| What do the guidelines build upon and complement? | an adjunct to and build on the relevant recommendations of the NPCDCS guidelines2 and recently developed Operational Framework for Cancer Screening and management | Essentially the focus of these guidelines is on: screening and diagnosing (xiii) common NCDs; identifying and addressing modifiable risk factors, referral of pre-cancerous conditions, hypertension and diabetes, based on protocols, and community level follow up. The guidelines are an adjunct to and build on the relevant recommendations of the NPCDCS guidelines2 and recently developed Operational Framework for Cancer Screening and management. Thus details of roles and responsibilities of the MOs, Staff nurses, etc, above are not elucidated, since they are already covered in the NPCDCS Operational Guidelines and Operational Framework. | 281 | definition | 1.000 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | The guidelines are an adjunct to and build on the relevant recommendations of the NPCDCS guidelines2 and recently developed Operational Framework for Cancer Screening and management. | 27 | page=27,block=0 | 0.850 | valid |
| What is the purpose of scoring in the context of identifying risk factors? | not a point of elimination but a means to highlight risk factors | ASHA/ANM will be sensitized to the fact that a low risk score does not mean that the individual is to be exempted from screening, as NCDs could exist, even in the absence of risk factors. The scoring is not a point of elimination but a means to highlight risk factors. In addition, the tool includes questions related to symptoms for cancer cervix, breast cancer, oral cancers, epilepsy and COPD, so that such cases may be identified and referred to appropriate centres. | 203 | definition | 1.000 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | The scoring is not a point of elimination but a means to highlight risk factors. | 29 | page=29,block=0 | 0.850 | valid |
| What is one of the purposes of the form for frontline workers? | use it is as memory trigger | The purpose of the form is to help the frontline workers use it is as memory trigger, (ii) highlight the fact that the six variables in the tool increase the risk of these NCDs, and generally serve as a way of educating the community on these issues. The form will also be used as a key training instrument. The frontline workers would also be trained to understand that it is important for all those over 30 to be screened, but that the form helps them emphasise certain aspects of causation, prevention, and | 57 | definition | 1.000 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | The purpose of the form is to help the frontline workers use it is as memory trigger, (ii) highlight the fact that the six variables in the tool increase the risk of these NCDs, and generally serve as a way of educating the community on these issues. | 29 | page=29,block=0 | 0.700 | valid |
| What is the purpose of assigning scores in the form? | a means to highlight risk factors | This form is intended to capture data related to age, family history, treatment for any of the NCDs, waist circumference, and risky behaviours such as physical inactivity, use of/ or exposure to tobacco and alcohol use. There is some overlap also with the individual health card. This section of the form has questions that are allocated a score. A score of below four implies Low risk. ASHA/ANM will be sensitized to the fact that a low risk score does not mean that the individual is to be exempted from screening, as NCDs could exist, even in the absence of risk factors. The scoring is not a point of elimination but a means to highlight risk factors. the tool includes questions related to symptoms for cancer cervix, breast cancer, oral cancers, epilepsy and COPD, so that such cases may be identified and referred to appropriate centres. | 621 | definition | 1.000 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | The scoring is not a point of elimination but a means to highlight risk factors. | 29 | page=29,block=0 | 0.700 |
| What is the reason that Non-Communicable Diseases (NCDs) are increasingly posing a major public health challenge? | high morbidity and mortality associated with these diseases in India | Message Non-Communicable Diseases (NCDs) are increasingly posing major public health challenge due to high morbidity and mortality associated with these diseases in India. In particular, four diseases, viz., CVD, Diabetes, Cancer and Chronic Obstructive Pulmonary Disease, account for large morbidity and mortality due to NCDs. | 102 | relationship | 0.970 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | Message Non-Communicable Diseases (NCDs) are increasingly posing major public health challenge due to high morbidity and mortality associated with these diseases in India. | 5 | page=5,block=0 | 0.800 | valid |
| What action should the ANM take for individuals with high blood pressure or blood glucose levels requiring further investigation? | Refer cases with high BP and blood glucose, symptoms requiring investigation for cancer to the appropriate facility for confirmation and initiation of treatment plan | Roles and Responsibilities of the Primary. HWC/SC or Village (fixed day/week): role of asha Raise awareness and mobilize the community to attend weekly ‘fixed day’ NCD screening at the HWC/ village States to consider the possible role of ASHA for the delivery of screening (i.e. measuring blood pressure and blood glucose). Lifestyle counselling/ BCC for people with diabetes and hypertension,; role of anm Undertake blood pressure and blood glucose measurement; Refer cases with high BP and blood glucose, symptoms requiring investigation for cancer to the appropriate facility for confirmation and initiation of treatment plan. Provide follow-up management for patients (monthly drug supply, periodic BP/ blood sugar measurement, referral for complications) Supportive supervision for ASHAs conducting NCD screening; role of phc team mo lady health visitor laboratory technician Technical support for the ANM/ ASHA Maintain records, analyse and submit to district. Supportive supervision on NCD Day. Plan review of select cases during routine visits. Confirmation of diagnosis** and initiation of a treatment plan for people with diabetes and hypertension at PHC/CHC/DH. Provide one-three months’ supply of drugs. First follow up at three - months for all, or sooner for patients with concerns/ complications, Manage and/or refer complications and cases requiring diagnostic work-up for cancer/ |
