Unlocking the Power of Digital Health Interventions for Management of NCDs

Non-communicable Diseases (NCDs) and their Growing Burden

Non-communicable diseases (NCDs) killed at least 43 million people in 2021, and among them 18 million people died from an NCD before the age of 70 years; 82% of these premature deaths occur in low- and middle-income countries (WHO, 2024).

NCDs, particularly cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases, are responsible for 74% of deaths globally and negatively impact the lives of millions of people (Going Digital for Non-communicable Diseases, 2024).

Digital Health Interventions

Digital health is an umbrella term that encompasses the application of digital technologies in health care. Digital Interventions include various technologies, such as smartphone applications, short message service (SMS), activity trackers, electronic records, video-based interventions, virtual reality, web-based or internet-based interventions, and telehealth platforms.

Role of Digital Health Interventions in Management of NCDs

Digital Health Interventions can be used for various purposes including disease prevention, diagnosis, treatment, and management. They can also promote health literacy among the communities and facilitate self-management by encouraging them to take an active role in monitoring and managing their conditions by providing accessible and user-friendly information(World Health Organization, 2024).

Examples of Successful Digital Health Interventions that help in the management of NCDs

Telemedicine (eSanjeevani)

It is a safe and effective alternative when in-person care cannot be provided without compromising acceptable standards of care, particularly for managing high-burden primary health conditions such as hypertension and diabetes (World Health Organization, 2024). The eSanjeevani app was launched by the Ministry of Health & Family Welfare of the Government of India in November 2019. The cloud-based eSanjeevani platform was introduced in two modes:
eSanjeevaniAB-HWC (a provider-to-provider telemedicine platform): It is an assisted telemedicine system that connects patients through health workers and medical officers in Health & Wellness Centres to the doctors and specialists in hubs established in secondary/tertiary level health facilities or medical colleges.
eSanjeevaniOPD (a patient-to-provider telemedicine platform): It empowers citizens to access outpatient services in the confines of their homes through smartphones or laptops, etc.

Wearable Devices

A wearable health device is a miniaturized electronic device with sensors that can be worn on the body or integrated into clothing or other body-worn accessories capable of noninvasive, longitudinal monitoring of vital physiological and biochemical parameters. These devices include smartwatches, smart rings, smart wristbands, and smart patches. (Babu et al., 2023).

Wearable devices such as fitness trackers help users increase their physical activity, which is beneficial in preventing cardiometabolic disorders. Devices like Continuous glucose monitors (CGMs) help in diabetes management by providing real-time glucose readings, leading to more precise insulin dosing and improved glycemic control (Jafleh et al., 2024).

mHealth

mHealth uses mobile and wireless devices such as mobile phones, tablets and personal digital assistants to support health care management. They enhance self-management for chronic conditions by incorporating self-monitoring features that allow the user to monitor their weight, blood pressure, blood glucose level, dietary intake, and fluid intake. The most common self-monitoring features found in the apps are weight trackers, food intake trackers, and step trackers (Cheah et al., 2024).

Nutrition and healthy lifestyle applications are low-cost and practical approaches to spreading diet and nutrition information to the public. These apps also provide focused information to specific populations, such as overweight persons, cancer survivors, and people at risk for heart diseases (Ulfa et al., 2022).

Electronic Health Record

Electronic Health Record (EHR) is a collection of various medical records generated for a beneficiary during any clinical encounter. It includes a range of data, which includes demographics, personal statistics like age, weight, vital signs, medical history, medication details, allergies, immunization status, laboratory test results, radiology images, and billing information.

They can be a useful way to help generate the much-needed real-time data on NCDs, which can help service providers and programme managers to take evidence-based decisions to improve service delivery (Electronic Health Record (EHR) Standards for India 2016, Standards Set Recommendations V2, 2019).

Health Chatbots

This intervention includes the use of computer programs based on AI to simulate conversations with human users. Chatbots can be used to promote healthy lifestyle choices and to provide personalized recommendations based on an individual’s health history and risk factors (World Health Organization, 2024).

Swasthya Pahal

It is an innovative community-based program, facilitated through an interactive, multi-lingual, standalone, and internet-enabled touchscreen computer-based program that aims to enhance self-management of NCDs, including diabetes, hypertension, and obesity, among individuals living across diverse community settings.

This community program facilitates the collection of individual subjective and objective data using the SMAART informatics platform to generate tailored risk profiles in the form of a SMAART card. It provides an individualized self-management plan of action supported by perpetual monitoring and interactive health information, and shared decision-making (Joshi et al., 2021).

Information flow in Swasthya Pahal (health for all) implementation using SMAART informatics platform.

Sangyan

Sangyan Podcast is a multilingual Interactive Decision making enabler through Educational Audios (IDEA) platform that aims to connect communities to the evidence-based information that can enhance the good health and well-being of individuals, families, and the communities they live in.

It provides information about various topics such as Diabetes, Hypertension, Obesity, and Malnutrition across seven different languages.

