are initiated but in phased manner and will take considerable time to gain the momentum to reach each and every part of the country considering large population and geographical size of India. To conclude with, considering the ever increasing burden of cardiovascular diseases in India the Government of India has taken certain initiatives at national level that is really commendable. Now it is also important to implement these initiatives more aggressively and effectively. The National Family Health Surveys which are of periodic activity at a national level can be used for regular evaluation of these initiatives. The sustainable efforts are required for future.