Lok Sabha Question No. 735 (UNSTARRED), answered on 2024-07-26
Subject: Cases of Non-Communicable Diseases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Chavda Vinod Lakhamshi

## GOVERNMENTOFINDIA MINISTRY OFHEALTH AND FAMILY WELFARE DEPARTMENT OFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 735 TO BE ANSWERED ON 26 th July, 2024

## CASES OFNON COMMUNICABLE DISEASES

## 735. SHRI CHAVDAVINOD LAKHAMSI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)whether more than 60 percent of deaths in India are caused by Non-Communicable Diseases (NCD) which include chronic diseases like diabetes, cancer and heart disease, if so, the details thereof;
- (b) the steps taken/proposed to be taken by the Government to address the said issue;
- (c) whether the number of per capita mental healthcare professionals is lowest in India and if so, the details thereof; and
- (d) the steps taken/proposed to be taken by the Government to address the said issue and the details thereof?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV )

- (a) & (b): As per Indian Council of Medical Research (ICMR) study report 'India: Health of the Nation's States', the burden of Non-communicable Diseases (NCDs) in India have increased from 37.9% in 1990 to 61.8% in 2016. The contribution of major NCDs to total deaths is given in the table below:

| Name of the Diseases Group   | Contribution to Total Deaths   | Contribution to Total Deaths   |
|------------------------------|--------------------------------|--------------------------------|
| Name of the Diseases Group   | 1990                           | 2016                           |
| All NCDs                     | 37.9%                          | 61.8%                          |
| Diabetes                     | 10.0*                          | 23.1*                          |
| Cancer                       | 4.15%                          | 8.3%                           |
| CVDs                         | 15.2%                          | 28.1%                          |

The detailed report is available at the following link- https://www.healthdata.org/sites/default/files/files/policy\_report/2017/India\_Health\_of\_the\_N ation%27s\_States\_Report\_2017.pdf

The Department of Health & Family Welfare, Government of India, provides technical and financial support to the States/UTs under the National Programme for Prevention and Control of Non Communicable Diseases (NP-NCD), as part of National Health Mission (NHM), based on the proposals received from the States/UTs and subject to the resource envelope.

Diabetes, cancer and heart diseases are an integral part of NP-NCD. The programme focusses on strengthening infrastructure, human resource development, health promotion & awareness generation for prevention, early diagnosis, management and referral to an appropriate level of healthcare facility for treatment of the Non-Communicable Diseases (NCDs), including Cancer. Under NP-NCD, 753 District NCD Clinics, 356 Day Care Centres, 220 District Cardiac Care Units, and 6238 Community Health Center NCD Clinics has been set up acrosss the country.

A population-based initiative for prevention, control and screening for common NCDs has been rolled out in the country under NHM and also as a part of Comprehensive Primary Health Care. Under the initiative, persons more than 30 years of age are targeted for their screening for the common NCDs i.e. Diabetes, Hypertension and three common cancers i.e oral, breast and cervical. Screening of these common NCDs is an integral part of service delivery under Ayushman Bharat - Ayushman Arogya Mandir. .

Preventive aspect of NCDs is strengthened under Comprehensive Primary Health Care through Ayushman Arogya Mandir by promotion of wellness activities and targeted communication at the community level. Other initiatives for increasing public awareness about NCDs and promotion of healthy lifestyle includes observation of Health Days pertaining to NCDs and use of print, electronic and social media for continued community awareness. Furthermore, healthy eating is also promoted through FSSAI. Fit India movement is implemented by Ministry of Youth Affairs and Sports, and various Yoga related activities are carried out by Ministry of AYUSH. In addition, NP-NCD gives financial support under NHM for awareness generation (IEC) activities for NCDs to be undertaken by the States/UTs as per their Programme Implementation Plans (PIPs).

Diagnosis and treatment of NCDs is available at various levels in the health care facilities. The treatment in Government Hospitals is either free or highly subsidized for the poor and needy. Treatment of major NCDs are also available under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PMJAY). Besides, quality generic medicines are made available at affordable prices to all, under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in collaboration with the State Governments. Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacy stores have been set up in some hospitals/institutions, with an objective to make drugs available at a substantial discount vis-à-vis the Maximum Retail Price.

(c) & (d); For increasing the number of psychiatrists in the Country, PGMEB of NMC has issued the Minimum Standard of Requirements for Post-Graduate Courses - 2023 (PGMSR2023) on 15.1.2024. For starting/ increase of seats in MD (Psychiatry), PGMSR-2023 has brought down the number of OPD to 30 per day, for annual intake of maximum 2 PG students with 20% increase for each additional seat. Similarly, the minimum beds required per unit for starting MD (Psychiatry) course with 2 seats in a medical college is 8 beds and 12 beds for 3 seats and 20 beds for 5 seats.

Under the tertiary care component of NMHP, 25 Centres of Excellence have been sanctioned to increase the intake of students in PG departments in mental health specialities as well as to provide tertiary level treatment facilities. Further, the Government has also supported 19 Government medical colleges/institutions to strengthen 47 PG Departments in mental health specialties. Mental Health Services are also provisioned for 22 AIIMS through Psychiatry Departments.

Mental Health infrastructure development is being implemented across the primary, secondary, and tertiary care facilities for implementing the measures detailed in National Mental Health Policy 2014. As part of the National Mental Health Programme (NMHP), the District Mental Health Programme (DMHP) component has been sanctioned for implementation in 767 districts of the country, for which support is provided to States/UTs through the National Health Mission. As per DMHP Guidelines, one psychiatrist, one clinical psychologist, one psychiatric social worker, one psychiatric nurse, one community nurse, one monitoring and evaluation officer and case registry assistant and one ward assistant are the staff of the District Mental Health Programme Team.

Under the District Mental Health Programme implemented under the National Mental Health Programme, the manpower is trained at various DMHP units. One of the components of DMHP is to provide training to specialist and non- specialist cadres such as Medical Officers, Psychologists, Social Workers, and Nurses.

The Government is also augmenting the availability of manpower to deliver mental healthcare services in the underserved areas of the country by providing online training courses to various categories of general healthcare medical and para medical professionals through the Digital Academies, since 2018, established at the three Central Mental Health Institutes namely National Institute of Mental Health and Neuro Sciences, Bengaluru, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, and Central Institute of Psychiatry, Ranchi.

In addition,the Government is also taking steps to strengthen mental healthcare services at primary healthcare level. The Government has upgraded more than 1.73 lakh SHCs, PHCs, UPHCs and UHWCs to Ayushman Arogya Mandirs. Mental health services have been added in the package of services under Comprehensive Primary Health Care provided at these Ayushman Arogya Mandirs. Operational guidelines on Mental, Neurological, and Substance Use Disorders (MNS) at Ayushman Arogya Mandirs have been released under the ambit of Ayushman Bharat.

Besides,the Government has launched a 'National Tele Mental Health Programme' on 10th October, 2022, to further improve access to quality mental health counselling and care services in the country. As on 23.07.2024, 36 States/ UTs have set up 53 Tele MANAS Cells and have started tele mental health services. More than 11,76,000 calls have been handled on the helpline number.

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