Abstract P182: Workforce Reforms And Task Sharing To Improve Hypertension Treatment Coverage In India

Abstract

Background: Most patients with hypertension in India are not treated, in part due to insufficient healthcare providers. Objective: Estimate the current hypertension treatment capacity of the public healthcare system in India and simulate the effects of workforce system and treatment reforms designed to increase coverage of hypertension treatment. Methods: We estimated the hypertension treatment capacity and salary costs of public healthcare facilities (subcenters, primary and community healthcare centers) under different assumptions on workforce size, task sharing, and treatment frequencies. Results: In 2020, an estimated 9% of all hypertensives in India (~23 million adults) are being treated for hypertension in subcenters and primary/community healthcare centers. Treating 30% of hypertensives without task sharing would require an additional >400,000 staff and >340 billion INR/year in salaries ( Figure ). Task sharing under current legislation was estimated to allow the current workforce to treat 14%, while a feasible extension of task sharing beyond the current legislation (e.g., allowing nurses to prescribe medicines) could treat 57% of hypertensive adults with the same workforce. Applying quarterly visits in addition to the extended task sharing, the current workforce could treat all hypertensives adults in India. Conclusion: Under the current practice, even modest increases of hypertension treatment coverage will require substantial additional human and financial resources. Extended task sharing plus fewer visits with longer prescription period may achieve nationwide hypertension treatment at public systems without additional workforce.