Public health facility type was significantly associated with clinical control of NCDs (P<0.001), with district hospitals achieving the highest hypertension-control rates (45.3%).
Cross-Sectional
Yes
Does the type and location (urban vs rural) of public health facilities affect the quality of hypertension and diabetes care in India?
Rural CHCs and district hospitals outperform urban primary care facilities in managing hypertension and diabetes in India, highlighting the need for strategic strengthening of urban health centers.
p-value: p=<0.001
Introduction: Non-communicable diseases (NCDs), particularly hypertension and diabetes, are major contributors to India’s growing disease burden. Strengthening public health systems for effective prevention and management is imperative. So, the aim was to assess and improve the quality of hypertension and diabetes care and control in healthcare facilities in India. Methods: A multicentric cross-sectional study was conducted across six purposively selected states of India encompassing Uttarakhand, Punjab, Gujarat, Maharashtra, Assam, and Arunachal Pradesh. In each state, data were collected from one district hospital, two Community Health Centers (CHCs), and two Health and Wellness Centers (HWCs)—one rural and one urban—capturing services at all public healthcare levels. A questionnaire based on National Programmer for Prevention and Control of non-communicable diseases (NP-NCD) and Indian Public Health Standards (IPHS) guidelines, along with supervision checklists, was used. Ethical approvals were obtained, and field teams were regularly monitored for quality assurance. Results: Significant urban–rural disparities were observed in NCD service delivery. Rural HWCs had better availability of NCD clinics, essential medicines, and follow-up mechanisms, whereas urban HWCs showed higher diagnostic testing, but lower treatment adherence and control. Rural CHCs demonstrated superior service utilization and clinical outcomes compared to urban CHCs. District hospitals offered the most comprehensive care, achieving the highest treatment-adherence (71.2%) and hypertension-control rates (45.3%). System-wide issues such as medicine stock-outs and limited staff training were prevalent. Statistical analysis revealed a significant association between facility type and clinical control of NCDs ( P < 0.001). Conclusion: Rural CHCs and district hospitals outperformed urban primary care facilities in managing hypertension and diabetes. To meet national NCD targets, strategic strengthening of urban HWCs through workforce training, uninterrupted drug supply, digital tracking, and governance reforms is essential.
Aggarwal et al. (Fri,) conducted a cross-sectional in Hypertension and diabetes. Public health facility type was evaluated on Clinical control of NCDs (p=<0.001). Public health facility type was significantly associated with clinical control of NCDs (P<0.001), with district hospitals achieving the highest hypertension-control rates (45.3%).
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