📄 district level. • Participate in decision-making regarding recruitment of PMU staff. • Orient newly hired staff on program details to enhance capacities and meet program requiremen

NATIONAL PROGRAMME FOR TRAINING MODULE FOR PROGRAM MANAGERS NON-COMMUNICABLE DISEASES (NP-NCD) �वा�य एवं प�रवार क�याण मंत्रालय MINISTRY OF HEALTH AND FAMILY WELFARE -- 1 of 156 -- -- 2 of 156 -- National Programme for Non-Communicable Diseases (NP-NCD) Training Module for Program Managers -- 3 of 156 -- -- 4 of 156 -- -- 5 of 156 -- -- 6 of 156 -- -- 7 of 156 -- -- 8 of 156 -- -- 9 of 156 -- -- 10 of 156 -- TABLE OF CONTENTS Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Module 1: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Module 2: Risk Factors for common NCDs with Screening & Diagnostic criteria . . 15 Module 3: Health Promotion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Chapter 3.1 Health Communication . . . . . . . . . . . . . . . . . . . . . . . . 42 Chapter 3.2 National Multisectoral Action Plan for Prevention and Control of Common NCDs (NMAP) . . . . . . . . . . . . . . . . . . . . . . . . 46 Module 4: Screening (Population Based Screening) and Health Care Delivery System for NCDs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Module 5: NCD Programme Management: Human Resource . . . . . . . . . . . . . 57 5.1 Human Resource Recruitment and Performance Monitoring . . . . . . . 58 5.2 Capacity Building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Module 6: Supply Chain Management . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Module 7: NCD Data Information System . . . . . . . . . . . . . . . . . . . . . . . . . 77 Module 8: Programme Monitoring & Evaluation and Supervision . . . . . . . . . . 83 Module 9: Integration/Linkages of NP-NCD with Other Programs . . . . . . . . . . 93 Module 10: Preparing Action Plan for Strengthening NCD services . . . . . . . . . 103 Module 11: Financial Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Annexures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 List of Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 -- 11 of 156 -- -- 12 of 156 -- 1 ABBREVIATIONS AAM Ayushman Arogya Mandir AMRIT Affordable Medicines and Reliable Implants for Treat- ment ANM Auxiliary Nurse Midwives ASHA Accredited Social Health Activist AYUSH Alternative Systems of Medicine BC Breast cancer BCC Behavioural Change Communication BPL Below Poverty Line CBAC Community Based Assessment Checklist CCRAS Central Council for Research in Ayurvedic Sciences CCRH Central Council for Research in Homoeopathy CCRUM Central Council for Research in Unani Medicine CCU Critical Care Unit CHC Community Health Center CKD Chronic Kidney Diseases COPD Chronic Obstructive Pulmonary Diseases CPHC Comprehensive Primary Health Care CVD Cardiovascular Disease DH District Hospital -- 13 of 156 -- 2 DHAP District Health Action Plan DHS District Health Society DM Diabetes Mellitus DPI Dry Powder Inhalers DPMU District Program Management Unit DPO District Program Officer ECG Electrocardiogram ESRD End Stage Renal Disease FC-XV Fifteenth Finance Commission FMG Financial management groups FMR Financial Monitoring Report GD Gestational Diabetes GFR Glomerular Filtration Rate GoI Government of India GOLD Global Initiative for Chronic Obstructive Lung Disease GTT Glucose Tolerance Test HD Haemodialysis HPV Human Papillomavirus HRH Human Resource for Health HTN Hypertension HWC Health & Wellness Centre ICMR-INDIAB Indian Council of Medical Research–India Diabetes -- 14 of 156 -- 3 IDDM Insulin-Dependent Diabetes Mellitus IEC Information, Education & Communication IGT Impaired Glucose Tolerance IHCI India Hypertension Control Initiative IPC Interpersonal Communication KT Kidney transplant LEEP Loop Electro Surgical Excision Procedure MC Medical College MI Myocardial Infarction MO Medical Officer MoHFW Ministry of Health & Family Welfare NAFL Non-Alcoholic Fatty Liver NAFLD Non- Alcoholic Fatty Liver Disease NAP National Alcohol Policy NASH Non-Alcoholic Steatohepatitis NCD Non-Communicable Diseases NHM National Health Mission NHP National Health Policy NIDDM Non- Insulin-Dependent Diabetes Mellitus NMAP National Multisectoral Action Plan NMHP National Mental Health Program NMAP National Multisectoral Action Plan for Prevention -- 15 of 156 -- 4 NOHP National Oral Health Program NPCB&VI