Srinivas Vani, Urs Vinay, Kumar N Suresh, Arora Narendra Kumar, Raghav Pankaja, Das Sarangi, Galhotra Abhiruchi, Kulkarni Praveen, Patro Binod Kumar, Ram Ananth, Swetha R, Singh Saurabh, Joshi Pradeep, Lakshmanasamy Ravivarman, Mathur Prashant
ICMR-National Centre for Disease Informatics and Research, Bengaluru, Karnataka, India.
The INCLEN Trust International, New Delhi, India.
Indian J Med Res. 2025 Apr;161(4):327-335. doi: 10.25259/IJMR_755_2024.
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.
背景与目标 印度是全球成年糖尿病患者人数第二多的国家，超过四分之一的成年人患有高血压。本文描述了公立和私立医疗机构对2型糖尿病和高血压管理的准备情况。方法 在印度七个邦的19个地区对医疗机构进行了横断面调查，其中包括对公立和私立医疗机构的评估。我们使用印度公共卫生标准及其他相关指南进行评估。根据世界卫生组织的《服务可用性和准备情况评估手册》，计算了设备、药品、诊断能力、工作人员（包括指南的可获取性）四个领域的服务领域得分以及总体准备情况得分。该研究将准备情况得分≥70%的机构归类为有能力提供高血压和糖尿病服务。结果 在调查涵盖的415家医疗机构中，75.7%为公立机构。大多数是初级保健机构（57.6%），且位于农村地区（53.3%）。与其他机构相比，分中心（SCs；61%）和社区卫生中心（CHCs；59%）提供高血压和糖尿病服务的总体准备情况得分最低。公立初级卫生中心（PHCs）和私立初级保健机构（2级）的准备情况得分分别为73%和57%。地区医院、政府私立医学院和其他私立三级护理机构的准备情况得分高于70%，被认为有能力提供服务。解读与结论 初级卫生中心在糖尿病和高血压护理方面的准备情况优于分中心、社区卫生中心和次级保健医院。通过确保充足的人力资源供应和基本药物的不间断供应，项目管理者可以进一步提高所有公共卫生机构的准备情况。
