CATCH

CHIEF MINISTER’S COMPREHENSIVE ANNUAL AND TOTAL CHECKUP FOR HEALTHY SIKKIM (CATCH)

Introduction:

The Government of Sikkim under the visionary and dynamic leadership of Shri Pawan Chamling, Hon’ble Chief Minister of Sikkim has launched Mission Healthy Sikkim. Sikkim is only state in India to have such a mission. CATCH is a flagship Programme of the Government of Sikkim which is aimed at providing universal comprehensive check-up on Annual and Periodic basis. Though the primary focus is Annual Health Check-up, based on the Epidemiological ethic of “No survey without Service”, an attempt has also been made to provide comprehensive health care with primary focus on Health Promotion and Prevention of diseases.

Comprehensive health care is being provided through convergence of all programmes and services from village to State level to all the citizens of Sikkim to make a health movement for a healthy Sikkim. Detailed history, thorough physical check-up, screening of major health problems, laboratory investigations, Counseling, Information Education Communication (IEC), Behavioral Change Communication (BCC), Treatment and graded referral system is being carried out. Recording in a family folder and individual case sheets and data entry into CATCH software are being done to develop into a health card which will allow access to details of health profile of each individual, family and the community. This will enable us to know their health status, spot potential problems in their early stages, help in early diagnosis and provide timely treatment and comprehensive health care. Issues can also be prioritized and discussed at the community level and solutions formulated to make their society healthy. Steps are also being taken to works towards policy changes so that required changes can be made to build a strong and healthy society.

Catch is historical initiative and is the first of its kind to provide community based Comprehensive Annual and Total Health Checkup and Care which is free of charges and close to the people’s doorsteps. This will go a long way to make Sikkim one of the healthiest States in India.

Vision:

To provide comprehensive annual and total health checkup to all citizens for appropriate interventions individually and collectively to make Sikkim the healthiest state in India.

Objectives

The short to medium term goal is to provide a systematic and comprehensive health check up to all citizens of Sikkim on an annual basis closest to their doorsteps, so as to enable them to know their health status and help them to maintain good health by spotting potential risk factors and diseases in their early stages.

To provide cost effective treatment through early detection of diseases and comprehensive health care.

The long term goal is to prepare a data base substantial enough to understand the actual health problems and needs of the Sikkim’s populace and plan accordingly to enable the state to put in place locally relevant and responsive interventions.

 

OVERALL PERFORMANCE OF CATCH PROGRAMME AND SOME OF THE FINDINGS IN THE PROGRAMME TILL DATE.

Population of Sikkim as per Census 2011 is 610577 and estimated residential population having Voter ID card which had to be covered under CATCH Programme was approximately 550000. Under the CATCH Programme, 552767 population was covered in the first and second rounds along with data entry of 461001. 145000 Health Cards have been distributed so far.

Demographic distribution shows that 25% of our population is in the age group of 0-14 yrs, 68% in the age group of 15-59 yrs and 7% above 60 yrs. When community wise analysis was done among the population who participated in the camps, majority were Hindu by religion (57%) followed by Buddhist (32%), then Christian (10%). Among the communities, 14% of the population is Rai, Chettri (12%), Bhutia (11%), Limbu (9%) and Lepcha & Bahun (8%).

 

Overall literacy rate of Sikkim is 89% as per the population who attended the CATCH camp (census 2011 literacy rate was 81.4%). Females (15%) are more illiterate as compared to males (8%). Majority of the people have primary level of education (29%) and the percentage of those having college & above level of education in Sikkim is low (9%). There is not much difference between males and females having college & above level of education.

Dietary Habit Of The Population Who Attended The Camp

8% of the population who attended the camps consumed extra salt on a daily basis, 81.8% consume extra salt in their diet occasionally, and 91% of the population who attended the camp is Non-Vegetarians. Out of those, 60% take non-vegetarian diet weekly and 2% take non-vegetarian diet daily. It is also seen that 52% of males take non vegetarian diet daily as compared to 48% females). As per the report, majority of the population has high oil consumption (64.4%).

PREVALENCE OF HIGH BLOOD PRESSSURE IN SIKKIM AMONG THOSE WHO ATTENDED THE CAMP

 MaleFemaleTotal
Normal8408591695175780
High Blood Pressure31086 (27%)26585 (22%)57671 (25%)
Total115171118280233451

As per CATCH report, overall prevalence of High Blood Pressure detected in one reading of persons above 15 yrs in Sikkim is 25%. Male population of Sikkim has a higher prevalence of high blood pressure (27%) as compared to females (22%). As it is usually seen that the prevalence of hypertension increases with age, the same trend is seen in our state too (age group 30-49 yrs is 27%, 50-59 yrs (43%) and more than 60yrs (50%).

When the analysis on community wise was done it was seen that the prevalence of high blood pressure is seen more in Lepcha community (32%) followed by Gurung, Mangar and Sherpa (29%), Limbu (27%), Rai (26%), Tamang/Pradhan/Bhutia (25%). The least prevalence is seen in Chettri (20%), Bahun/Bihari (18%), others (19%). Prevalence of high blood pressure in Damai and Kami is 23% and 22% respectively. Rest of the community i.e., Jogi, Marwari is showing prevalence of 28% and 25%, respectively, but the population of this community who attended the camp was less. Surprisingly, rural population of Sikkim is showing higher prevalence of high blood pressure (25%) as compared to urban population (23%). The reason for this may be due to high intake of salt among the rural population, and low level of awareness than the urban population.

