Preparedness of public & private health facilities for management of diabetes & hypertension in 19 districts in India.

Abstract

Background & objectives India has the second highest number of adults with diabetes in the world, and more than one-fourth of adults have hypertension. This article describes the preparedness of public and private health facilities for type 2 diabetes mellitus and hypertension management. Methods A cross-sectional survey of the health facilities was conducted in 19 districts of seven States in India, which included an assessment of both public and private health facilities. We used the Indian Public Health Standards and other relevant guidelines for assessment. The service domain score for four domains: equipment, medicine, diagnostics capacity, staff, including the availability of guidelines, and overall readiness score, was calculated following the Service Availability and Readiness Assessment manual of the World Health Organisation. The study considered a readiness score of ≥70 per cent to classify a facility as prepared for providing hypertension and diabetes services. Results Out of 415 health facilities covered in the survey, 75.7 per cent were public facilities. Most were primary care facilities (57.6%) and were located in rural areas (53.3%). The overall readiness score for providing hypertension and diabetes services was lowest for Sub-Centres (SCs; 61%) and Community Health Centres (CHCs; 59%), compared to other facilities. The readiness score for public Primary Health Centres (PHCs) and private primary care facilities (level 2) was 73 and 57 per cent, respectively. The readiness score of district hospitals, government private medical colleges, and other private tertiary care facilities was above 70 per cent, and they were considered prepared for services. Interpretations & conclusions PHCs were better prepared for diabetes and hypertension care than SCs, CHCs, and SDHs. By ensuring adequate human resources availability and uninterrupted supply of essential medicines, programme managers can further improve the preparedness of all public health facilities.