Non-Communicable Diseases: NPCDCS ... - SIHFW Rajasthan

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DMHP Evaluation Lessons learnt Limited development of the DMHP in its operational aspects by the Central agency Limited state level capacity to implement the DMHP Lack of emphasis on creating awareness in the community Lack of mental health indicators Lack of monitoring <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 474
NMHP Achievement Scheme Financial Support Provided District under DMHP 123 Up gradation of 85 Psychiatry Wing Psychiatry wings of Medical colleges/GHs Modernization of State 29 institutions run Mental hospitals Centers of Excellence 9 Institutions Support for new 19 departments of Mental Health disciplinesi <strong>SIHFW</strong>: An ISO:9001:2008 certified Institution 475
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Non-Communicable Diseases: NPCDCS &
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Risk factors and NCDs largely preve
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Drivers of NCDs SIHFW: an ISO 9001:
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SIHFW: an ISO 9001:2008 certified I
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Epidemiological Transition Communi
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Challenges Many communicable disea
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SIHFW: an ISO 9001:2008 certified I
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Magnitude SEAR-2008: 14.5million t
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50 45 40 35 30 25 Estimated %of pre
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Trends in estimated %of deaths 80%
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Estimated and Projected Deaths due
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Pop.(2010): 1 224 614 327 Age stand
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Metabolic Risk factor Trends 126 Me
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26 Mean BMI 24 22 Male 20 Female 18
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Reported Cases & Deaths due to NCD-
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Total Number of Diabetic Cases - Ra
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Reported Deaths :Type 1 DM- Distric
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District Reported Deaths of Type 2
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Reported Cases of Deaths Due to Can
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District -wise reported Cancer Deat
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SIHFW: An ISO:9001:2008 certified I
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Implications of ↑ burden of NCDs
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MDG-6 NCD burden threatenst the (Co
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2% annual reduction in Chronic Dise
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Answer to the problem: ACT NOW Prev
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Risk factor/disease Tobacco use: Us
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Action at National Level: Two comp
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Strategies Prevention through beha
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Services Preventive, promotive , c
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Facility DH Services Early diagnosi
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Institutional Framework Integratio
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Screening MO to do: To conduct com
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Work closely with other sectors/ de
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Surveillance Surveillance is the on
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Risk Factor Surveillance: Focus …
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Risk factors common to major non-co
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Levels of Risk Factor Surveillance
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Actions at Hospitals Proper depict
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Structure re of presentation Risk
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Risk factor in NCD Any attribute,
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Risk factors May be truly causativ
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NHD of NCD Changes in life style st
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The WHO STEP approach to Surveillan
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STEPS emphasizes that small amounts
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SIHFW: an ISO 9001: 2008 certified
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Step1:Questionnaire Based Assessmen
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Step 3: Biochemical Measurements D
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Core Items Expanded Items Optional
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Behavioral Risk Factors “Actions/
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Modifiable Risk Factor: 2008 estima
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B. Diabetes ‣ Obesity ‣ Sedenta
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D. Cancer ‣ Environment ‣ Life
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Risk factors and level of NCD preve
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Goals of implementing these guideli
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Follow up Once the condition of th
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High risk With established cardiov
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If cholestrol can not be measured S
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Prevention of CVD (according to ind
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NPCDCS Components Prevention throu
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Thank you SIHFW: An ISO:9001:2008 c
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Problem on the rise : NCDs MI HT CO
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Major diet related NCDs Diabetes Ca
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Type of cancers Risk factors Diet R
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Prominent risk factor Disease Heart
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Life Style Modification Primary Pr
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Burden of the Bulge In India 1 in
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Android : Upper-body obesity--apple
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Assessment of central obesity Wais
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Why is this happening Drivers of th
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Nutrition transitions: Absolute cau
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Body Mass Index (BMI ) Quetlet’s
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Classification BMI Classification W
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Sleep apnea and respiratory problem
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Weight management Weight gain Calor
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Weight loss goals Realistic Achie
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Lifestyle medicine: Need for change
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Dietary interventions Managing g /
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Life style modification & Diet Bala
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SIHFW: an ISO 9001: 2008 certified
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Total energy requirement Total ener
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Diet for NCD: Main focus ‣ Gradua
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Promoting Healthy lifestyle le Tra
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Strategies for Obesity Prevention e
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Tips for weight reduction Slow and
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‣ Avoid fried foods and bakery pr
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When to eat Set aside a time for
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Way to eat Eat slowly. Chew prop
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Recommendations in preventing diabe
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Calculating balanced diet Know Rec
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How to calculate balance diet Step
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Key recommendations -Diet • Frui
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Thank you SIHFW: an ISO 9001: 2008
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Structure re of presentation Basic
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What is Cancer SIHFW: an ISO 9001:
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Growth of Cells • Undesirable •
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Common Cancer sites Male- • Mout
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Prefix adeno- chondro- Meaning Nami
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India 0.8 million new cases/year
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Five Common Cancers Rank World Indi
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Issues in Cancer control Burden of
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Cancer patterns Predominance of To
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Prevention ention and screening Se
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Early diagnosis ‣ Individual’s
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Diagnosis Radiological Biochemica
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Cancer Interventions in different E
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350 Age wise distribution of deaths
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Common Cancer in Male 50000 45000 4