National Programme for Control of Blindness and Visual Impairment NPCC National Programme Coordination Committee NPCDCS National Programme for Prevention and Control of Can- cer, Diabetes, Cardiovascular Diseases and Stroke NPHCE National Program for Healthcare of Elderly NP-NCD National Programme for Prevention and Control of Non-Communicable Diseases NPPC National Programme for Palliative care NTCP National Tobacco Control Program NTEP National Tuberculosis Elimination Program NUHM National Urban Health Mission OPD Out-Patient Department OVE Oral Visual Examination PBS Population Based Screening PCI Percutaneous Coronary Intervention PD Peritoneal Dialysis PHC Primary Health Centre PIP Programme Implementation Plan PMBJP Pradhan Mantri Bhartiya Janaushadhi Pariyojana PMJAY Pradhan Mantri Jan Arogya Yojana PMNDP Pradhan Mantri National Dialysis Programme -- 16 of 156 -- 5 PTA Parent Teacher Association RAN Rastriya Arogya Nidhi RBSK Rashtriya Bal Swasthya Karyakram RKSK Rashtriya Kishor Swasthya Karyakram (RKSK) RMNCAH+N Reproductive Maternal Newborn & Child Adolescent Health and Nutrition RoP Record of Proceedings RRT Renal Replacement Therapy SC Sub- Centre SHC Sub Health Centre SHS State Health Society SNO State Nodal Officer SoE Statement of Expenditure SPMU State Program Management Unit SPO State Program Officer STEMI ST-Elevated Myocardial Infarction TB Tuberculosis TCCC Tertiary Cancer Care Centre TIA Transient Ischemic Attack UC Utilization Certificate VHSNC Village Health Sanitation & Nutrition Committee WHO World Health Organization -- 17 of 156 -- -- 18 of 156 -- MODULE 01INTRODUCTION -- 19 of 156 -- 8 Learning Objectives: 1.1 Introduction: At the end of this module, you will be able to answer the following questions: 1. What is the burden of Non-Communicable Diseases – Global and Indian Scenario? 2. What are the risk factors associated with Non-Communicable Diseases? 3. What is the National Programme for Prevention & Control of Non-Communicable Diseases, its evolution, and its components? Non-Communicable Diseases (NCDs) are chronic diseases that are not transmissible from one person to another. Taking this definition into account, NCDs may thus include wide spectrum of medical disorders both acute and chronic like Cancers, Diabetes, Hypertension, Cardiovascular Diseases and Stroke, Chronic Kidney Diseases (CKDs), Chronic Obstructive Pulmonary Diseases (COPDs) and Asthma, Non- Alcoholic Fatty Liver Disease (NAFLD), and a range of other diseases1 . NCDs cause significant morbidity and mortality, both in urban and rural populations and across all socio-economic strata, with considerable loss in potentially productive years of life1. NCDs also result in substantial out-of-pocket healthcare expenditures2. In India alone, the economic impact of NCDs (excluding mental conditions) is estimated to be $3.55 trillion from 2012 to 20303. 1. World Health Organization. Non-Communicable Diseases. (2022). Available from: who.int/news- room/ factsheets/detail/noncommunicable-diseases [Accessed 16th Sep 2023]. 2. World Health Organization. Impact of out-of-pocket payments for treatment of NCDs in developing countries: a review of literature. (2011). Available from: https://www.who.int/publications/i/item/ impact-of-out-of-pocket-payments-for-treatment-of-non-communicable-diseases-in-developing- countries-a-review-of-literature [Accessed 16th September 2023]. 3. Economics of Non-Communicable Diseases in India. A report by the World Economic Forum and the Harvard School of Public Health. (2014). Available from: https://www3.weforum.org/docs/WEF_ EconomicNonCommunicableDiseasesIndia_Report_2014.pdf [Accessed 16th September 2023]. -- 20 of 156 -- 9 1.2 Burden of Non-Communicable Diseases: Global Scenario: Indian Scenario: Figure 1: Burden of NCDs and proportional mortality in India According to the World Health Organization (WHO), NCDs account for over 74 percent of global deaths, including heart disease, stroke, cancer, chronic respiratory diseases, and diabetes1. Cardiovascular diseases account for most NCD deaths annually (17.9 million) followed by cancers (9.3 million), chronic respiratory diseases (4.1 million), and diabetes (2.0 million, including kidney disease deaths caused by diabetes)4. As per the WHO – NCD India profile - 2022, NCDs are estimated to account for 66% of all deaths in country of which the