Natl Med J India
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BACKGROUND. Analysis of the scope and quality of evaluations of health system/policy interventions done in India is not available. Such analysis can help in conducting more useful evaluations. METHODS. ⋯ This analysis of health system/policy intervention evaluation reports from India identifies specific areas that need improvement. We recommend that Indian agencies should commission more evaluations as international agencies currently dominate, involvement of intervention implementer in the evaluation needs scrutiny as potential bias is suggested by our analysis, and health system components other than services need more attention. Outcome/impact evaluations need to incorporate controls in design and multivariate techniques more often in their analysis to achieve higher quality robust evaluations in India.
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Non-communicable diseases (NCDs) are a global health and developmental emergency, as they cause premature deaths,exacerbate poverty and threaten national economies. In 2008, they were the top killers in the South-East Asia region, causing 7.9 million deaths; the number of deaths is expected to increase by 21% over the next decade. One-third of the 7.9 million deaths (34%) occurred in those <60 years of age (compared to 23% in the rest of the world). ⋯ Key strategies for the prevention and control of NCDs include (i) reducing exposure to risk factors through health promotion and primary prevention, (ii) early diagnosis and management of people with NCDs, and (iii) surveillance to monitor trends in risk factors and diseases. Tackling NCDs calls for a paradigm shift: from addressing each NCD separately to collectively addressing a cluster of diseases in an integrated manner, and from using a biomedical approach to a public health approach guided by the principles of universal access and social justice. High levels of commitment and multisectoral actions are needed to reverse the growing burden of NCDs in the South-East Asia region.