HEAL (Healthy Eating Active Living)

This intervention helps to create awareness about risk factors for non-communicable diseases (NCDs) such as diabetes, hypertension, and obesity and also to encourage and support the adoption of healthier lifestyles through regular SMS messaging across eight languages that offer guidance on diet, physical activity, stress management, home remedies and medication adherence tailored to individual preferences and needs.

Public Health ki Rasoi

It aims to empower individuals using video multimedia to make informed dietary choices by blending nutrition science with cultural and regional practices. Information related to topics like food safety, diabetes, mental health and nutrition, air pollution, and nutrition is provided in different languages.

• Key challenges in implementing digital health interventions for the management of NCDs
• Low digital literacy among the population
• Lack of specific guidelines on cross-border consultations
• Privacy and confidentiality issues
• Affordability (Gudi et al., 2021)

Conclusion

Digital interventions have immediate, long-term health and economic benefits for the populations, and using digital health solutions to complement conventional health-care services in the management of non-communicable diseases can significantly improve the efficacy and quality of and access to health care and give individuals more control over their health and well-being.

References

• Going digital for noncommunicable diseases. (n.d.). https://www.who.int/publications/b/71552
• World Health Organization: WHO. (2024, December 23). Noncommunicable diseases.https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
• Roser, M., Ritchie, H., & Spooner, F. (2021, September 1). Burden of disease. Our World in Data. https://ourworldindata.org/burden-of-disease
• Kardan, M., Jung, A., Iqbal, M., Keshtkar, S., Geidl, W., & Pfeifer, K. (2024). Efficacy of digital interventions on physical activity promotion in individuals with noncommunicable diseases: an overview of systematic reviews. BMC Digital Health, 2(1). https://doi.org/10.1186/s44247-024-00097-6
• Yiengprugsawan, V. S., Kim, J. K., Apostol, M., Osewe, P., Human and Social Development Office, Bajaj, P., Malik, D. W., Parikh, R., Mahajan, S., India Country Office, & PATH. (2024). Integrated primary care technologies for noncommunicable diseases and mental health in Asia and the Pacific [Report]. https://www.adb.org/sites/default/files/publication/967041/adb-brief-301-integrated-primary-care-technologies.pdf
• World Health Organization. (2024). Going digital for noncommunicable diseases: the case for action.https://iris.who.int/bitstream/handle/10665/378478/9789240089921-eng.pdf?sequence=1&isAllowed=y
  Union Health Minister, Dr Mansukh Mandaviya hails the “eSanjeevani” landmark milestone of providing telemedicine services to more than 10 Crore patients. (n.d.-b). https://pib.gov.in/PressReleasePage.aspx?PRID=1899855
• Babu, M., Lautman, Z., Lin, X., Sobota, M. H. B., & Snyder, M. P. (2024). Wearable Devices: Implications for Precision Medicine and the Future of Health Care. Annual review of medicine, 75, 401–415. https://doi.org/10.1146/annurev-med-052422-020437
• Jafleh, E. A., Alnaqbi, F. A., Almaeeni, H. A., Faqeeh, S., Alzaabi, M. A., & Al Zaman, K. (2024). The Role of Wearable Devices in Chronic Disease Monitoring and Patient Care: A Comprehensive Review. Cureus, 16(9), e68921. https://doi.org/10.7759/cureus.68921
• Cheah, K. J., Abdul Manaf, Z., Fitri Mat Ludin, A., Razalli, N. H., Mohd Mokhtar, N., & Md Ali, S. H. (2024). Mobile Apps for Common Noncommunicable Disease Management: Systematic Search in App Stores and Evaluation Using the Mobile App Rating Scale. JMIR mHealth and uHealth, 12, e49055. https://doi.org/10.2196/49055
• World Health Organization: WHO. (2024a, September 23). Boosting digital health can help prevent millions of deaths from noncommunicable diseases. WHO NEWS. https://www.who.int/news/item/23-09-2024-boosting-digital-health-can-help-prevent-millions-of-deaths-from-noncommunicable-diseases
• Ulfa, M., Setyonugroho, W., Lestari, T., Widiasih, E., & Quoc, A. N. (2022). Nutrition-Related mobile Application for daily Dietary Self-Monitoring. Journal of Nutrition and Metabolism, 2022, 1–11. https://doi.org/10.1155/2022/2476367
• Electronic Health Record (EHR) Standards for India 2016, Standards Set Recommendations V2. (2019). Operationalising Electronic Health Records to Capture Beneficiary Data at Urban Primary Health Centre within NCD programs inMysuru,Karnataka.https://www.khpt.org/wp-content/uploads/2022/05/EHR-Tecnical-Brief-28052019.pdf
• Joshi, A., Kaur, M., Arora, S., Bhatt, A., Sharma, P., Kaur, H., Kumar, K., Arora, M., Malhotra, B., & Anshuman, A. (2021). A pilot evaluation of Swasthya Pahal program using SMAART informatics framework to support NCD self-management. mHealth, 7, 55. https://doi.org/10.21037/mhealth-20-110
  Sangyan. SMAART LAB. (2025, February 26). https://smaartlab.org/sangyan/