Medicine Packaging Research Articles

English

The aim of this study was to determine the knowledge base of traditional medicine practitioners (TMPs) in Benue State in relation to current good manufacturing practice for effective quality, safety, and increased economic value. A cross-sectional study was conducted among the TMPs using questionnaire. Information such as practice area, type of herbal medicine preparations, water quality, preservatives as well as knowledge of packaging of finished herbal medicines was evaluated. Over 55% of the TMPs practice herbal medicine alone, while others combine other traditional medicine disciplines alongside herbal medicine. Majority of the TMPs produce extemporaneous products for their patient while 10% produce products for sale. A number corresponding to 18% of the TMPs use either tap or borehole water, the others use water from well, streams and rivers. The herbal medicines produced by the TMPs are largely liquids and only 47% have any knowledge of preservatives and fewer have any knowledge on packaging of herbal medicines. This study shows that the majority of the TMPs lack appropriate technical resources and knowledge for herbal medicine production. Hence, there is an urgent need for a coordinated intervention in terms of working tools and trainings. Key words: Herbal medicine, Benue State, herbal active ingredients, formulation, conventional dosage form, water supply.

Willingness and ability to pay for health insurance in Afghanistan

The study assessed willingness to join and willingness to pay for health-insurance in Afghanistan and identified associated determinants. A household survey was conducted. Two health-insurance and two medicine-insurance packages were explained to respondents, who were then asked if they would be willing to join the packages and pay for them. The double-bounded dichotomous choice contingent valuation method was used to elicit the maximum amount respondents would be willing to pay for the various benefit packages. Logistic and linear regression models were used to examine determinants of willingness to join and willingness to pay. Most respondents had never heard of health insurance. And yet, when they were told about it, the vast majority of respondents said they would be willing to join one of the four benefit packages and pay for them, ranging from 70.7% for a medicine-only package that included only essential medicines, to 92.4% for a health-insurance package that would cover only primary and secondary care. The average willingness to pay cost was 1,236 (US$21.3), 1,512 (US$26.0), 778 (US$13.4) and 430 (US$7.4) Afghani per person, per year for the primary and secondary; comprehensive primary, secondary and some tertiary; all medicine; and essential medicine packages; respectively. Key determinants of willingness to join, and to pay were similar, including the provinces where respondents were located, wealth status, health expenditures and some demographic characteristics.

Production and optimization of bioplastic (Polyhydroxybutyrate) from Bacillus cereus strain SH-02 using response surface methodology

BackgroundPolyhydroxybutyrate (PHB) is a biopolymer formed by some microbes in response to excess carbon sources or essential nutrient depletion. PHBs are entirely biodegradable into CO2 and H2O under aerobic and anaerobic conditions. It has several applications in various fields such as medicine, pharmacy, agriculture, and food packaging due to its biocompatibility and nontoxicity nature.ResultIn the present study, PHB-producing bacterium was isolated from the Dirout channel at Assiut Governorate. This isolate was characterized phenotypically and genetically as Bacillus cereus SH-02 (OM992297). According to one-way ANOVA test, the maximum PHB content was observed after 72 h of incubation at 35 °C using glucose and peptone as carbon and nitrogen source. Response surface methodology (RSM) was used to study the interactive effects of glucose concentration, peptone concentration, and pH on PHB production. This result proved that all variables have a significant effect on PHB production either independently or in the interaction with each other. The optimized medium conditions with the constraint to maximize PHB content and concentration were 22.315 g/L glucose, and 15.625 g/L peptone at pH 7.048. The maximum PHB content and concentration were 3100.799 mg/L and 28.799% which was close to the actual value (3051 mg/l and 28.7%). The polymer was identified as PHB using FTIR, NMR, and mass spectrometry. FT-IR analysis showed a strong band at 1724 cm− 1 which attributed to the ester group’s carbonyl while NMR analysis has different peaks at 169.15, 67.6, 40.77, and 19.75 ppm that were corresponding to carbonyl, methine, methylene, and methyl resonance. Mass spectroscopy exhibited molecular weight for methyl 3- hydroxybutyric acid.ConclusionPHB–producing strain was identified as Bacillus cereus SH-02 (OM992297). Under optimum conditions from RSM analysis, the maximum PHB content and concentration of this strain can reach (3100.799 mg/L and 28.799%); respectively. FTIR, NMR, and Mass spectrometry were used to confirm the polymer as PHB. Our results demonstrated that optimization using RSM is one of the strategies used for reducing the production cost. RSM can determine the optimal factors to produce the polymer in a better way and in a larger quantity without consuming time.

