Key result
India Hypertension Control Initiative linked to ~54% more individuals seeking hypertension treatment at government facilities.
Why the study?
The study evaluated changes in health-seeking behaviour, prescription practices, and key predictors influencing public sector hypertension treatment adoption under the India Hypertension Control Initiative.
Does the India Hypertension Control Initiative improve health-seeking behavior, prescription practices, and blood pressure control in the public sector among adults in India?
Cross-Sectional (n=6,149)
Yes
Does the India Hypertension Control Initiative improve health-seeking behavior, prescription practices, and blood pressure control in the public sector among adults in India?
Relative Risk: 1.54 (95% CI 1.4–1.7)
Absolute Event Rate: 32% vs 20%
p-value: p=<0.01
The India Hypertension Control Initiative was associated with increased public sector healthcare utilization, improved blood pressure control, enhanced drug availability, and reduced out-of-pocket medication costs.
May support scaling public-sector hypertension programs in India; leaves open causal effects and generalizability.
The India Hypertension Control Initiative (IHCI) aimed to strengthen public sector primary care for hypertension treatment and control. Our study describes changes in health-seeking behaviour, prescription practices, and key predictors influencing treatment adoption in the public sector using data from IHCI repeat cross-sectional surveys. We conducted baseline (2018-19) and follow-up (2023-24) surveys in nine districts across five Phase I states in India - two districts each from Punjab, Madhya Pradesh, Telangana, and Kerala, and one from Maharashtra. We conducted the survey among 3,900 adults (18-69 years) per district at two time points. We computed frequencies and proportions for socio-demographic variables, healthcare utilisation, blood pressure (BP) control, drug availability, medication costs, and prescription practices. We used a log-binomial model to estimate unadjusted and adjusted prevalence ratios (PRs, APRs) with 95% confidence intervals for factors influencing care-seeking for hypertension in government facilities. Among 2,873 baseline and 3,276 follow-up respondents, the proportion seeking treatment at government facilities increased from 20% to 32%. Individuals on treatment were 1.5 times more likely to use government facilities in 2023-24 than in 2018-19 (aPR 1.54, 95% CI: 1.4-1.7). BP control improved in government (37% to 48%) and non-government (35% to 47%) facilities. Drug availability (always available) in government facilities rose from 72% (425/588) to 81% (844/1041), with Amlodipine 5 mg remaining the most prescribed drug (18%). The proportion of individuals paying for medications dropped from 47% to 9%. There was increased public sector use, improved BP control, enhanced drug availability, and reduced costs, possibly due to IHCI interventions. We recommend using representative surveys for NCD surveillance to monitor healthcare utilisation patterns and assess the impact of interventions on hypertension outcomes. KeywordsBlood Pressure; Hypertension; Public Sector; Primary Health Care; Drug Prescriptions; Patient Acceptance of Health Care; India.
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Kaur et al. (2025) conducted a cross-sectional in Hypertension (n=6,149). Follow-up period (2023-24) post-IHCI implementation vs. Baseline period (2018-19) was evaluated on Seeking treatment at government facilities (aPR 1.54, 95% CI 1.4-1.7, p=<0.01). Following the implementation of the India Hypertension Control Initiative, the proportion of individuals seeking hypertension treatment at government facilities increased from 20% to 32% (aPR 1.54).
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