According to the district wise analysis, West (30%) and North (28%) districts have high prevalence of high blood pressure followed by South and East (26% and 22% respectively).

Prevalence Of Random Blood Sugar >200mg/Dl In Sikkim Among Those Who Attended The Camp

Overall prevalence of RBS > 200mg/dl is 3%. The prevalence of RBS >200mg/dl in males is 2.94% and in females is 2.51%. Age group wise distribution of RBS >200mg/dl shows 50-59 yrs having prevalence of 4% and 60 yrs and above with 4.5%.

Prevalence of RBS above 200mg/dl is more among the urban population (4%) as compared to rural (2%).

East (2.93%) and South (2.76%) districts have the higher prevalence of RBS more than 200mg/dl followed by West (2.43%) and North (1.91%).

Among the Communities, Marwari and Bihari are showing high prevalence of RBS >200mg/dl (5%) followed by Pradhan, Bahun and Gurung community (3.4%, 3.1%, and 3% respectively). Rest of the communities have almost the same prevalence (2%) of RBS >200mg/dl.

Prevalence Of Random Blood Sugar >140-200mg/dl In Sikkim Among Those Who Attended The Camp

Overall prevalence of RBS >140-200mg/dl is 9.3%.The prevalence of RBS 140-200mg/dl in male is 10% and in female is 8%. Those having RBS 140-200mg/dl is being followed up for further evaluation during the second round.

Prevalence of RBS 140-200mg/dl in Bahun/Gurung Community is 11.4%, Chettri/Limbu (10.3%), Pradhan/Rai (9%), and Bhutia/Lepcha/Tamang (8%).

Both the sexes have the same prevalence of RBS 140-200mg/dl (10%). Rural population is showing more prevalence of RBS>140-200mg/dl (11%) as compared to urban population (7%).

Prevalence of Anaemia In Sikkim Among Those Who Attended The Camp

Prevalence of anemia in Sikkim is 51% (mild anaemia-45.5%, moderate anaemia-5.69%, & severe anaemia-0.21%). Sex wise distribution shows females having prevalence of 63% as compared to males (37%). Mild, Moderate & Severe anaemia is seen more in females (55%, 8% & 0.28% respectively) than males (35%, 3.2% & 0.13%). Prevalence of anaemia as per district wise distribution shows South district having 64%, West (55%), North (48%) and East (40%).

Prevalence of mild, moderate and severe anemia is more in rural population (51%, 7%, and 0.25%) as compared to urban (28%, 2%, and 0.07%).

Prevalence of anaemia is seen more in Limbu community (56%) followed by Rai (55%), Gurung (54%), Lepcha (52%), Sherpa (51%), Bahun (47%) and Bhutia (46%).

Prevalence of Overweight And Obesity In Sikkim (>20 Years) Among Those Who Attended The Camp

Prevalence of overweight in Sikkim is 41%. When compared sex wise, females have increased prevalence of overweight (31%) as compared to males (30%).

District wise prevalence of overweight is seen more in North & East districts (34%), West (26%) and south (27%). 48% of the population is overweight in the age group of 30-49 yrs.

Prevalence of obesity in Sikkim is (6%). When compared sex wise, females have increased prevalence of obesity (6%) as compared to males (3%). 9% of the population is obese in the age group of 50-59 yrs. Obesity is prevalent more in East & North districts (5%) followed by West (4%) and South (3%).

Both overweight and obesity prevalence is higher among the urban population (50.8%, 9.4%) as compared to rural population. Overweight and obesity is prevalent more in Bhutia community (48.5%, 8.6% respectively) and Lepcha & Pradhan communities (46%, 7.3%). Both overweight and obesity prevalence is higher among the urban population (50.8%, 9.4%) as compared to rural.

Prevalence of underweight in Sikkim is 8%. Among the districts, West district has the maximum number of underweight population (15%) while North district has the least (5%). Rural populations were found to be more underweight (9%) as compared to urban population (4.9%).

Prevalence Of High Cholesterol (More Than 30 Years) Among Those Who Attended The Camp

The overall prevalence of high cholesterol among those who attended the camps is 5%. Prevalence of high cholesterol is found to be more in the age group of 50 to 59 (6.12%), as compared to those of 60 years (5%) and 30 to 49 year (4.4%).

Community wise prevalence of high cholesterol is shown below in decreasing order

CommunityPercentage
Lepcha0.0814
Pradhan0.0636
Rai and Limbu0.06
Sherpa0.05
Bhutia and Chettri0.04
Bahun0.03

VIA Test Status In Sikkim

Sikkim is the only state in India where VIA is done at the community level. At the beginning of the program there was reluctance to undergo the test but gradually when awareness on the importance of the test was understood, females started coming for the test. Out of females screened during the first and second round of VIA test, 55 were found to be VIA positive. Out of the positives, one was diagnosed as having carcinoma cervix, during follow up at higher centre. VIA positive cases are being followed up at the higher centre.

Progress So Far

Till now 1, 45,000 Health Card have been issued. 300 camps have been organized during the financial year 2015-16. Community diagnosis of the first round of CATCH is being discussed during the training on community process with VHSNC members to make them aware of the health issues of their areas, to take action and to motivate the people having health problems to go for follow up at the higher centres. This way the VHSNC members can take ownership to make their villages healthy.

Way Forward

Confirmation of the diagnosis and follow up.

Regular annual health-check up to continue.

To develop a centralized database mechanism.

Systematic use of Health card on a pilot basis.

Thorough check up of those who were left out during the 1st round.

Complete data entry & continue issuing health cards.

Appropriate policy making based on the findings of CATCH report.