Herbal Medicine Products Sold in Nigeria: A Pilot Survey

Background: The use of herbal medicine is believed to be on the increase. There is a gradual shift from the use of crude drugs to well packaged, developed and registered herbal medicinal product. Evidence of this trend in Nigeria is seen in the increasing number of herbal medicine products on store shelves.
 Objectives: The aim of the survey was to examine and document herbal medicine products sold in retail stores, pharmacies, generally closed and open markets in the Federal Capital Territory, Abuja and neighbouring localities.
 Methodology: A cross-sectional study using open ended semi-structured questionnaires and data collection tool was employed; descriptive and inferential statistics were done.
 Results and Discussion: Open markets primarily stocked crude drugs (95.7%). In the open markets, only 26.1% of stalls had herbal medicine products. Over 70% of herbal medicines consumed in the FCT were administered orally. Sixty-eight percent of herbal medicine products were made in Nigeria with indications centred around bitters and detoxification (26.4%), fertility and aphrodisiac (16.7%), diabetes and cardiovascular disease (10%). Only 39.3% of products had a form of NAFDAC registration/listing. In the open markets, a huge gap exists in the knowledge of branding, packaging and registration of herbal medicines.
 Conclusion: There is a need to educate traditional medicine practitioners on the essence of drug development and packaging to improve acceptability, national relevance and international recognition. Herbal medicine producers must be further enlightened on the registration requirements and encouraged to register their products.

Quality of clinical studies present in the package inserts of coagulation factors used in the treatment of hemophilia.

ABSTRACTObjective To identify and analyze the quality of scientific evidence from clinical efficacy studies present in the package inserts of coagulation factors, used in the treatment of hemophilia A and B.Methods Documentary study developed in two stages. The first stage consisted of identifying the medicine packages inserts electronically registered in the Brazilian Health Regulatory Agency, and analyzing the availability of the bibliographic references cited therein. This analysis was conducted in the PubMed, SciELO, Google Scholar, and Web of Science databases. The second step was the analysis of the methodological quality of the efficacy studies. Two trained researchers used the Cochrane Collaboration Risk of Bias version 5.1.0 tools for methodological quality analysis, and Review Manager 5.4 software to generate the risk of bias graph.Results Of the 17 medicines listed, 7 had referenced package inserts. Of these, 10 studies were eligible for analysis of methodological quality. More than half of the analyzed studies did not control for selection, performance, and detection bias. A total of 100% controlled attrition and reporting biases, and 50% had a high risk of conflict of interest.Conclusion The biases present are significant and may have influenced the overestimation of the effects of the outcomes of each of the studies.

ANALISIS PENGETAHUAN MAHASISWA TENTANG LOGO PADA KEMASAN OBAT GOLONGAN TRADISIONAL DI UNIVERSITAS IMELDA MEDAN

In Indonesia, traditional medicines are grouped into three types, namely traditional medicines (herbs, imported traditional medicines, licensed traditional medicines), standardized herbal medicines (OHT) and phyto-pharmacy. There are three types of logos with their respective criteria for grouping traditional medicines or natural medicines from Indonesia. The three kinds of traditional medicine logos are the herbal medicine logo, the OHT logo and the fitofarmaka logo. The purpose of this study was to determine the level of knowledge of Imelda University students about the logo on the packaging of traditional medicines. This research is a descriptive survey research and is cross-sectional in nature, namely research that aims to describe the phenomena found at one time and once, both in the form of risk factors and effects or outcomes. Pharmacy students have good knowledge of 84.6% compared to non-pharmaceutical students who have good knowledge of 34.6% about logos on traditional medicine packaging. This is because students in the pharmaceutical field better understand and learn things related to health sciences including information about logos on traditional medicine packaging. Based on research data, it can be concluded that the origin of the study program affects the level of knowledge of the respondents (students), while age, gender, and place of origin did not affect the level of knowledge of the respondents.

