Primary healthcare system preparedness for tackling rising trend of non-communicable diseases among tribals: a study from resource-limited setting in India

Introduction: The burden of non-communicable diseases (NCD) is increasing in tribal and rural areas along with urban areas in India. This highlights the importance of preparedness of health system for managing NCD as well as incorporating and implementing preventive strategies in comprehensive primary health care services.   
Objectives: To assess the existing primary health system regarding provision of NCD related services to the community along with the needs of the community in context of NCD  
Methods: This was a cross-sectional study conducted in a tribal district using multiple strategies, such as a desk review of NCD related data (human resource availability, their capacity to cater to NCD patients, services provided for NCD, and logistics and medicine availability for NCD related services) and an on-site assessment of health and wellness centres (HWC) providing primary level care for NCDs in the community. 
Results: The HWCs served a larger population than the expected norms, which could affect the quality of services being provided. Human resources at all HWC were filled and trained for NCD management. Infrastructure needed improvement as one-fourth of the centres had limited space for examination of the patients or for laboratory investigations compared to the available guidelines. Logistics related challenges showed availability of stock of hypertension and diabetes related medicines in almost one third of the centres. This remote tribal region faces telephonic connectivity related issues hampering service delivery through teleconsultation at 51.5% of the centres. Awareness raising activities pertaining to NCD were initiated by 76.5% of the HWCs.  
Conclusions & Recommendations: NCD related services are available at primary healthcare level in this tribal community, but improvement is needed in infrastructure, equipment and medicines availability, provision of preventive services and teleconsultation.