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Authors: J Thakur, S Pala, S Jainc, S Kumaric, R Kumara

Reference: CVD Prevention and Control 2010; 4: 193-199
http://www.precon-journal.com/article/S1875-4570%2809%2900062-X/abstract

Reviewer: Carlos Mendoza Montano, PhD, ProCor contributing editor; President, Guatemalan Association for the Prevention of Heart Diseases (APRECOR), Guatemala City, Guatemala

Reviewer comments: This article contains the first report of an integrated community-based intervention for prevention and control of non-communicable diseases (NCD) in India. The Chandigarh healthy heart action project (CHHAP) was initially designed as a cardiovascular disease (CVD) prevention project. The project was then scaled up to an integrated NCD control program in 2006-2007. Studies have shown that integrated NCD control programs focusing on preventable risk factors and common chronic NCDs are more relevant and cost-effective for developing countries than programs focusing on single diseases. From this 3-year demonstration project, it can be concluded that integrated NCD control program is feasible through health services in a low resources setting by capacity building of health staff, logistic support, provision of essential drugs and by adopting a health promotion model focusing on common risk factors in different settings.

Purpose of study: To increase awareness for major NCD risk factors in the community by health promotion, implementation of a standard protocol for CVD risk management and diabetes by health care staff, and to conduct surveillance of NCD risk factors.

Location of study: India

Study design: The community-based intervention project was undertaken from October 2004 to September 2007 in all the sectors, villages and slums of Chandigarh. 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: Training was organized for different categories of staff in CVD risk assessment and management. Most of doctors in public and private sectors, health workers, school teachers and pharmacists/staff nurses were trained for CVD assessment and management in batches. NCD risk factor surveillance encompassed 2763 individuals in the population of Chandigarh. The risk factor surveillance found that 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.

Additional references:
H Swami, V Bhatia, M Gupta, S Bhatia, A Sood. Population based study of hypertension among the elderly in northern India. Public Health 2002; 116(1):45-9. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B73H6-4BYN6PH-8&_user=2112300&_coverDate=01%2F31%2F2002&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1398040452&_rerunOrigin=google&_acct=C000056196&_version=1&_urlVersion=0&_userid=2112300&md5=f3700c5f936440a7512d4878845e3363

Puska P. Successful prevention of non-communicable disease: 25 year experiences with North Karelia Project in Finland. Public Health Med 2002; 4:5-7 (open access). http://www.who.int/hpr/NPH/docs/successful_prevention.pdf