Strengthening primary health care in rural western India-team based approach
DOI:
https://doi.org/10.18203/2320-6012.ijrms20230880Keywords:
Team based care, NCDs, Primary health care, Rural healthcare, Western India, ModelAbstract
Background: Non-communicable diseases (NCDs), such as cardiovascular diseases (CVDs), diabetes, have taken an epidemic form. With a huge population and existing sedentary lifestyle, in developing countries like India, there exists a struggle to deliver quality chronic care. A reorganization of systems in healthcare service delivery is crucial to improve primary healthcare. We have reported our model to address primary healthcare service delivery in rural settings. The SPARSH team-based care approach is designed with the objective of improving adherence to anti-hypertensive and anti-diabetic medications to improve blood pressure (BP) and blood sugar (BS) control among hypertension (HTN) and diabetes mellitus (DM) patients.
Methods: This is a descriptive study describing a model and array on interventions delivered through a team-based care approach from 2016 till 2020 by Shree Krishna Hospital, Karamsad across three districts in Gujarat. Data was collected on case record forms and later was analysed using Microsoft excel.
Results: From the financial year of 2016 till 2020 patients enrolled in SPARSH increased from 932 till 1920 for availing treatment and ongoing care. A total of 108 training sessions were conducted and facilitated by a senior member of SPARSH. Average monthly cost of treatment for hypertensive, diabetic and patients with both conditions was Rs. 38, 78 and 130 respectively.
Conclusions: Our model described here can be tested for effectiveness through a rigorous community trial focusing on objective outcome measures such as BP control and glycemic control.
Metrics
References
Dandona L, Dandona R, Kumar GA, Shukla DK, Paul VK, Balakrishnan K, et al. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet. 2017;390:2437-60.
Charlson FJ, Baxter AJ, Cheng HG, Shidhaye R, Whiteford HA. The burden of mental, neurological, and substance use disorders in China and India: a systematic analysis of community representative epidemiological studies. The Lancet. 2016;388:376-89.
SDGs. Sustainable Development Knowledge Platform, 2020. Available at: https://sustainabledevelopment.un.org/topics/sustainabledevelopmentgoals. Accessed on 10 January 2023.
Cabinet approves National Health Policy, 2017. Available at: https://www.pmindia.gov.in/en/news_ updates/cabinet-approves-national-health-policy-2017/. Accessed on 10 January 2023.
The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990-2016. Lancet Global Heal. 2018;12:e1339-51.
Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32:1170-7.
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: phase I results of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Diabetologia. 2011;54:3022-7.
Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002;15:1909-14.
Organization WHO. Technical package for cardiovascular disease management in primary health care: healthy-lifestyle counselling, 2018. Available at: https://apps.who.int/iris/handle/ 10665/260422. Accessed on 10 January, 2023.
Jacob V, Chattopadhyay SK, Thota AB, Proia KK, Njie G, Hoplins DP, et al. Economics of Team based Care in Controlling Blood Pressure: A Community Guide Systematic Review. Am J Prev Med. 2015;49:772-83.
Team-Based Care and Improved Blood Pressure Control, 2020. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672378/. Accessed on 10 January 2023.
SPARSH Programme. Available at: https://youtu.be/E7fhFQTqdmE. Accessed on 10 January, 2023.
Rao CR, Kamath VG, Shetty A, Kamath A. A study on the prevalence of type 2 diabetes in coastal Karnataka. Int J Diabetes Dev Ctries. 2010;30:80-85.
Nguyen KH, Chien AT, Meyers DJ, Li Z, Singer SJ, Rosenthal MB. Team-Based Primary Care Practice Transformation Initiative and Changes in Patient Experience and Recommended Cancer Screening Rates. Inq J Med Care Organ Provis Financ. 2020;57:46958020952911.
WHO | HEARTS Technical Package, 2021. Available at: https://www.who.int/cardiovascular_ diseases/hearts/en/. Accessed on 10 January 2023.
Roy K, Dutt B, Patel JM, Raithatha SJ. SPARSH electronic sub-health centers (e‐SHCs)-A model of nurse‐run SHCs supported by general practitioners through telemedicine. J Family Med Prim Care 2022;11:5556-62.