India: Towards Universal Health Coverage 3 Chronic diseases and injuries in India
India: Towards Universal Health Coverage 3 Chronic diseases and injuries in India
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DOI：
10.1016/s0140-6736(10)61188-9
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发表时间：
2011-01-01
期刊：
影响因子：
168.9
通讯作者：
Reddy, K. Srinath
中科院分区：
文献类型：
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作者：
Patel, Vikram;Chatterji, Somnath;Reddy, K. Srinath
慢性疾病（如心血管疾病、精神健康障碍、糖尿病和癌症）和伤害是印度死亡和残疾的主要原因，我们预计在未来25年内，它们对疾病负担的贡献将显著增加。大多数慢性病在贫困人口和农村人口中同样普遍，而且往往同时发生。虽然有各种成本效益高的初级和二级预防战略，但其覆盖面普遍较低，特别是在贫穷和农村人口中。许多慢性病和受伤的护理是在私营部门提供的，可能非常昂贵。有足够的证据证明，应立即采取行动，通过私营和公共部门扩大慢性病和伤害的干预措施;改善公共卫生和初级保健系统对于实施具有成本效益的干预措施至关重要。我们强烈主张，必须加强社会和政策框架，以便能够实施干预措施，如对小手卷香烟、无烟烟草和当地酿造的酒类征税。我们还主张将各种慢性疾病和伤害的国家方案相互结合并与国家卫生议程结合起来。印度已经度过了慢性病和伤害流行病的早期阶段;鉴于对未来疾病负担的影响以及印度正在进行的人口结构转型，应大幅提高有效预防和控制的实施速度。如果要实现全民保健，新出现的慢性病和伤害议程应成为政治优先事项，并成为国家意识的核心。
Chronic diseases (eg, cardiovascular diseases, mental health disorders, diabetes, and cancer) and injuries are the leading causes of death and disability in India, and we project pronounced increases in their contribution to the burden of disease during the next 25 years. Most chronic diseases are equally prevalent in poor and rural populations and often occur together. Although a wide range of cost-effective primary and secondary prevention strategies are available, their coverage is generally low, especially in poor and rural populations. Much of the care for chronic diseases and injuries is provided in the private sector and can be very expensive. Sufficient evidence exists to warrant immediate action to scale up interventions for chronic diseases and injuries through private and public sectors; improved public health and primary health-care systems are essential for the implementation of cost-effective interventions. We strongly advocate the need to strengthen social and policy frameworks to enable the implementation of interventions such as taxation on bidis (small hand-rolled cigarettes), smokeless tobacco, and locally brewed alcohols. We also advocate the integration of national programmes for various chronic diseases and injuries with one another and with national health agendas. India has already passed the early stages of a chronic disease and injury epidemic; in view of the implications for future disease burden and the demographic transition that is in progress in India, the rate at which effective prevention and control is implemented should be substantially increased. The emerging agenda of chronic diseases and injuries should be a political priority and central to national consciousness, if universal health care is to be achieved.