Integrated non-communicable disease control program in a Northern part of India: Lessons from a demonstration project in low resource settings of a developing country

Background

Chandigarh healthy heart action project (CHHAP) was initiated in 2004 to increase awareness in the community for the major NCD risk factors by health promotion, training of health staff for CVD risk assessment and management, and surveillance of NCD risk factors.

Methods

Key strategies included capacity building, health promotion in different settings, risk factor surveillance and advocacy. Educational materials for the project included modules for doctors, health workers and school teachers; brochures, WHO protocol charts for CVD risk assessment and management, handbills and posters. Multiple health promotion activities were undertaken. An intersectoral committee for policy issues and a coordination committee for technical issues were also constituted.

Results

Most of doctors in public (245) and private sectors (150), health workers (227), school teachers (190) and pharmacists/staff nurses (181) were trained for CVD assessment and management in batches during 2005–07. NCD risk factor surveillance encompassed 2763 individuals in the population of Chandigarh. The prevalence of smoking was 10.2% (20.1% among males and 0.8% among females). Alcohol was consumed by 14.2% (26.8% males and 1.2% females). A sedentary occupation was identified in 94.2% in Chandigarh. Due to strong advocacy, Chandigarh was declared a smoke free city from July 2007, which is a first in the developing world, and the project was up scaled to an integrated State NCD control program in the 11th 5-year plan (2007–12).

Conclusion

CHHAP is a large-scale implementation of the WHO CVD risk management package, implemented as a routine in the health care delivery system.