Challenges and opportunities in employing digital health to address self-management needs of people with NCDs in India

© Author(s) (or their employer(s)) 2021. No commercial reuse. See rights and permissions. Published by BMJ. The WHO declared COVID-19 as a Public Health Emergency of International Concern on 30 January 2020. On 22 March 2020, the Government of India imposed the ‘Janata Curfew’ to enforce rapid physical distancing measures and prepare the health system to reduce the spread of COVID-19. This lockdown was repeated three times until 17 May 2020, adversely affecting large sectors of people due to lack of access to health services and staff for usual medical care. Evidence shows that people living with noncommunicable diseases (PLWNCDs) in India are presenting less to health facilities and also there are denial of healthcare services under the nation’s lockdown. 4 PLWNCDs were not able to see their physicians in a regular consultation, and access to lab services was limited as many of these labs were converted to COVID-19 testing centres. Access to regular counselling sessions and healthy lifestyle behaviours were affected as PLWNCDs were forced to limit their activity. They were also unable to secure healthy foods and had limited access to preventive or health promotion services owing to strict lockdown. A WHO survey from 2020 highlighted the disruption of NCD services for diabetes, cancer treatment and cardiovascular emergencies thereby urging countries to promote innovations to address an emerging tsunami of NCDs. The ongoing pandemic has had welldocumented economic, sociocultural and systemic impacts which have been well debated in the press and academic literature, but there is also growing concern of the effect on health for PLWNCDs and is termed as the syndemic effect of COVID-19.