Early detection of chronic diseases and their risk factors: a women empowerment model from Kerala, India.

Identification of risk factors through screening is an important tool in the fight against chronic diseases. We have used a unique model, named Saantwanam (to console) in Malayalam language, for health screening in Kerala, India. Under the Saantwanam programme, government selects suitable women care-givers who are trained and equipped by a nongovernmental organization through loans from a public sector bank. After training, care-givers deliver screening services by measuring the weight and height, and blood pressure, glucose and cholesterol levels of people concerned in their local communities at a reasonable fee-for-service that provides a source of income to them. All care-givers are trained to counsel on healthy living, i.e. appropriate diet, exercise and unhealthy habits such as tobacco consumption. When cases are detected they are referred to local physicians and later on followed up by care-givers at their residence. In the last five years, the Saantwanam programme has screened more than 300 000 people for various diseases and risk factors. They have been counselled to avail of health-care services. The Saantwanam model does not cause additional expenditure to the government for early detection of chronic diseases and their risk factors. Moreover, it ensures that the care-givers are rewarded for their effort. However, before large-scale implementation of this model, measurement of baseline risk factors in a sample population should be done so that their impact can be measured at a later date. The cost-effectiveness of the model also needs to be determined.