Sampoorna Clinics: Paving the way to good health

Non-communicable diseases (NCDs) are currently responsible for over 60% of global deaths causing major public health challenges to the world. NCDs threaten economic and social development causing high morbidity and mortality which adversely impact human productivity and health care expenditure. Amongst women, NCDs like cervical cancer and breast cancer contribute to the maximum burden of disease and death in India. With one woman dying every 8 minutes, India reports an alarming rate of death due to cervical cancer, followed by breast cancer which accounts for about a quarter of all cancers in women in Indian cities. Sensitive to the healthcare needs of women, the Government of Uttar Pradesh launched the Sampoorna Project in the year 2015 as a unique initiative dedicated to screening and treating women for all major non communicable diseases in the state. The project "Sampoorna" launched under the umbrella of National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) brings forth the preventive approach towards the non-communicable diseases (NCDs) in women. The project not only aims to screen for diseases but also makes women aware about life style modifications and screening approaches which are important for prevention of NCDS including cervical and breast cancers. Women are pivots of the families, hence educating them and taking care of their health will definitely improve the family's health and will shift community's perspective from curative health care to preventive health care.

The project was initially launched in five districts to pilot the proof of concept and document learning for scale up. It has now been expanded to additional 23 districts in the state. Under this Project, "Sampoorna clinics" have been established at district women hospitals and selected community health centres for screening and management of diabetes, hypertension, Cardio Vascular Diseases, cervical Cancer and breast cancer amongst women aged 30-60 years. The clinics are being operationalized by a team of trained female health care providers, to serve women with utmost privacy and belongingness. Training sites have been established at Medical Colleges for capacity building of different health care professionals on screening techniques and management of the diseases covered under the project. To roll out the program, a Memorandum of Understanding has been signed between National Health Mission, State Innovations in Family Planning Services Agency and Population Services International, India, wherein NHM will support with the funds, SIFPSA will lead implementation and PSI will provide technical support.

Over 15000 women have availed screening services in Sampoorna Clinics for various non communicable diseases till now. Obesity is a high risk factor for cardiovascular diseases, hypertension and diabetes. In Sampoorna clinics obesity is measured through Body Mass Index. All the women falling under the criteria of obesity and overweight are counselled for life style management i.e. nutritious and low fat diet and regular exercise. Blood pressure of all the clients is measured to identify hypertensive and pre hypertensive clients. Pre hypertensive clients are counselled for improvement in life style so that disease can be prevented. These clients are asked to come again for check-up after 3 months to see if counselling was effective. If the client remains in the pre hypertensive range she is counselled again and if she turns out to be hypertensive, she is referred for treatment.

For diabetes, Random Blood Sugar of all the clients is measured and if found more than 140mg/DL, fasting and PP blood sugar are checked to identify pre diabetic and Diabetic cases. Pre diabetic cases are counselled to change their life style and called for follow up after 3 months to assess the impact of counselling. If the client is not following the advice she is again counselled. Overt cases are referred to NCD clinic for treatment. Prevention of Obesity, hypertension and diabetes is important because they are risk factors for cardiovascular diseases.

Out of total 14500 screened cases for cervical cancer, 2.8 % were found positive which means they had lesions in the cervix which could have developed into cervical cancer in future. These cases were treated with cryo therapy or they were referred to the medical colleges for treatment. There has never been a more important time to strengthen the state's capacity to prevent and treat non communicable diseases (NCDs). Towards celebrating the year of mother and child, the Sampoorna Project is a unique initiative of the Govt. of Uttar Pradesh, empowering women with awareness of their health care rights and strengthening capacity of the health care system to prevent, treat, manage and refer women for a range of non communicable diseases (NCDs).