Contribution of Unmanned Autonomous Systems (UAS) for the Development of High Tech, Intelligent Machines Capable of Traveling by Air, Land, or Sea without A Human Crew on Board

This article is focused on the contribution of unmanned autonomous systems that are based on the Hitech autonomous system. On the other hand, it also includes an intelligent machine that has the capacity to travel by sea, land, and air without humans. There are different kinds of autonomous robots, vehicles, drones, and warehouse and factory system that helps to provide smart service to individuals. Artificial intelligence plays a major role in the autonomous system and it is responsible for developing the smart system. unmanned aerial vehicle (UAV) that is also known as a drone and is generally used for mapping, wars, product deliveries as well as surveillance. This study has also shone a light on the safe environment development that leads to providing a safe environment through proper surveillance in a large area within a limited time period. In this context, UAVs play a major role in monitoring environmental law enforcement, geographical mapping, and wildlife monitoring. Transportation systems one other advanced facilities provide extraordinary service to society. It can deliver emergency medical products such as medicine, equipment, and other package products. It has been seen that several kinds of transport and logistic markets use these drones to enhance their business and deliver products safely. Accordingly, this study has also discussed the limitations of the UAS system on land, sea, and air. It can be stated that it can be effective for society and future generations. Keywords : Search And Rescue (SAR) drones, Unmanned Aerial Vehicle (UAV), Unmanned Autonomous Systems (UAS)

Analysis of medicines returned to pharmacies for disposal and estimation of the cost due to medicine wasting

BackgroundStudies have shown that waste medicines generate a significant cost for the national health system (NHS) in many countries. No data are available on costs and therapeutic classes of unused medicines in Italy.Objective: Conduct a quantitative and qualitative analysis of unused medicines returned for disposal to selected pharmacies in Rome, Italy, as well as to estimate the related costs for the NHS. MethodsMedicines returned to 4 pharmacies were collected for 8 months. Therapeutic class, number of remaining dosage units, remaining validity, and reimbursement by the NHS were analysed. The cost of reimbursed medicines was estimated on the prices provided by the Italian regulatory agency (AIFA). ResultsThe study sample consisted of 3219 medicine packages containing remaining dosage units, of which 72.4% had expired while 27.6% had not. The average remaining validity of unexpired medicines was 13 months. Medicines reimbursed by the NHS accounted for 73% of the total. Cardiovascular drugs and anti-infectives were the main therapeutic classes (17.2% and 15.2% of total packages, respectively), followed by gastrointestinal drugs, central nervous system (CNS) drugs, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids. The average of remaining dosage units found in the examined packages was 68% of the initial number of units. In terms of cost, antibiotics were the most relevant therapeutic class, followed by cardiovascular drugs, analgesics, corticosteroids, and NSAIDs. The estimated cost for the Italian NHS was € 200,656,780 per year. ConclusionWaste medicines constitute a significant, but reducible cost for the NHS. The high prevalence of anti-infectives in the study sample appears to be a distinctive Italian characteristic and may be due to inappropriate prescribing. Policies aimed at reducing waste should improve prescriptive appropriateness and increase the variety of packaging size.

Pengembangan Plastik Pengemas Obat yang Informatif dan Beradsorben

The problem of labeling on plastic medicine packaging which is less informative and its function in maintaining drug quality is very crucial. The purpose of this research and development is to produce informative and absorbent drug packaging plastics. The method used is the ADDIE research and development model. The development stage is carried out by testing physical stability and chemical stability testing. The implementation phase was carried out by asking for responses from 10 pharmacists and 15 ordinary people. Based on the results of the physical stability test, the drug stored in the plastic packaging of the drug that was developed was more physically stable. Based on the results of chemical stability tests, the absorbance of drugs stored in drug packaging plastics developed is more stable than ordinary drug packaging plastics, which is indicated by a smaller slope value. Based on the questionnaires distributed to pharmacists, they strongly agree with the adequacy of the information and agree with the readability, attractiveness of appearance, and usefulness of the adsorbent in the plastic drug packaging developed. Based on the questionnaires distributed to the general public, they strongly agree with the adequacy of the information and agree with the readability, attractiveness of appearance, and the usefulness of the adsorbent in the plastic drug packaging developed.

