The Indo-American Cancer Association launched “Project Life” at the AAPI (American Association of Physicians from India) Global Summit in Udaipur on December 29, 2016.
The pilot project was implemented by the World Health Organization’s International Agency for Research in Cancer in collaboration with the GBH Memorial Cancer Hospital as the lead local partner. They had three objectives in mind: evaluation of the knowledge, attitude and practices (KAP) of the rural women related to the common NCDs and their prevention, assessment of the common barriers to access the NCD early detection and prevention services in rural Rajasthan, and Evaluation of the feasibility and acceptability of delivery of the NCD early detection services by trained community health workers at-home settings.
In this community health intervention, ten trained female health workers visited homes of men and women aged 30-60 years in the Gogunda block of Udaipur, Rajasthan to check their height, weight, blood pressure, and random blood sugar. They also educated the men and women about ill-effects of tobacco and alcohol and counseled the users to give up these habits. They performed an oral visual examination on the tobacco and alcohol habitual users to screen for oral cancer.
The women were educated about the common symptoms of breast cancer using a prosthetic model and were advised to provide self-collected vaginal samples for HPV testing for cervical cancer screening. This was the first study in India, in which self-collected HPV samples were obtained at home.
Men and women with abnormalities in any of the tests were navigated to a multi-disciplinary clinic set up at a local medical college hospital for further investigations and treatment. The screen-positives are being recalled for further management.
The project was initiated in January 2017 and concluded in March 2018. It sought over 5000 women and 2000 Men for screening and follow up of around 2500 participants in various categories. A survey was completed in 6 weeks, which included 1200 women. A film made by WHO on this project was screened at the 71st World Health Assembly held in May 2018.
The study concluded that poor knowledge about the common risk factors of the NCDs and limited access to the early detection facilities lead to late detection. Screening for NCDs at home settings by trained health workers is feasible & acceptable. Among the individuals with high BP at screening, 42% were confirmed to be hypertensives. Among the individuals with high random sugar at screening, 35% were confirmed to be diabetics. The study demonstrates the high prevalence of hypertension and diabetes even in rural populations. Being overweight is an independent risk factor for both hypertension and diabetes.