Combating Cancer: Challenges and Recommendations of NITI Aayog Report

Context: The government should address the Niti Aayog report’s warning about gaps in cancer detection by investing in training grassroots professionals.

Challenges Highlighted in the NITI Aayog’s Report

• Low Screening Rate: In India, government projects like the National Programme for the Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke emphasise early detection, particularly for cervical, oral, and breast cancers, which constitute a third of all cancer cases in the country.
  • However, National Family Health Surveys show that only a small percentage of people over 30, the vulnerable age group, get screened for cancer.
• Underperformance of Health and Wellness Centres (HWCs): Under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), turning 1,50,000 HWCs into cancer detection nodes could have been transformative by reducing accessibility issues.
  • However, a Niti Aayog report highlights significant performance gaps, with less than 10% of these centres completing one round of screening for non-communicable diseases, including cancer.
• Insufficient Training and Awareness: Although ASHA workers are involved in cancer screening, there has been inadequate investment in their training and education about cancer prevention protocols.
  • Low awareness about cancer among ASHA workers and the general population hampers early detection efforts.
• Poor Working Conditions for ASHA Workers: ASHA workers, who are critical to the screening process, face low pay and overburdened workloads, affecting their effectiveness and morale.
• Technological and Resource Limitations: Many HWCs lack the necessary resources and technology to effectively carry out cancer screenings.
  • The migration of skilled personnel and technicians has further strained the system, particularly in the maintenance and operation of medical equipment.

Recommendations and Conclusion of the Report

• Enhanced Training Programs: Utilise the expertise of the Noida-based National Institute for Cancer Prevention and Research to train healthcare professionals.
  • Implement online training modules to educate ASHA workers and other frontline professionals on cancer screening techniques and protocols.
• Increase Awareness and Sensitization: Conduct widespread awareness campaigns to educate the public and healthcare workers about the importance of early cancer detection.
  • Sensitize ASHA workers to the risk factors, symptoms, and necessity of regular screenings.
• Improve Working Conditions for ASHA Workers: Address the low pay and high workload issues faced by ASHA workers to improve their efficiency and job satisfaction.
  • Provide additional support and resources to reduce their burden and enhance their role in the screening process.
• Upgrade Health and Wellness Centres: Ensure HWCs are well-equipped with the necessary technology and resources for cancer screening.
  • Address the gaps identified by the Niti Aayog report by completing the required rounds of screening and improving the infrastructure.
• Leverage Technology and Community Trust: Expand the use of low-tech, scalable screening approaches that can be deployed by community-level workers.
  • Build on the trust that grassroots professionals have within communities to enhance participation in screening programs.
• Policy and Budgetary Support: Ensure adequate budgetary allocations for cancer screening initiatives and related health programs.
  • Develop policies that support the sustainable operation of screening services, including regular maintenance of equipment and retention of skilled personnel.

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