ИЗМЕНЧИВОСТЬ СОДЕРЖАНИЯ БИОЛОГИЧЕСКИ АКТИВНЫХ ВЕЩЕСТВ ТРАВЫ ЧЕРЕДЫ ПОНИКШЕЙ В ПРОЦЕССЕ ХРАНЕНИЯ

The aim is to study the variability of the content of Bidens cernua herb biologically active substances in the storage process. The content of biologically active substances (polysaccharides and flavonoids) in Bidens cernua herb during storage for two years was monitored every 3 months for two series: series A simulated the storage of medicinal plant raw materials prior to their use in industrial production, series B completely repeated the most frequently used packaging for herbal medicines. Additionally, the content of the dominant flavonoids quercitrin and luteolin-O-7-glucoside, as well as the product of its hydrolysis, luteolin, was assessed annually by liquid chromatography. It has been established that a decrease in the polysaccharides content by no more than 5% in series A was observed within 9 months, in series B - within 12 months. After 24 months of storage, the polysaccharides content in Bidens cernua herb was higher in series B. A decrease in the content of the sum of flavonoids by no more than 5% was observed within 6 months for both series. After 24 months, the content of the sum of flavonoids, as well as quercitrin and luteolin-O-7-glucoside, was higher in series A. Thus, the choice of the optimal packaging for storing Bidens cernua herb will be determined by the requirement for the quality of medicinal plant raw materials in terms of the content of biologically active substances, which, in its turn, will determine the expected pharmacological activity of this type of medicinal plant material.

Synthesis, characterization and significant antimicrobial properties of CZTS nanoparticles against pathogenic strains

Antibacterial properties have wide application in water disinfection, textile industry, medicine, and food packaging. The present work focuses on the efficacy of Cu2ZnSnS4 (CZTS) nanoparticles as a possible promising antibacterial agent along those directions. CZTS nanomaterials were synthesized following the solvo-thermal method using Teflon-lined stainless-steel autoclave. Nanoparticles were characterized using XRD, Raman spectroscopy, UV–visible spectroscopy, and SEM techniques. SEM shows that the size of synthesized nanoparticle was 50-100 ​nm. Antibacterial activity of CZTS nanoparticles was performed against ten pathogenic bacterial strains, which include 5 Gram-positive strains (viz. Staphylococcus epidermidis, Bacillus megaterium, Mycobacterium smegmatis, Lactobacillus and Staphylococcus aureus) and 5 Gram-negative strains (viz. Serratia marcescense, Salmonella typhi, Escherichia coli, Proteus vulgaris and Pseudomonas aeruginosa), using the well diffusion method. CZTS nanoparticles shows significant antibacterial activity against both the Gram-positive and Gram-negative bacterial strains. Notable increase in the antibacterial activity of CZTS nanoparticles has been observed with the increase in the concentration of nanoparticles in terms of zone of inhibition (ZOI), which helps us to study the cell toxicity. Minimum inhibitory concentration (MIC) has been observed with the lowest concentration of nanoparticles that show visible growth of bacteria, which certainly may contribute significantly toward possible medicinal applications of CZTS nanoparticles.

Public and pharmacist views on the appearance of and messaging on antibiotics to address inappropriate use

The main purpose of medicines labelling and packaging is to provide clear unambiguous identification of the medicine and the conditions for its safe use. This information, together with its format and style, is essential for minimising medication errors by enabling patients, carers and healthcare professionals to select the correct medicine, use it safely and to […]

A quality audit of the medicinal package insert information of drugs marketed in India

Background: A package insert (PI) accompanying medicinal products is a concise and accessible source of evidence-based information for health professionals and consumers alike. In India, the supplied information should be adequate and fulfill the statutory regulations of the Drug and Cosmetics Rules (1945) to ensure the safe and effective use of the drug. Aim and Objectives: The present observational study aimed to evaluate the uniformity and adequacy of information on PIs available in India. Materials and Methods: PIs of approved and marketed drugs were collected from pharmacies and analyzed with the help of a 30-item checklist comprising of components of statutory guidelines and other quality indicators. Each item was assigned a weightage of two if the information was complete, one if inadequate, and 0 if absent. The total score was calculated for each PI. Results: The median score of the 150 analyzed PIs was 41 (Inter quartile range, 36.00–45.25) out of a maximum value of 60. The major deficiencies observed were in providing missed dose instructions (91.33%), further reading resources (84.67%), supporting references (83.33%), and drug disposal instructions (76%). Other notable missing information were laboratory parameter interference (68.67%), clinical trial data (62%), adverse drug reaction reporting contact information (56.67%), and a list of excipients (49.33%). Conclusion: There are important inadequacies in the clinical information provided in Indian PIs which can affect patient health and hinder rational drug use. Thorough evaluation and revision of the PIs is warranted to make them more reliable and popular among users.

