Non Communicable Disease Risk Factors and their Trends in India.

Background: India is a populous country of about 1.3 billion. Non communicable diseases (NCDs) contribute to around 5.87 million (60%) of all deaths in India. Hence, the objectives of this paper are to find baseline information on different NCD risk factors coverage and to determine their trends in India. Methods: For this systematic review, PubMed, Google and different surveillance systems were searched. Of the search results, 41 papers/survey reports were eventually assessed for eligibility. National and state representative data on NCD risk factors (for the major NCDs like cardiovascular diseases, chronic respiratory disease, cancer and diabetes) having World Health Organization(WHO) indicator definitions, covering rural and urban population, were included in the study. Thereafter, state-wise population proportion was added and divided by the total Indian population to determine the percentage of population coverage for each risk factor by the surveys. Also, the old and current data of the periodic surveys were compared to assess prevalence trends. Results: Various national/state level surveys in India include single or multiple risk factors. Nationwide coverage is available for tobacco use, alcohol drinking, raised blood pressure and overweight and obesity. Periodic National Family Health Surveys provide information on selected risk factors during 2005-16 among adults aged 15-49 years. An overall significant increase was noted in overweight and obesity while decline was noted in tobacco and alcohol use during the same period. From GATS 1 (2009-10) to 2 (2016-17) also, the prevalence of tobacco consumption decreased in India. Conclusion: India has a much delayed response on NCD risk factors surveillance and information of the same are sporadic and incomplete. In order to increase information comprehensiveness, standard WHO NCD risk factors questions must be incorporated in the ongoing surveys. India should also plan for cost and time effective NCD surveillance system.