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No of Cancer Deaths -India 350 300
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Cancer Deaths -Rajasthan 60 50 40 5
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District wise Reported Cancer Death
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Projected Cases of Oral Cancer in I
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Age - wise distribution of Deaths d
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Symptoms of Cervical Cancer Post-m
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Evaluation and Management after Pap
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VIA Category Negative Positive Crit
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Cryotherapy (ablation) Management
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Age - wise distribution of Deaths d
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Sign and Symptoms A lump or thicke
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Diagnosis Breast awareness & breas
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Health professionals can - Key Mess
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Projected Cases of Lung Cancer in I
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Symptoms Persistent cough or worse
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National Programme SIHFW: An ISO:90
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National Cancer Registry Programme
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Schemes under NCCP Recognition of
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District Services under NCCP Healt
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Medical college Health Promotion &
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Why include Cancer In NPCDCS No u
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Objective e of TCC Scheme Develop
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Thank You For more details log on t
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Definition ‣ Group of brain dysfu
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Burden of Disease 7000000 6000000 5
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Risk Factors ‣ Age and Sex ‣ Hy
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Cerebrovascular Accident Risk Facto
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Cerebrovascular Accident Anatomy of
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Ischemic Cascade Cerebrovascular Ac
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‣ Trouble in walking Symptoms ‣
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Identification of an acute event S
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Diagnosis: CT without contrast Cer
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Cerebrovascular Accident Classifica
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CVA Recognition SIHFW: An ISO:9001:
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Cerebrovascular Accident Thrombotic
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Cerebrovascular Accident Common Sit
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Cerebrovascular Accident Embolic St
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Cerebrovascular Accident Goals for
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Cerebrovascular Accident Hemorrhage
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Cerebrovascular Accident Hemorrhagi
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Delayed Neurological deficit in Re
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Hemorrhagic-Subarachnoid Cerebral A
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Cerebrovascular Accident Clinical i
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Cerebrovascular Accident Clinical M
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Cerebrovascular Accident Treatment
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Cerebrovascular Accident Diagnostic
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CVA - Treatment Goals Surgical Tre
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Drug Therapy Cerebrovascular Accide
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Cerebrovascular Accident Rehabilita
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Cardio-Vascular Diseases SIHFW: An
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Source: WHO Burden of Disease Numb
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Cardiovascular Diseases group of di
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Newly emerging CVD risk factors ‣
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Resource Scenario-1 Scenario-2 Scen
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Prevention of CVD Heart disease and
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Hypertension “ high blood pressur
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Classification Primary / Essential
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Epidemiological Determinants Risk/
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Symptoms ‣ Headache ‣ Drowsines
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Criteria for diagnosing high blood
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Headache (severe hypertension) < mo
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Physical examination should include
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Desirable: (at CHC/sub-district/dis
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Life style advice is advocated for
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Treatment Goals The aim should be
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Diuretics Thiazide Inhibit Na + /C
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Beta blockers Act by decreasing ca
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α adrenergic blockers Lower BP by
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Medicines are tailored depending on
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‣ Start with calcium channel bloc
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Compelling Indications for Compelli
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Management of Hypertension at diffe
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Follow-up and Monitoring Patients
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Ischemic Heart Disease Myocardial i
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Burden of IH Disease 10000000 22367
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Symptoms ‣ Abrupt, unexpected car
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Treatment of IHD ‣ Medical treatm
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Management & Prevention: Modifying
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‣ Weakness in sternocleidomastoid
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Prevention ention ‣ Strokes are p
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‣ Physical therapy to improve str
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Rheumatic heart diseases ‣ Compli
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‣ Breathlessness ‣ Fatigue ‣
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Prevention ‣ Seek immediate medic
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Conceptualization ation of NPHCE U
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Objectives es Provide Preventive,
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Ageing Ageing is a progressive biol
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Ageing means….. Demographers: A
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Ageing Progressive and generalized
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Some Facts! World population of 6.
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Projections 60+ 24 million in 1961
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India: Some Facts! Life expectancy
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Household population p + 60 Age By
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Ageing: Common Myths Most elderly
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Integumentary System Production of
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Page 425 and 426: Nervous System Progressive loss of
Page 427 and 428: Urinary System Decreased circulati
Page 429 and 430: Reproductive e System Female: vagi
Page 431 and 432: Psychosocial Changes of Aging Lone
Page 433 and 434: Psychosocial changes can be a major
Page 435 and 436: Dementia Term used to describe a l
Page 437 and 438: Alzheimer’s Disease (continued)
Page 439 and 440: Meeting the Needs of the Elderly G
Page 441 and 442: SIHFW: An ISO:9001:2008 certified I
Page 443 and 444: Gender and Ageing g in India Discr
Page 445 and 446: Care - Services for Elderly l in In
Page 447 and 448: Primary Health Center Training of
Page 449 and 450: How to achieve it Ati Active advoc
Page 451 and 452: Mental Health : Problem, Strategies
Page 453 and 454: Health "Health is a state of compl
Page 455 and 456: Mental Health Problems in India 1%
Page 457 and 458: Extent of the problem… Mental He
Page 459 and 460: Mental Health Resources In India Ma
Page 461 and 462: Mental Health Resources In India…
Page 463 and 464: Mental Health Resources in India 2
Page 465 and 466: Objectives National Mental Health P
Page 467 and 468: Essentials of DMHP 1. A decentraliz
Page 469 and 470: Restrategised NMHP 2003 Components
Page 471 and 472: Integration of NMHP in NRHM Nation
Page 473: DMHP Evaluation Independent evalua
Page 477 and 478: Failures It is top down approach
Page 479 and 480: Urban Mental Health Meta analysis b
Page 481 and 482: NGO Work In INDIA SCARF (Schizophr
Page 483 and 484: Mental Health NGO Activities Treat
Page 485 and 486: Community Awareness Role of media
Page 487 and 488: Tobacco As per Global Adult tobacc
Page 489 and 490: Stepped Care Approach in Substance
Page 491 and 492: Future Direction Vision i 2020: Roa
Page 493: For more details log on to www. sih
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