| What do cardiovascular diseases and diabetes share in terms of risk factors and public health approaches? | common risk factors and for which there are a set of similar public health approaches related to health promotion, prevention and management. | Cardiovascular diseases and diabetes represent a set of conditions which share (vii) common risk factors and for which there are a set of similar public health approaches related to health promotion, prevention and management. Key factors linked to the onset and course of these four NCDs are Tobacco use and exposure, unhealthy diet, physical inactivity, alcohol mis-use, Indoor and ambient air pollution, stress, poverty (as a cause and consequence), poor health seeking behaviours and low access to health-care services. Diabetes and hypertension can | 85 | relationship | 0.970 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | Cardiovascular diseases and diabetes represent a set of conditions which share (vii) common risk factors and for which there are a set of similar public health approaches related to health promotion, prevention and management. Key factors linked to the onset and course of these four NCDs are Tobacco use and exposure, unhealthy diet, physical inactivity, alcohol mis-use, Indoor and ambient air pollution, stress, poverty (as a cause and consequence), poor health seeking behaviours and low access to health-care services. |
| What do the guidelines draw upon to provide their recommendations? | the relevant recommendations of the NPCDCS guidelines2 and recently developed Operational Framework for Cancer Screening and management | Essentially the focus of these guidelines is on: screening and diagnosing (xiii) common NCDs; identifying and addressing modifiable risk factors, referral of pre-cancerous conditions, hypertension and diabetes, based on protocols, and community level follow up. The guidelines are an adjunct to and build on the relevant recommendations of the NPCDCS guidelines2 and recently developed Operational Framework for Cancer Screening and management. Thus details of roles and responsibilities of the MOs, Staff nurses, etc, above are not elucidated, since they are already covered in the NPCDCS Operational Guidelines and Operational Framework. These guidelines are the first in a series intended to support states to add on (xiv) NCDs and other packages for delivery of comprehensive primary health care. | 308 | relationship | 0.970 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | The guidelines are an adjunct to and build on the relevant recommendations of the NPCDCS guidelines2 and recently developed Operational Framework for Cancer Screening and management. |
| What does population-based enumeration and mobilization help women access? | present for screening for HT, diabetes and cancers | Initiating the programme through a population based screening programme, has several benefits. It creates an environmental milieu and increases awareness in the community regarding NCDs. Buttressed by active IEC, the risk assessment questionnaire undertaken by ASHA/ASHA facilitator trained to do this, would enable an increased understanding among respondents of risk factors and the need to be screened. Thus population based screening could serve as an entry point strategy. As awareness increases, states could gradually move towards opportunistic screening. Currently neither is being done. Such population based enumeration and mobilization for population based screening also enables women, to present for screening for HT, diabetes and cancers. | 701 | relationship | 0.970 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | Such population based enumeration and mobilization for population based screening also enables women, to present for screening for HT, diabetes and cancers. | 32 | page=32,block=0 | 0.700 |
| What factors contribute to an increased likelihood of financial vulnerability related to non-communicable diseases? | The chronic nature of NCDs and the lack of interventions focused on ensuring a continuum of care from community to secondary care | The chronic nature of NCDs and the lack of interventions focused on ensuring a continuum of care from community to secondary care, results in a higher risk of financial vulnerability. The guidelines should be considered by states as a document that provides inputs to enable moving from a district and sub-district intervention to reaching the community, through the network of the public health system for NCD interventions focused on hypertension and diabetes. The National Health Mission has supported substantial augmentation of infrastructure and human resources, particularly in the form of frontline workers- the ANM and the ASHA and these platforms need to be leveraged to implementing this effort. Data for large scale surveys show that the use of services at the primary health care levels, namely at the sub centre and the PHCs is low, representing a significant missed opportunity. | 0 | relationship | 0.970 | https://www.nhm.gov.in/images/pdf/NHM/NHM-Guidelines/Operational_Guidelines_NCDs.pdf | The chronic nature of NCDs and the lack of interventions focused on ensuring a continuum of care from community to secondary care, results in a higher risk of financial vulnerability. |