ABSTRACT Background: Punjab and Haryana, two high epidemiological transition states in India, experience a substantial and rising burden of noncommunicable diseases (NCD) driven by elevated blood pressure, tobacco use, harmful alcohol use and low physical activity. The National Programme for Prevention and Control of NCD (NP-NCD) aims to strengthen early detection, service delivery, and continuity of care. This study examines the early implementation of the program during 2010–2015 in Punjab and Haryana, assessing infrastructure, service delivery, monitoring systems, and equity, while establishing a baseline for effectiveness assessment and future comparisons. Methodology: A mixed-methods descriptive evaluation approach integrating a targetted review with facility-based assessments across districts at different stages of operationalization was conducted. Structured field observations, document and policy review, and routine program data analysis were grounded in stakeholder perspectives to document real-world challenges in implementation. A thematic framework guided the analysis, with attention to human resources, community engagement, service utilization, financing, and data systems. Secondary data were also triangulated with STEPS survey findings from both states. Results: Despite structural establishment, major operational readiness gaps persisted. Underutilized infrastructure, staff shortages, lack of follow-up systems, and weak data reporting were prominent. Punjab showed higher screening volumes and program expenditure, but these were not accompanied by proportional improvements in diagnostic confirmation, referral completion, or continuity of care. Haryana reported lower screening volumes with incomplete follow-up documentation. Community and workplace interventions were largely absent. Electronic tracking, referral mechanisms, and disaggregated monitoring by age, sex, or residence were inadequately developed. Inequities were observed in screening participation among men and gaps in treatment access and continuity in rural facilities. Conclusion: NP-NCD implementation in its early phase revealed critical bottlenecks in service delivery, follow-up, and equity. Establishment of disaggregated follow-up reporting and institutionalization of concurrent program audits by public health institutes is recommended. Strengthening workforce capacity, establishing decentralized surveillance, and integrating evidence from global best practices will be key to achieving sustainable NCD control in India.
Jeet et al. (Thu,) studied this question.