Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS)
Abstract Background The monitoring framework for evaluating health system response to noncommunicable diseases (NCDs) include indicators to assess availability of affordable basic technologies and essential medicines to treat them in both public and private primary care facilities. The Government of...
Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2021-07-01
|
Series: | BMC Health Services Research |
Subjects: | |
Online Access: | https://doi.org/10.1186/s12913-021-06530-0 |
_version_ | 1831655103781666816 |
---|---|
author | Anand Krishnan Prashant Mathur Vaitheeswaran Kulothungan Harshal Ramesh Salve Sravya Leburu Ritvik Amarchand Baridalyne Nongkynrih Himanshu Kumar Chaturvedi P. Ganeshkumar Vinay Urs K S Avula Laxmaiah Manjit Boruah Sanjeev Kumar Binod Kumar Patro Pankaja Ravi Raghav Prabu Rajkumar P. Sankara Sarma Rinku Sharma Muralidhar Tambe N. Arlappa Tulika Goswami Mahanta Pranab Jyoti Bhuyan Rajnish P. Joshi Abhijit P. Pakhare Abhiruchi Galhotra Dewesh Kumar Binod Kumar Behera Roshan K. Topno Manoj Kumar Gupta Neeti Rustagi Atulkumar V. Trivedi K. R. Thankappan Sonia Gupta Suneela Garg Sangita Chandrakant Shelke ICMR-NNMS investigator group Co-investigators Collaborators |
author_facet | Anand Krishnan Prashant Mathur Vaitheeswaran Kulothungan Harshal Ramesh Salve Sravya Leburu Ritvik Amarchand Baridalyne Nongkynrih Himanshu Kumar Chaturvedi P. Ganeshkumar Vinay Urs K S Avula Laxmaiah Manjit Boruah Sanjeev Kumar Binod Kumar Patro Pankaja Ravi Raghav Prabu Rajkumar P. Sankara Sarma Rinku Sharma Muralidhar Tambe N. Arlappa Tulika Goswami Mahanta Pranab Jyoti Bhuyan Rajnish P. Joshi Abhijit P. Pakhare Abhiruchi Galhotra Dewesh Kumar Binod Kumar Behera Roshan K. Topno Manoj Kumar Gupta Neeti Rustagi Atulkumar V. Trivedi K. R. Thankappan Sonia Gupta Suneela Garg Sangita Chandrakant Shelke ICMR-NNMS investigator group Co-investigators Collaborators |
author_sort | Anand Krishnan |
collection | DOAJ |
description | Abstract Background The monitoring framework for evaluating health system response to noncommunicable diseases (NCDs) include indicators to assess availability of affordable basic technologies and essential medicines to treat them in both public and private primary care facilities. The Government of India launched the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) in 2010 to strengthen health systems. We assessed availability of trained human resources, essential medicines and technologies for diabetes, cardiovascular and chronic respiratory diseases as one of the components of the National Noncommunicable Disease Monitoring Survey (NNMS - 2017-18). Methods NNMS was a cross-sectional survey. Health facility survey component covered three public [Primary health centre (PHC), Community health centre (CHC) and District hospital (DH)] and one private primary in each of the 600 primary sampling units (PSUs) selected by stratified multistage random sampling to be nationally representative. Survey teams interviewed medical officers, laboratory technicians, and pharmacists using an adapted World Health Organization (WHO) – Service Availability and Readiness Assessment (SARA) tool on handhelds with Open Data Kit (ODK) technology. List of essential medicines and technology was according to WHO - Package of Essential Medicines and Technologies for NCDs (PEN) and NPCDCS guidelines for primary and secondary facilities, respectively. Availability was defined as reported to be generally available within facility premises. Results Total of 537 public and 512 private primary facilities, 386 CHCs and 334 DHs across India were covered. NPCDCS was being implemented in 72.8% of CHCs and 86.8% of DHs. All essential technologies and medicines available to manage three NCDs in primary care varied between 1.1% (95% CI; 0.3–3.3) in rural public to 9.0% (95% CI; 6.2–13.0) in urban private facilities. In NPCDCS implementing districts, 0.4% of CHCs and 14.5% of the DHs were fully equipped. DHs were well staffed, CHCs had deficits in physiotherapist and specialist positions, whereas PHCs reported shortage of nurse-midwives and health assistants. Training under NPCDCS was uniformly poor across all facilities. Conclusion Both private and public primary care facilities and public secondary facilities are currently not adequately prepared to comprehensively address the burden of NCDs in India. |
first_indexed | 2024-12-19T16:40:50Z |
format | Article |
id | doaj.art-e26c57fbca2148e49179c5ae47260b2b |
institution | Directory Open Access Journal |
issn | 1472-6963 |
language | English |
last_indexed | 2024-12-19T16:40:50Z |
publishDate | 2021-07-01 |
publisher | BMC |
record_format | Article |
series | BMC Health Services Research |
