Lone Abrar Nazir
“A healthcare system should not celebrate only the number of patients it treats; it should also ask how many people it could have kept from becoming patients in the first place.” We often measure the strength of a healthcare system by the number of hospitals it has, the availability of specialists, sophisticated medical equipment and the number of patients treated every day. These are important indicators, but they tell only part of the story. An equally important question remains overlooked: how effectively are we preventing people from falling ill? In Kashmir, healthcare conversations frequently begin when someone develops symptoms, receives a diagnosis or requires hospital admission. Families rush to hospitals, seek consultations and spend considerable amounts on investigations and medicines. Yet, far less attention is given to measures that could have prevented many health problems or detected them earlier. This reflects a larger weakness in our healthcare approach: we have become increasingly accustomed to treating illness, but prevention has not received the attention it deserves.
The Numbers Demand Attention: The need to strengthen preventive healthcare in Jammu and Kashmir is not merely a theoretical concern. Available health data point towards a significant burden of non-communicable diseases. According to the National Family Health Survey-6 (2023–24), approximately one in every four women aged 15 years and above in J&K has elevated blood pressure or is taking medication to control it. This proportion increased from 20 per cent in NFHS-5 (2019–21) to 25 per cent in NFHS-6. Among men, the corresponding figure increased from 18.9 to 20.9 per cent. The findings are particularly concerning because hypertension often progresses without noticeable symptoms. Many individuals may remain unaware of their condition until complications develop. The ICMR-INDIAB study offers another important perspective. Among its Kashmir and Ladakh study population, diabetes prevalence was reported at 7.8 per cent, comprising 5.4 per cent previously diagnosed cases and 2.4 per cent newly detected cases. Another 10.5 per cent had pre-diabetes, while hypertension prevalence was reported at 30 per cent. Although these figures should not be interpreted as estimates for the entire Union Territory, they underline the importance of early identification and sustained prevention. These are not merely numbers in research reports. Behind every undiagnosed case is a person who may have benefited from timely screening, counselling and medical intervention.
The Problem Begins Long Before The Hospital Visit: Diabetes, hypertension and cardiovascular diseases frequently develop gradually. A person can have elevated blood pressure without experiencing a headache. Diabetes may progress without dramatic warning signs, while high cholesterol rarely announces its presence through symptoms. By the time some individuals seek medical attention, complications may already have begun. Simple measures such as periodic blood pressure checks, appropriate blood glucose testing and lipid assessment based on individual risk can help identify health problems earlier. However, screening is not simply about conducting tests. It must be followed by proper interpretation, counselling, treatment where necessary and continued follow-up.
Lifestyle|The Neglected Prescription: Physical inactivity, unhealthy dietary patterns, tobacco consumption, inadequate sleep and chronic stress contribute to the development of several non-communicable diseases. Kashmir is not isolated from these challenges. Changing food habits, sedentary routines and increasing dependence on convenience have altered the way many people live, particularly among younger generations. The concern is that lifestyle advice is often delivered only after a diagnosis. Patients are advised to exercise, modify their diets and manage their weight when their blood pressure, blood glucose or cholesterol levels become abnormal. Why should such conversations begin only after the problem appears? Lifestyle education should become a regular part of schools, colleges, workplaces and community health programs. Health awareness must move beyond occasional campaigns and become a continuous process.
“The true measure of a healthcare system should not just be hospital treatment capacity, but its focus on early screening, disease detection, community education, and prevention—ultimately striving to keep people healthy rather than just treating them after they fall ill.”
Screening: Are We Reaching Everyone? The challenge is not limited to the prevalence of disease; it also concerns how effectively people are being reached through screening programmes. NCD Portal figures presented for Kashmir Division in December 2024 showed considerable district-level variation in hypertension screening. Kulgam reported approximately 60 per cent screening coverage, compared with around 58 per cent in Baramulla and 51 per cent in Srinagar. In contrast, the reported figures were approximately 20 per cent in Anantnag and 21 per cent in Bandipora. These figures relate to reported programme screening activity up to December 2024, not disease prevalence. Nevertheless, the variation raises important questions about the reach and consistency of preventive health services. Screening should also be appropriate to a person’s age and individual risk. The objective is not to subject everyone to unnecessary investigations but to ensure that those who need screening receive it at the right time.
Primary Healthcare | The First Line Of Defence: Jammu and Kashmir has an extensive network of primary healthcare facilities, including 398 Primary Health Centres, 239 New Type PHCs, 1,910 sub-centres and 84 Community Health Centres, according to the NHM health-facilities directory.
However, infrastructure alone cannot guarantee effective healthcare. Facilities need adequate personnel, diagnostic equipment, essential medicines, referral mechanisms and reliable follow-up systems. Primary healthcare centres should become more than places where patients visit after falling ill. They must serve as centres for health education, risk assessment, early diagnosis, counselling and continuity of care. The role of medical officers, nurses, pharmacists, community health workers and other healthcare professionals should extend beyond treatment. Each can contribute to identifying health risks and educating communities.
Prevention Is An Economic Necessity: Illness affects more than an individual’s health. It affects household finances, productivity and the wider economy. Long-term treatment, repeated hospital visits, investigations and complications can place considerable financial pressure on families. Preventive healthcare cannot eliminate every medical expense, but appropriately designed prevention and early-intervention programs can reduce avoidable complications and improve quality of life. Schools must introduce meaningful health education, primary healthcare facilities must strengthen screening and follow-up, and healthcare professionals must make prevention an integral part of routine consultations. Public health authorities should also evaluate progress through indicators such as screening coverage, early diagnosis and disease control. The responsibility does not rest with the government alone. Individuals must adopt healthier habits, seek appropriate medical advice and avoid self-medication. However, personal responsibility cannot replace accessible healthcare services and reliable public health infrastructure.
A Change In How We Define Healthcare: A hospital is an essential part of healthcare, but it should not be the entire definition of healthcare. Perhaps it is time to change the question we ask about our healthcare system. Instead of asking only how many patients our hospitals treat, we should also ask how many people receive timely screening, how many diseases are detected early and how effectively communities are being educated about preventable health risks. Because the real achievement of healthcare is not simply bringing a patient back from illness; it is building a society in which fewer people have to become patients in the first place.
(The author is a freelancer. The views, opinions and conclusions expressed in this article are those of the author and aren’t necessarily in accord with the views of “Kashmir Horizon”)
[email protected]
