Jharkhand would start a massive community-based assessment to screen non-alcoholic fatty liver diseases (NAFLD) and other diseases of its populace over 30 years with a deadline of December 2025 under a comprehensive primary health care programme.

NAFLD is an umbrella term for various liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells.

The door-to-door community-based assessment would commence in September in two pilot districts of Khunti and Lohardaga before being replicated in the remaining 22 districts before December 2025.

“We have decided to start with two districts of Khunti and Lohardaga for two reasons — proximity to state capital Ranchi and having less population. We will be seeking assistance from health workers (accredited social health activists — ASHA, popularly known as Sahiya Didi) in conducting the door-to-door survey from September this year,” said state nodal officer of non-communicable disease cell, Dr L.R. Pathak.

A meeting in this connection was chaired by the additional chief secretary of health, Arun Kumar Singh, along with representatives of Rajendra Institute of Medical Sciences (RIMS, Ranchi), WHO and Institute of Liver and Biliary Sciences (ILBS, Delhi) in Ranchi on Friday.

The revised operational guidelines of the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) released in May this year have included NAFLD along with Chronic Obstructive Pulmonary Disease (COPD) and asthma, chronic kidney disease (CKD) and ST elevation of myocardial infarction (STEMI) apart from hypertension, diabetes and three common cancers including oral, breast and cervical.

“We have received a directive from the Union health ministry to conduct the screening programme for NAFLD which is emerging as a growing health concern globally with one out of every four persons having this disease. After screening those with NAFLD will be counselled and referred for treatment in state-owned hospitals at block or district level. NAFLD at its initial stage can also be reversed with lifestyle changes, weight reduction and diet management,” said Dr Pathak.

The community-based assessment checklist, prepared by the Jharkhand health department and to be filled by the health workers, would have the residents’ details such as name, age, address and phone numbers and also information on whether they are covered under state health insurance scheme.

The health workers would also have to enter if the residents suffer from any disability, any addiction (smoking, chewing tobacco products or drinking alcohol), measurement of the waist, their physical exercises (minimum 150 minutes in a week), if anybody in their family has hypertension, diabetes and heart diseases. “Obesity and family diabetic history will come under our suspect for NAFLD and would be bracketed for counselling at the primary health care level,” said Dr Pathak.

The other primary details include any breathing distress, blood in sputum, sudden weight reduction, fever for more than a week, sweating at night and questions on tuberculosis, hearing problems, questions on menstrual hygiene and suspected breast cancer for women and cooking process (gas/wood etc) and exposure to pollutants.