A PERSPECTIVE OF PRIVATE HEALTH CARE PROVIDERS IN THE STATE OF MADHYA PRADESH ON ADOPTING KEY STRATEGIES OF INDIA HYPERTENSION CONTROL INITIATIVE

Abstract

Objective: The India Hypertension Control Initiative (IHCI) has been implemented in public health facilities of three districts of Madhya Pradesh (MP). In India, more than 70% of outpatient visits take place in the private health sector. To achieve the Government of India's goal of a 25% relative reduction in the prevalence of raised blood pressure (BP) by 2025, it is critical to expand the implementation of quality hypertension treatment. This study aimed to assess the perspective of private practitioners (PPs) on adopting the core strategies of the IHCI in Bhopal district of MP Design and method: A semi-structured detailed interview was purposely applied to 30 PPs who were familiar with IHCI to obtain their opinions on standardised hypertension treatment protocols, patient-centred services and easy-to-use information system in their private practice. Verbatim data were recorded and analysed thematically using the Microsoft 2010. Results: Only 11 PPs followed the State approved hypertension treatment protocol. Among the remaining 19 PPs, the major reasons for not adopting protocol were (1) limited availability of single component hypertension drugs (13 PPs), (2) preferences for single fixed combinations drug (10 PPs) and (3) fear of losing patients due to a lack of immediate BP control or drug-related adverse effects (7 PPs). None of the interviewed doctors had resources to provide patient-centred care and use the information system. Overall, the interviewed doctors identified that free supply of standard treatment protocols (12 PPs), inclusion of single-pill combinations in treatment protocol (10 PPs), increasing number of staff for follow-up visits and patient education (19 PPs), IT-based solutions for patient records (17 PPs), employee incentives (5 PPs) and preparation of national data sharing policies (5 PPs) are the key actions to accelerate the adoption of IHCI strategies in the private sector. Conclusions: This exploratory study suggests that engagement of the private sector in IHCI is feasible. Future studies should focus on ensuring the wider availability of hypertension treatment protocol drugs and developing a simple user-friendly digital platform for patient monitoring.