THIRUVANANTHAPURAM: Burdened by the economics of an ageing population and lifestyle diseases, the state government is set to launch an ambitious health programme to tackle non-communicable diseases (NCDs) such as cancer, heart diseases, and diabetes. The Rs 3,000-crore, multi-year initiative will be funded largely by the World Bank.
The ‘Kerala Health Systems Improvement Programme' envisages building a resilient health system to deliver value-based healthcare by addressing advanced demographic and epidemiological transitions. It will also enhance inter-sectoral collaboration to effectively respond to emerging threats, including climate change.
The project will be implemented in 14 districts for a five-year period from 2024. The state government’s contribution will be Rs 900 crore. Under the programme, the output of primary and secondary healthcare centres will be improved to provide NCD care.
Though the government has started several initiatives to tackle NCDs, the disease burden continues to rise. The state is the diabetic capital of the country, according to the National Family Health Survey. Kerala also has the highest percentage of people aged 60 and over.
Approximately 120,000 deaths annually are attributable to cardiovascular and chronic kidney diseases in Kerala. It is also estimated that 6 million adults live with either hypertension or diabetes. “We also expect 1.8 million individuals with prevalent cardiovascular conditions, 8,00,000 with heart failure and 40,000 adults with end-stage renal disease on dialysis in the state,” said Dr Jeemon Panniyammakal, additional professor (epidemiology) at Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST).
Creative solutions needed to tackle NCD burden; says expert
“Hypertension and diabetes are attributable to 26 per cent of all deaths. Around 23,000 deaths every year can be averted if we can improve the control rate of hypertension and diabetes at the population level. Achieving optimal control in at least 50 per cent of individuals with diabetes or hypertension will avert 5.4 million disability-adjusted life years in 10 years,” said Dr Jeemon.
“Individual disease-based management strategies may have a limited impact given the high prevalence of multimorbidity. Our surveys suggest that at least two of five adults seeking care from our primary health centres suffer from multimorbidity. Developing a patient-centred and integrated care delivery model for managing multimorbidity in primary care is a high priority for the state,” he added.
The effect of a large number of morbid patients was felt during the pandemic when more people extended their stay in hospitals and succumbed to the infection. The health department started a survey on December 7 with the intention of assessing the level of NCDs in the population and more importantly, making early interventions to control them.
The survey covered over 82 per cent of the population above the age of 30. As many as 8,66,414 persons have been sent for cancer screening, so far. The survey also found that over 15 lakh people suffer from hypertension and over 12 lakh have diabetes. Dr Althaf A, an epidemiologist and associate professor at Thiruvananthapuram Government Medical College Hospital, said the state requires creative solutions as the NCD burden keeps on increasing despite spending big money on disease management.“Parks and walkways would encourage people to become more physically active. It would help prevent the growth of diabetes and hypertension,” said Dr Althaf.