Indian Public Health Standards 2012 and the diabetes pharmacopoeia

Abstract

As India grapples with an unprecedented epidemic of non-communicable diseases, the healthcare system faces more demands and newer challenges. Earlier geared towards infectious diseases, maternal and child health problems, public health issues and now includes in its ambit ‘modern’ or non-communicable disease diabetes mellitus. The growing concern of disease burden as per global and national statistics is well-known and needs no repetition in this journal. The Indian Public Health Standards (IPHS), revised in 2012,[1,2,3,4,5] are an attempt to set operating standards for government health institutions, ranging from sub-centers and primary health centers to sub-district/sub-divisional and district hospitals. The IPHS provide exhaustive coverage of the physical and human resources necessary to run health institutions, duties and responsibilities of staff, and the processes and procedures by which these are to be achieved. Included in the IPHS are lists of drug to be made available at health facilities of various levels. To some extent, but not completely, the drug lists of the IPHS demonstrate concordance with the National List of Essential Medicines (NLEM).[6] The NLEM, last revised in 2011, is a governmental list of drugs, which are essential at primary, secondary, and tertiary levels of healthcare system. The strong presence of endocrine pharmacopoeia in the Indian NLEM has already been discussed.[7] This underscores the heightened importance given to endocrine and metabolic disease at the policy-maker level. Equally important, it also demonstrates the responsibility felt by the endocrine community towards fulfilling its mandate of better patient care at not only the individual, but also the public health level. This editorial discusses the diabetes drugs listed in the IPHS, and suggests simple changes which maybe implemented to improve care for people with diabetes, irrespective of which healthcare facility they choose to visit. The Indian public health system comprises of sub-centers, primary healthcare centers, community health centers, sub-district and sub-divisional hospitals (31 to 100 beds), and district hospitals (101 to 500 beds). Each level of healthcare performs different duties and fulfils unique responsibilities. This is achieved with a pre-specified set of physical equipments and drug lists.