Addressing the double burden of disease in a country like India is a massive challenge, especially when the system is tuned to do monitoring and surveillance of mainly communicable diseases. Achieving the sustainable development goal target 3.4 to bring down the premature mortality from non-communicable diseases (NCDs) to one-third will need to consider the requirement of robust indicators at the national level to keep track of the prevalence of NCD and its risk factors among its population. The state of Kerala in contrast has a strong primary health care system that it can build on to address the rising NCD burden.
Noncommunicable diseases. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases(cited 2021, April 17).
2.
DandonaL, DandonaR, KumarGA, . Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the global burden of disease study. Lancet. 2017 December 2;390(10111):2437-2460.
3.
SarmaPS, SadanandanR, ThulaseedharanJV, . Prevalence of risk factors of non communicable diseases in Kerala, India: results of a cross-sectional study. BMJ Open. 2019;9:e027880. doi:10.1136/Ûmjopen-2018-027880
4.
MohantyS, VenkataraoE, YasobantS.Non-communicable disease care and physical activity promotion in India: analysis of recent policies, guidelines and workplans. Fam Med Community Health. 2020 April;8(2):e000206.
5.
Non-communicable diseases. National Health Portal of India. https://www.nhp.gov.in/healthlyliving/ncd2019(cited 2021, March 22).
6.
NCD global monitoring framework. World Health Organization. https://www.who.int/teams/ncds/surveillance/monitoring-capacity/gmf(cited 2021, September 26).
7.
Expanding IHCI for blood pressure control. Express Healthcare, 2019. https://www.expresshealthcare.in/strategy/expanding-ihci-for-blood-pressure-control/413979/(cited 2021, April 29)
8.
PanikarPGK.Health status of Kerala: the paradox of economic backwardness and health development. Centre for Development Studies; 1984:159. https://catalog.hathitrust.org/Record/006257832
9.
KunhikannanTP, AravindanKP.2000. Changes in the health status of Kerala, 1987–1997. Thiruvananthapuram: Kerala research programme on local development. Centre for development studies, Thiruvananthapuram.
10.
RajanSI, JamesKS.Kerala’s health status: Some issues. Econ Pol Wkly. 1993;28(36):1889-1892.
11.
SalahudheenOP.Palliative care: a malappuram epitome. Proc Indian Hist Congr. 2009;70:1220-1230.
12.
Government of Kerala. Aardram: National Health Mission. https://arogyakeralam.gov.in/2020/04/01/aardram/(cited 2021, September 27).
13.
FriedenTR.A framework for public health action: the health impact pyramid. Am J Public Health. 2010 April;100(4):590-595.
