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Rising Non-Communicable Diseases in Rural India
Why non-communicable diseases are rising in rural India
Context: India is witnessing a rapid and concerning escalation in the prevalence of Non-Communicable Diseases (NCDs), with lifestyle changes, environmental pressures, and inadequate healthcare infrastructure, especially in rural areas, NCDs have emerged as a leading public health crisis.
What Are NCDs and Their Impact?
- NCDs are chronic conditions that are not transmitted from person to person. They include cardiovascular diseases, diabetes, cancers, chronic respiratory diseases, and mental health disorders.
- NCDs are the leading cause of death worldwide, responsible for 74% of all deaths. Nearly three-quarters of NCD deaths occur in low- and middle-income countries.
- This shift is no longer confined to urban areas—rural India is increasingly affected, raising serious concerns about healthcare equity and access.
Key Drivers of NCDs in Rural India
- Urbanisation-driven lifestyle changes: Increased fast food consumption, lack of sleep and exercise, rising stress.
- Globalised consumer habits are displacing traditional diets and physical routines.
- Overuse of fertilisers and pollution are affecting both human and animal health.
- India’s dual burden: While some parts of the population suffer from malnutrition, others face obesity-related risks.
Case Study: Gangnauli Village, Uttar Pradesh – A Rural NCD Hotspot
- Gangnauli, a small village in Baghpat district, Western Uttar Pradesh, provides a microcosmic view of this national crisis.
- Om Singh, a 65-year-old resident, first noticed a gum wound in 2009. After local treatments failed, he was diagnosed with cancer at Safdarjung Hospital, New Delhi in 2010.
- Contributing factors include:
- Polluted groundwater due to industrial waste from nearby sugar mills seeping through check dams into irrigation channels.
- Shift to monoculture (sugarcane and paddy) farming in response to environmental and policy pressures.
- Rising stray cattle due to restrictions on cattle trade.
- Shrinking forest cover, pushing wild animals into croplands.
Challenges in Addressing NCDs in Rural Settings
- Inadequate infrastructure: Many villages lack functional primary health centres. The Primary Health Centre is 10 km away, accessible only by private transport.
- Shortage of trained personnel: Especially specialists and diagnostic technicians. Diagnostic facilities are absent; most patients travel to Delhi for treatment.
- High out-of-pocket costs: Push families into debt or deter care-seeking.
- Poor follow-up systems: Chronic care requires continuity, which is often missing. Only five ASHA and four Anganwadi workers serve the village.
Government Response and Interventions
- Ayushman Bharat and Health and Wellness Centres (HWCs): Launched in 2018, HWCs aim to provide comprehensive primary care, including NCD screening, free medicines, and teleconsultation.
- NPCDCS: Launched in 2010, the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke supports infrastructure, training, and screening across all states.
- Intensified NCD Screening Drives: In 2025, the government launched a nationwide campaign to screen all individuals aged 30+ for diabetes, hypertension, and common cancers.
- Mobile Medical Units and Telemedicine: These are being deployed to bridge access gaps in remote areas, offering diagnostics and specialist consultations.
Way Forward
- Frontline local health workers (ASHAs, ANMs) are critical for outreach, screening, and follow-up. Foster public-private partnerships and leverage innovations like mobile health apps for screening and follow-up.
- Implement data-driven, region-specific interventions to address local risk factors. Integrate NCD care into routine services, especially maternal and child health platforms.
- Enhance rural health literacy and introduce school-based awareness programs to promote healthy lifestyles from a young age.