Effectiveness of community-based screening and counselling in reducing burden of non-communicable diseases and associated risk factors: a follow-up study in tribal Jharkhand, India

Background: Non-communicable diseases (NCDs) such as hypertension and diabetes have become major contributors to morbidity and mortality worldwide. Initially labelled as diseases of affluence, NCDs are a rising concern in tribal populations due to delayed diagnosis, low health literacy, and poor access to healthcare. This study evaluated the impact of a community-based screening and counselling intervention on the burden of NCDs and risk factor modification in Boram block, Jharkhand. Methods: A pre-post interventional study was conducted on individuals screened in 2024 under the non-communicable diseases control initiative. 400 adults (>30 years) from a tribal population were followed up after 6 months by TATA steel Foundation. Anthropometry, blood pressure, and random blood sugar were measured using standard tools. Risk behaviours and treatment adherence were reassessed. Results: Significant improvements were observed in drug adherence, reduction in salt and tobacco use, increased physical activity, and improved awareness of hypertension/diabetes status. Blood pressure and waist circumference showed modest reduction post-intervention. Mean systolic BP reduced from 149.1±21.0 to 134.8±16.9 mmHg; diastolic BP from 91.5±11.1 to 82.8±10.1 mmHg; RBS from 146±56.3 to 132±36.2 mg/dl. Waist circumference and weight decreased significantly. Medication adherence improved from 35% to 72%; physical activity rose from 28% to 65%. All changes were statistically significant (p<0.001). Conclusions: Community-based screening with structured counselling and referral improves NCD control and lifestyle behaviours in tribal settings. Future studies should include control groups and longer follow-up.