spelling | doaj.art-e26c57fbca2148e49179c5ae47260b2b2022-12-21T20:13:48ZengBMCBMC Health Services Research1472-69632021-07-0121111210.1186/s12913-021-06530-0Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS)Anand Krishnan0Prashant Mathur1Vaitheeswaran Kulothungan2Harshal Ramesh Salve3Sravya Leburu4Ritvik Amarchand5Baridalyne Nongkynrih6Himanshu Kumar Chaturvedi7P. Ganeshkumar8Vinay Urs K S9Avula Laxmaiah10Manjit Boruah11Sanjeev Kumar12Binod Kumar Patro13Pankaja Ravi Raghav14Prabu Rajkumar15P. Sankara Sarma16Rinku Sharma17Muralidhar Tambe18N. Arlappa19Tulika Goswami Mahanta20Pranab Jyoti Bhuyan21Rajnish P. Joshi22Abhijit P. Pakhare23Abhiruchi Galhotra24Dewesh Kumar25Binod Kumar Behera26Roshan K. Topno27Manoj Kumar Gupta28Neeti Rustagi29Atulkumar V. Trivedi30K. R. Thankappan31Sonia Gupta32Suneela Garg33Sangita Chandrakant Shelke34ICMR-NNMS investigator groupCo-investigatorsCollaboratorsCentre for Community Medicine, All India Institute of Medical SciencesIndian Council Medical Research – National Centre for Disease Informatics and ResearchIndian Council Medical Research – National Centre for Disease Informatics and ResearchCentre for Community Medicine, All India Institute of Medical SciencesIndian Council Medical Research – National Centre for Disease Informatics and ResearchCentre for Community Medicine, All India Institute of Medical SciencesCentre for Community Medicine, All India Institute of Medical SciencesIndian Council Medical Research - National Institute of Medical StatisticsIndian Council Medical Research - National Institute of EpidemiologyIndian Council Medical Research – National Centre for Disease Informatics and ResearchDivision of Public Health Nutrition, Indian Council Medical Research - National Institute of NutritionDepartment of Community Medicine, Assam Medical CollegeDepartment of Community and Family Medicine, All India Institute of Medical SciencesDepartment of Community and Family Medicine, All India Institute of Medical SciencesDepartment of Community Medicine and Family Medicine, All India Institute of Medical SciencesIndian Council Medical Research - National Institute of EpidemiologyAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and TechnologyCentre for Noncommunicable Diseases, National Centre for Disease Control, Directorate General of Health ServicesDepartment of Community Medicine, B J Govt. Medical CollegeDivision of Public Health Nutrition, Indian Council Medical Research - National Institute of NutritionDepartment of Community Medicine / Prevention & Social Medicine, Tezpur Medical CollegeRegional Director Office, Ministry of Health and Family WelfareDepartment of General Medicine, All India Institute of Medical SciencesDepartment of Community and Family Medicine, All India Institute of Medical SciencesDepartment of Community and Family Medicine, All India Institute of Medical SciencesDepartment of Preventive and Social Medicine, Rajendra Institute of Medical SciencesDepartment of Community and Family Medicine, All India Institute of Medical SciencesDepartment of Epidemiology, Indian Council Medical Research - Rajendra Memorial Research Institute of Medical SciencesDepartment of Community Medicine and Family Medicine, All India Institute of Medical SciencesDepartment of Community Medicine and Family Medicine, All India Institute of Medical SciencesDepartment of Community Medicine, Government Medical CollegeDepartment of Public Health and Community Medicine, Central University KeralaCentre for Noncommunicable Diseases, National Centre for Disease Control, Directorate General of Health ServicesDepartment of Community Medicine, Maulana Azad Medical College and Associated HospitalsDepartment of Community Medicine, B J Govt. Medical CollegeAbstract Background The monitoring framework for evaluating health system response to noncommunicable diseases (NCDs) include indicators to assess availability of affordable basic technologies and essential medicines to treat them in both public and private primary care facilities. The Government of India launched the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) in 2010 to strengthen health systems. We assessed availability of trained human resources, essential medicines and technologies for diabetes, cardiovascular and chronic respiratory diseases as one of the components of the National Noncommunicable Disease Monitoring Survey (NNMS - 2017-18). Methods NNMS was a cross-sectional survey. Health facility survey component covered three public [Primary health centre (PHC), Community health centre (CHC) and District hospital (DH)] and one private primary in each of the 600 primary sampling units (PSUs) selected by stratified multistage random sampling to be nationally representative. Survey teams interviewed medical officers, laboratory technicians, and pharmacists using an adapted World Health Organization (WHO) – Service Availability and Readiness Assessment (SARA) tool on handhelds with Open Data Kit (ODK) technology. List of essential medicines and technology was according to WHO - Package of Essential Medicines and Technologies for NCDs (PEN) and NPCDCS guidelines for primary and secondary facilities, respectively. Availability was defined as reported to be generally available within facility premises. Results Total of 537 public and 512 private primary facilities, 386 CHCs and 334 DHs across India were covered. NPCDCS was being implemented in 72.8% of CHCs and 86.8% of DHs. All essential technologies and medicines available to manage three NCDs in primary care varied between 1.1% (95% CI; 0.3–3.3) in rural public to 9.0% (95% CI; 6.2–13.0) in urban private facilities. In NPCDCS implementing districts, 0.4% of CHCs and 14.5% of the DHs were fully equipped. DHs were well staffed, CHCs had deficits in physiotherapist and specialist positions, whereas PHCs reported shortage of nurse-midwives and health assistants. Training under NPCDCS was uniformly poor across all facilities. Conclusion Both private and public primary care facilities and public secondary facilities are currently not adequately prepared to comprehensively address the burden of NCDs in India.https://doi.org/10.1186/s12913-021-06530-0Health systemsHuman resourcesMedicinesNoncommunicable diseasesPrimary health careTechnologies |
