Evaluation of Performance of NP-NCD (National Programme for Prevention and Control of Non-Communicable Diseases)

Overview of the M&E Framework

Four Components of the M&E Cycle

Step-by-Step Evaluation Process

Step 1: Define and Finalize the List of Indicators

• Detection Rate: Newly diagnosed cases per eligible population screened per year
• Treatment Rate: Those currently on treatment out of those diagnosed
• Control Rate: Those achieving target values (controlled BP/blood glucose) among those on medication

Step 2: Establish Baseline Assessment at District Level

• Before initiating M&E cycles, a district-level baseline of all indicators is collected
• This is done via the National NCD Portal and monthly reporting forms from State/District NCD Divisions and CHC/NCD Clinics
• The CHC/Block level is the first level where major programme activities are envisaged; all data elements are collected here for computing input and process indicators

Step 3: Data Collection — Routine & Periodic

• National NCD Portal (primary digital tool)
• Monthly reporting forms (block, district, state)
• Published reports at all levels with NCD content

Step 4: Data Quality Assurance

• ~10% of collected data must undergo quality checks each quarter or half-year by programme managers
• State teams conduct regular monitoring visits to districts and below for data quality checks
• Checks assess: completeness, validation, service delivery effectiveness, and health outcomes against defined indicators
• Proportion of health facilities actively reporting through the IT system is itself tracked as a process indicator

Step 5: Performance Management — Supportive Supervision

• Monitors programme through HMIS, review meetings, field observations, surveillance, and operational research
• Conducts Joint Supportive Supervision Mission visits to States/UTs
• Reviews data from the National NCD Portal and shares findings with states for action
• Releases funds per State PIP approved in NPCC meetings, monitoring via key deliverable indicators

• Visits blocks and peripheral units to monitor, evaluate, and surveil NCD activities
• Organizes review meetings and orientation workshops
• Submits monthly/quarterly progress reports to the State NCD Division via the National NCD Portal

• Key indicators at this level are process and output indicators from routine reports
• Outcome indicators require population-level data (supplemented by surveys)

Step 6: Fix Targets for Each Indicator Across Time Frames

• Targets are adapted from WHO global NCD targets to national context
• Short-term targets aligned with Five-Year Plans and SDG Target 3.4 (reduce premature NCD mortality by one-third by 2030)
• Intermediate targets allow programme strategy modification based on effectiveness
• India may prioritize certain aspects (e.g., hypertension control) in the immediate future

Step 7: Periodic Review at State and National Level

• Review meetings at state and national levels assess progress against targets
• Data from the National NCD Portal is the primary tool for performance tracking
• Proportion of active MOs (Medical Officers) on the National NCD Portal in the last 30 days (denominator: total MOs) is tracked as a process indicator
• IT system usage across SHC, PHC, and NCD Clinics at CHC/DH is monitored monthly

Step 8: Evaluation Studies — Rapid Assessment and Implementation Research

• Rapid assessments of programme effectiveness are conducted
• Implementation research/evaluation studies commissioned or conducted by the national/state NCD cell
• These evaluate whether intended results are being achieved as planned
• Outcomes benchmarked internationally to track time trends of key indicators

Step 9: Learning — Documentation and Dissemination

• Findings are documented, reported, and disseminated at all levels
• Lessons inform policy development, advocacy for financial allocations, and reinforce political commitment
• Annual/bi-annual review meetings integrate learning into the next planning cycle

Step 10: Surveillance — Population-Level Component (ICMR as Nodal Agency)

• National NCD Monitoring Survey (NNMS) — provides prevalence data of NCD risk factors (e.g., tobacco use 32.8%, alcohol use 15.9%, insufficient physical activity 41.3% from 2017–18)
• GATS (Global Adult Tobacco Survey) for tobacco-specific data
• National Cancer Registry Programme for cancer case data
• These surveys occur biennially or five-yearly

Summary Flow of NP-NCD Performance Evaluation

Define indicators (Input → Process → Output → Outcome → Impact)
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Collect baseline at district/CHC level
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Routine data collection via National NCD Portal & reporting forms
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Data quality assurance (10% quarterly checks + monitoring visits)
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Supportive supervision at national, state, district, block levels
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Fix and track targets (short-term + SDG 2030 alignment)
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Periodic review meetings (state + national)
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Rapid assessments & implementation research/evaluation studies
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Documentation, reporting, dissemination (Learning)
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Population surveillance (NNMS, GATS, Cancer Registry) for impact
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Feedback into planning cycle

Key Reference Documents

• Revised Operational Guidelines of NP-NCD (2023–2030) — MoHFW, Government of India
• NHM Training Module on NCDs
• How to Effectively Monitor and Evaluate NCD Programmes in India — Indian Journal of Community Medicine, PMC3354904