Health facilities are still not functioning at full capacity to manage diabetes and hypertension, study finds
Public Primary Health Centres (PHCs) are better prepared for diabetes and hypertension care than Sub-Centres, Community Health Centres (CHCs), and Sub-District Hospitals, a study undertaken by the Indian Council of Medical Research-National Centre for Disease Informatics and Research (ICMR-NCDIR), Bengaluru has found.
A cross-sectional survey of health facilities was conducted in 19 districts of seven States in India, which included an assessment of both public and private health facilities.
India has the second highest number of adults with diabetes in the world, and more than one-fourth of adults have hypertension. The study was undertaken to assess 'preparedness of public & private health facilities for management of diabetes & hypertension in 19 districts in India''.
It found that the overall readiness score for providing hypertension and diabetes services was lowest for Sub-Centres (61%), and CHCs (59%), when compared with other facilities.
The readiness score for public PHCs, and private primary care facilities (level 2) was 73% and 57%, respectively. The readiness score of district hospitals, government private medical colleges, and other private tertiary care facilities was above 70%, and they were considered prepared for services.
The study found that out of the 415 health facilities covered in the survey, 75.7% were public facilities. More than half (57.6%) were primary care facilities, and 53.3% of them were situated in rural areas.
Experts have now recommended ensuring the availability of adequate human resources, uninterrupted supply of essential medicines, and programme managers for all public health facilities, to ensure full utilisation of healthcare centres for diabetes and hypertension care.
'Diagnostic services were less available at district hospitals, indicating that secondary higher-level public health facilities were not fully prepared to manage complications of these two conditions. Efforts to strengthen diagnostic services are essential for the continuum of care, as there will be in-referrals of patients from peripheral public health facilities to District Hospitals,'' the study said, adding that work must be done to ensure a reliable drug supply, and accurate information systems in primary healthcare facilities.
Equipment, medicines, diagnostics capacity, staff, the availability of guidelines, and overall readiness score was calculated following the World Health Organization's SARA (Service Availability and Readiness Assessment) manual.
The study was conducted in two-phases — the first phase was conducted from September 15, 2021 to December 15, 2021, and the second phase from February 1, 2023 to June 30, 2023.
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