Non-alcoholic fatty liver disease (NAFLD) integration into India’s NCD program – Obstacles and solutions for the implementation of guidelines at the national level

Abstract

ABSTRACT Individuals who have non-alcoholic fatty liver disease (NAFLD) are at high risk of metabolic comorbidities and can put a significant strain on healthcare systems. If not managed in a timely manner, NAFLD can lead to sustained healthcare costs, economic losses, and reduced health-related quality of life. In India, the Ministry of Health and Family Welfare recognized the need for a comprehensive approach to prevent NAFLD and integrated public health measures into the existing National Program for Prevention and Control of Non-Communicable Diseases (NP NCD). However, 3 years after the integration, there is no clear measure of the extent of implementation of this program, and the exact facilitators and barriers to implementing the program are yet to be determined. The next step toward providing comprehensive and effective healthcare services to those affected by NAFLD is the implementation of NAFLD guidelines under the NP NCD. The article emphasizes the importance of replacing old reporting formats with updated ones that incorporate NAFLD. It also highlights the need for healthcare personnel and community health workers to receive multiple trainings. While measuring waist circumference (WC) and identifying patients who need referral poses challenges, we can overcome them by updating the Non-Communicable Disease (NCD) application to include NAFLD, recording WC in registers, and using up-to-date reporting formats.