Cost-benefit ratio indicates savings for government

A massive scale-up of the pilot project on cardio vascular disease prevention, in a phased manner, is on the cards in Tamil Nadu.

The project, which aims at creating awareness and facilitating lifestyle modifications and providing medical care to those who require it, will be gradually scaled up over the years. In the first year (2010-2011), it will be implemented in 8 districts; in the second phase (2011-2012) in 10 districts; and the final phase (2012- 2013) in another 10 districts. Two districts — Virudhunagar and Sivaganga — have already been covered under the pilot project since 2007.

While initially the project will be implemented by the Tamil Nadu Health Systems Project (TNHSP), it is expected that the government of Tamil Nadu will absorb the project as routine activity, according to sources.

It is the encouragement provided by the outcomes and cost effectiveness during the pilot programmes that has spurred the scale-up, officials add.

“Pilot project”

“With the pilot project, we were looking to see whether we could narrow down on a particular protocol, what was the manpower we required, whether it would be cost effective, the drugs that would be required, and whether mainstreaming would be possible,” S. Vijayakumar, project director, TNHSP, says.

It turns out that during the evaluation (also conducted by an external agency — National Institute of Epidemiology, Chennai, an Indian Council for Medical Research institution) the cost effectiveness factor was established well. The cost-benefit ratio indicated that expanding the programme would result in savings for the government.

Over 73,000 new cases of hypertension were detected when about 11 lakh people were screened and tested. Mr. Vijayakumar says, “Any person above 30 years is screened in the health care centres for blood cholesterol, and blood sugar, and BMI is measured. Their risk of falling sick with CVD is estimated, and if high, course correction in terms of lifestyle modification is offered. We use WHO protocols only.”

Those who need drugs for their blood pressure or diabetes were prescribed medicines and given referrals to the larger medical centres. Follow-up of these cases was also initiated.

The pilot project was devised with the principle that even a small change in the risk factors in the community leads to remarkable reduction in the morbidity and mortality from cardio vascular diseases.

M. Kamatchi, expert advisor, TNHSP, says, “Primordial prevention, even before primary prevention, is what we are looking at. Our awareness campaign intends to help people keep hypertension and diabetes — two huge risk factors for CVD — away.”

While awareness messages will be sent into the general community, targeted intervention programmes will be conducted in schools and workplaces.