A Qualitative Assessment of Multi-sectoral Action for Non-communicable Diseases (NCDs) in Uttar Pradesh, India

Abstract

Introduction Non-communicable diseases (NCDs) are increasing globally, especially affecting vulnerable populations in low- and middle-income countries. To tackle this, urgent and comprehensive actions are needed. The main preventable risk factors for NCDs are tobacco and alcohol use, unhealthy diet, physical inactivity, and air pollution, rooted in social determinants of health (SDOH). In India, some states are adopting a multi-sectoral approach (MSA) to manage NCDs. A qualitative assessment was conducted to evaluate MSA implementation in Uttar Pradesh, India. Methods Inductive approach i.e., grounded theory was used to understand the perceptions regarding MSA. Key-Informant Interviews (KIIs) of senior level officers from both non-health and health sectors were conducted using an interview guide. We targeted all 17 priority non-health sectors as identified in National Multi-sectoral Action plan (NMAP) for prevention and control of NCDs in India. Data thus collected was transcribed, translated and coded for identifying themes. Results The non-health sectors are ready to act but don’t have a lead to guide them. They did explain the risk factors such as behaviours, nutrition and physical inactivity for NCDs and also appreciated the role of MSA in prevention and control of NCD. The attitude and perception of health sector towards implementation of MSA is not very promising. It is based upon the existing vertical structures, response and support they have experienced before from other sectors and from administration. All the non-health sectors opine that health needs to take lead for MSA as health sector has scientific knowledge and experience regarding operationalization of health programs. Conclusion There is still a long way to bring all priority non-health and health sectors on a common action platform for NCDs prevention and control. The trade-off between the two needs to involve a dedicated but separate structure which would act within or parallel to existing system and translate policy to practice.