Health promotion for prevention and control of non-communicable diseases: unfinished agenda.

The magnitude of Non Communicable diseases demands urgent attention. Common, preventable risk factors underlie most NCDs. These include behavioural risk factors and metabolic risk factors. The prevalence of these, varies between income groups and differs with gender. Majority of events occur in individuals with modest elevations of multiple risks rather than with significant elevation of a single risk factor. The need of the hour is to adopt a process which addresses the upstream determinants through enabling people, to increase control over their health and its determinants, thereby promoting and sustaining good health The answer lies in Health Promotion which involves changing behaviour at multiple levels. In order to change, there is need to understand and apply the models which have been widely used to empower people to make healthy choices. These include the Health Belief, Self-Efficacy, Social Learning and Self-empowerment models.Changing behaviour, however, is a process, not an event. Different strategies are most effective at different Stages of Change. The contextual determinants of health and health behaviour also significantly influence the risks of NCDs.Till date, there has been limited focus on these issues. We urgently, need a close look at policies and their impact on health. With increasing burden of NCDs, the Health Sector will face strain on services delivery and budgets. Special policies and programs are necessary for the disadvantaged poor to address their differential vulnerabilities and risks. The unfinished agenda of NCD prevention and control needs to be addressed urgently with an integrated comprehensive framework of Health Promotion.