Barriers in Implementing Multisectoral Action for Noncommunicable Diseases in Uttar Pradesh, India

Introduction: Noncommunicable diseases (NCDs) are escalating in all gradients of population across globe. India launched a plan in 2017 for prevention and control of NCDs by addressing its social determinants and focusing multisectoral action (MSA). An assessment study of MSA in Uttar Pradesh informed that MSA is still at nascent stage of execution, and more focused efforts are needed to align all nonhealth sectors with health. This research provides inputs for implementing MSA after in-depth exploration of barriers in districts of Uttar Pradesh, India. Objectives: To understand barriers in implementation of MSA for prevention and control of NCDs. Materials and Methods: A qualitative study was conducted with 29 key informants across various sectors from selected districts of Uttar Pradesh to identify barriers in MSA. Data were transcribed and translated before manual analysis. Codes and emerging themes were categorized into barriers. Content analysis of sector’s websites was done to capture content related to MSA in public domain to get comprehensive understanding of barriers through data triangulation. Results: There is no collaborative platform wherein different sectors could negotiate mandates and collaborate towards implementing MSA. Crucial barriers identified were lack of active participation from nonhealth sectors and frequent change of program nodal officers. The absence of monitoring mechanism for collaborative activities also emerged as an important barrier added by work culture and capacity of officers to implement MSA. Conclusions: Establishment of functional platforms at districts for collaborative actions between sectors is essential along with extensive use of digital media to enhance coordination.