National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke — Features and Implementation

The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS) is a major public health intervention launched in 2010 under the National Health Mission (NHM). In May 2023, the Ministry of Health and Family Welfare officially renamed the scheme as the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD). This change reflects a broader mandate that encompasses additional chronic health conditions beyond its original core focus. The program addresses the rapid epidemiological transition in India, where non-communicable diseases (NCDs) account for over 60 percent of total mortality.

Core Objectives and Strategic Pillars

The scheme builds healthcare capacity, strengthens primary infrastructure, and minimizes out-of-pocket medical expenditure for chronic illnesses.

Primary Objectives

• Health Promotion: Drive behavior change through Information, Education, and Communication (IEC) initiatives focused on healthy diets, physical activity, and reducing tobacco and alcohol consumption.
• Early Diagnosis: Conduct population-based screening to detect risk factors early among adults aged 30 years and above.
• Capacity Building: Train doctors, nurses, allied health workers, and Accredited Social Health Activists (ASHAs) in primary NCD care and long-term case management.
• Continuum of Care: Link grassroots health facilities with secondary and tertiary referral units through organized referral channels.

Governance and Institutional Architecture

The program uses a multi-tiered administrative structure embedded within the National Health Mission framework.

Management Framework

• National and State NCD Cells: Provide policy oversight, fund allocation, program monitoring, and logistical planning.
• District NCD Cells: Oversee local execution, drug supply chain logistics, and district-wide health education campaigns.
• District NCD Clinics: Provide outpatient care, diagnostic tests, free essential generic medications, and specialized counseling at District Hospitals.
• CHC NCD Clinics: Function at Community Health Centres (CHCs) to deliver secondary screening, treatment initiation, and basic diagnostic services.
• District Cardiac Care Units (CCUs): Provide emergency care for acute cardiovascular events like myocardial infarction and stroke.
• Day Care Centres: Deliver outpatient chemotherapy, blood transfusions, and palliative supportive care for cancer patients at the district level.

Screening and Service Delivery Model

The scheme targets early identification of risk factors through a multi-tiered public healthcare network.

Population-Based Screening (PBS)

• Target Demographic: Covers all individuals (men and women) aged 30 years and older.
• Screened Conditions: Diabetes, hypertension, and three common cancers (oral, breast, and cervical).
• Grassroots Community Screening: ASHAs complete the Community-Based Assessment Checklist (CBAC) during home visits to evaluate risk factors.
• Facility Screening: Auxiliary Nurse Midwives (ANMs) and Community Health Officers (CHOs) conduct clinical screening at Ayushman Arogya Mandirs (formerly Sub-Health Centres / Health and Wellness Centres).

Expanded Scope and Expanded Diseases

The transition from NPCDCS to NP-NCD expanded the scheme’s diagnostic scope to address emerging chronic health challenges.

Added Disease Conditions

• Non-Alcoholic Fatty Liver Disease (NAFLD): Integrated to enable early detection and lifestyle management of metabolic liver dysfunction.
• Chronic Kidney Disease (CKD): Added to identify early renal failure among diabetic and hypertensive patients.
• Chronic Obstructive Pulmonary Disease (COPD) and Asthma: Covered under routine screening at primary and secondary healthcare levels.
• ST-Elevation Myocardial Infarction (STEMI): Targeted for rapid emergency management and thrombolytic therapy.

Digital Ecosystem: The National NCD Portal

Digital tracking tools ensure long-term patient follow-up, electronic record keeping, and supply chain tracking.

Digital Infrastructure Features

• National NCD Portal: Renamed from the Comprehensive Primary Healthcare Non-Communicable Disease (CPHC NCD IT) system, serving as the central repository for screening data.
• ABHA ID Integration: Creates individual Ayushman Bharat Health Account IDs to record patient diagnoses and treatment histories.
• ASHA and HWC Mobile Apps: Allow frontline workers to record CBAC responses, register families, track non-compliant patients, and issue electronic referral slips.
• Health Official Dashboards: Enable real-time performance tracking and disease surveillance across district, state, and national levels.

Financial Architecture and Inter-Programmatic Synergies

Funding and implementation link directly with broader national health programs.

Key Facts

• Launched in 2010 as NPCDCS and renamed NP-NCD in May 2023 by the Ministry of Health and Family Welfare.
• Funded under the National Health Mission through the flexible NCD Flexi-Pool.
• Population-based screening targets five primary conditions: diabetes, hypertension, oral cancer, breast cancer, and cervical cancer.
• Covers individuals aged 30 years and older for routine community screening.
• Uses the Community-Based Assessment Checklist (CBAC) filled by ASHAs for initial risk profiling.
• Includes added coverage for Non-Alcoholic Fatty Liver Disease (NAFLD) and Chronic Kidney Disease (CKD).
• Supported by the National NCD Portal (formerly CPHC NCD IT system) for digital patient tracking.
• Complemented by AMRIT pharmacy outlets to provide discounted oncology and cardiovascular drugs.
• Aligns with Sustainable Development Goal (SDG) Target 3.4 to reduce premature mortality from non-communicable diseases by one-third by 2030.