NCDs plague Keralites’ health

Contact Counsellor

CategoryHealth

Last Updated14/06/2023

For a State which takes immense pride in consistently coming at the top in the health index rankings of NITI Aayog every year, the findings of the ICMR-INDIAB study, which puts Kerala right on top with the worst overall indicators for long-term morbidity and mortality due to non-communicable diseases (NCD), has come a cropper.

Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors.
The main types of NCD are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.
Causes are Tobacco use, unhealthy diet, harmful use of alcohol, physical inactivity and air pollution are the main risk factors contributing to these conditions.
According to WHO, over 60.46 lakh people died due to NCDs in India in 2019.

Kerala has known since the mid or late 90s that NCDs are going to be its biggest health challenge.
A current diabetes prevalence of nearly 24%, pre-diabetes at 18.1% and hypertension prevalence at a whopping 44%, is certainly not the picture of a healthy State.
With more than half the State’s population having high cholesterol levels and abdominal obesity, the incidence of cardiovascular diseases and chronic kidney diseases could skyrocket in the near future and have significant impact on the State’s health expenditure as well as private spending on catastrophic illnesses.
Experts point out that the high incidence of Chronic kidney disease in the State is a direct consequence of the spiraling levels of hypertension, which again is a result of poor adherence to the drug protocol, apart from factors like unhealthy diet and sedentary lifestyle.

Diabetes management requires the patient to have fair awareness on what makes the blood sugar spike. Limiting carbohydrates, improving nutrition through the increased consumption of vegetables and fruits and daily physical activity are important lifestyle interventions that patients need to imbibe.
Patients also have to be given affordable choices when it comes to diet and medication advice. Adherence to medication has to be ensured through consistent follow-up and people have to be motivated continuously to ensure that the changes they embrace become a part of their lifestyle.
Health workers or ASHAs in the field need to be trained better to impart awareness at the grassroots, to follow-up patients rigorously; they should be offered attractive incentives for the same.

National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) is being implemented under the National Health Mission (NHM).
The Central Government is implementing the Strengthening of Tertiary Care Cancer facilities scheme to support the setting up of State Cancer Institutes (SCI) and Tertiary Care Centres (TCCC) in different parts of the country.
Oncology in its various aspects has a focus in case of new AIIMS and many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojana (PMSSY).
Affordable Medicines and Reliable Implants for Treatment (AMRIT) Deendayal outlets have been opened at 159 Institutions/Hospitals with an objective to make available Cancer and Cardiovascular Diseases drugs and implants at discounted prices to the patients.
Jan Aushadhi stores are set up by the Department of Pharmaceuticals to provide generic medicines at affordable prices.

Identifying the scope of the problem and documenting it is the easy part.
But stepping in with effective interventions to increase public awareness about NCDs and its long-term consequences and-improving primary prevention of diabetes and hypertension through the promotion of a healthy lifestyle is where most health systems falter.

The problem is not unique to Kerala. It is a huge challenge to health systems-to create, implement and sustain programmes for the promotion of healthy lifestyles because it is not easy to change people’s attitudes towards self care, their long-term food habits or to inculcate new habits like daily exercise.