spellingShingle | Anand Krishnan Prashant Mathur Vaitheeswaran Kulothungan Harshal Ramesh Salve Sravya Leburu Ritvik Amarchand Baridalyne Nongkynrih Himanshu Kumar Chaturvedi P. Ganeshkumar Vinay Urs K S Avula Laxmaiah Manjit Boruah Sanjeev Kumar Binod Kumar Patro Pankaja Ravi Raghav Prabu Rajkumar P. Sankara Sarma Rinku Sharma Muralidhar Tambe N. Arlappa Tulika Goswami Mahanta Pranab Jyoti Bhuyan Rajnish P. Joshi Abhijit P. Pakhare Abhiruchi Galhotra Dewesh Kumar Binod Kumar Behera Roshan K. Topno Manoj Kumar Gupta Neeti Rustagi Atulkumar V. Trivedi K. R. Thankappan Sonia Gupta Suneela Garg Sangita Chandrakant Shelke ICMR-NNMS investigator group Co-investigators Collaborators Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS) BMC Health Services Research Health systems Human resources Medicines Noncommunicable diseases Primary health care Technologies |
title | Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS) |
title_full | Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS) |
title_fullStr | Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS) |
title_full_unstemmed | Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS) |
title_short | Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS) |
title_sort | preparedness of primary and secondary health facilities in india to address major noncommunicable diseases results of a national noncommunicable disease monitoring survey nnms |
topic | Health systems Human resources Medicines Noncommunicable diseases Primary health care Technologies |
url | https://doi.org/10.1186/s12913-021-06530-0 |
work_keys_str_mv | AT anandkrishnan preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT prashantmathur preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT vaitheeswarankulothungan preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT harshalrameshsalve preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT sravyaleburu preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT ritvikamarchand preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT baridalynenongkynrih preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT himanshukumarchaturvedi preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT pganeshkumar preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT vinayursks preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT avulalaxmaiah preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT manjitboruah preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT sanjeevkumar preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT binodkumarpatro preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT pankajaraviraghav preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT praburajkumar preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT psankarasarma preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT rinkusharma preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT muralidhartambe preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT narlappa preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT tulikagoswamimahanta preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT pranabjyotibhuyan preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT rajnishpjoshi preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT abhijitppakhare preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT abhiruchigalhotra preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT deweshkumar preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT binodkumarbehera preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT roshanktopno preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT manojkumargupta preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT neetirustagi preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT atulkumarvtrivedi preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT krthankappan preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT soniagupta preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT suneelagarg preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT sangitachandrakantshelke preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT icmrnnmsinvestigatorgroup preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT coinvestigators preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms AT collaborators preparednessofprimaryandsecondaryhealthfacilitiesinindiatoaddressmajornoncommunicablediseasesresultsofanationalnoncommunicablediseasemonitoringsurveynnms |