Active search about latex in injectable drugs for patient’s safety in medical therapy

Objectives: To classify injectable drugs used in a general hospital inventory according to latex presence or absence in vials with rubber stoppers, antibiotics, and electrolytes bags. Methods: The information about latex content has been collected from medicine industries, after identification of authorized manufacturers in Brazil, through the National Health Surveillance Agency (ANVISA) medicine search database. Medicines have been grouped per pharmaceutical manufacturers, and data were collected through telephone or e-mail. Only written information from pharmaceutical companies were considered. Results: Among 161 medicines used in the hospital packaged in vials with rubber stoppers, antibiotics, and electrolytes bags, 123 (76.4%) medicine-related responses were received, covering 540 (82.2%) different presentations. For this, from 87 contacts, 70 (80.5%) companies responded and 65 (74.7%) provided information related to the presence or absence of the allergen. Among the medicine list, 8 (6.5%) were identified as containing latex (in 12 different presentations – 2.2%) and 101 medications (82.1%) in 507 presentations (93.9%) do not contain latex. The manufacturers responded that the medicine was latex-free, but could not confirm for raw materials (6 medicines – 4.9% - in 6 different presentations – 1.1%) and that they were unable to ensure there was no contact with latex during manipulation (4 medicines – 3.3% - in 8 different presentations – 1.5%). For 4 medicines (3.3%) in 7 different presentations (1.3%), the companies were inconclusive, as they could not confirm whether they were latex-free or not. Conclusion: Although latex is a known allergen, information about the presence of latex components in pharmaceutical packaging and package inserts needs improvement, since the active search identified 161 medicines packaged in vials with rubber stoppers, antibiotics, and electrolytes bags that failed to depict this information. The results of this survey endorse the Importance of displaying this information on medicines label or packaging in order to ensure healthcare professionals easy access and prompt consultation.

Enhancing the thermostability, UV shielding and antimicrobial activity of transparent chitosan film by carbon quantum dots containing N/P

The chitosan (CS) transparent film has attracted much attention in food and medicine packaging areas due to their biodegradability and good availability. A novel carbon quantum dots compound containing nitrogen and phosphorus (NP-CQDs) was obtained by reacting citric acids, with urea and phytic acids. The density of the film was increased, and the water vapor permeation was reduced by the presence of NP-CQDs. The introduction of 4 wt% NP-CQDs increased the water contact angle of the CS film from 79.2° to 105.8°. The shielding on UV-A and UV-B transmittance was increased with the NP-CQDs loading. The film containing 4 wt% NP-CQDs blocked more than 90.2% UV-A and 96.5% UV-B; however, it only blocked 26.8% visible light. It also exhibited better antibacterial activity to both E. coli and S. aureus than the control CS film. This work provided a feasible way to prepare multifunctional bio-safe film.

Application of hot compress technique with Chinese herbal medicine package in a patient with knee osteoarthritis and related nursing management

Application of hot compress technique with Chinese herbal medicine package in a patient with knee osteoarthritis and related nursing management

Polyacrylate Decorating Poly(ethylene terephthalate) (PET) Film Surface for Boosting Oxygen Barrier Property

Polymeric barrier materials are critical in contemporary industries for food, medicine, and chemical packaging. However, these materials, such as PET films, are impeded by the optimization of barrier properties by virtue of molecular design. Herein, a new methyl methacrylate-methyl acrylate-diallyl maleate-maleic acid (MMA-MAc-DAM-MA) was synthesized to tailor the surface properties of PET films for maximizing oxygen barrier properties. During the MMA-MAc-DAM-MA coating and curing process, the chemical structure evolutions of MMA-MAc-DAM-MA coatings were characterized, indicating that the cross-linking conversion and proportion of –COOH groups are critical for the oxygen barrier properties of coatings. The inherent –COOH groups are transformed into designed structures, including intramolecular anhydride, inter-chain anhydride and retained carboxylic acid. Therein, the inter-chain anhydride restraining the activity of coated polymer chain mainly contributes to enhanced barrier properties. The thermal properties of novel coatings were analyzed, revealing that the curing behavior is strongly dependent on the curing temperatures. The impacts of viscosity of the coating solution, coating velocity, and coating thickness on the oxygen permeability (Po2) of the coatings were investigated using a gas permeability tester to explore the optimum operating parameters during practical applications, which can reduce the Po2 of PET film by 47.8%. This work provides new insights on advanced coating materials for excellent barrier performance.

Ecodesign approach for pharmaceutical packaging based on Life Cycle Assessment

Packaging ecodesign can contribute to improve the environmental performance of pharmaceutical products. The main goal of this article is to present an ecodesign approach based on Life Cycle Assessment (LCA) for pharmaceutical packaging, assessing opportunities to improve the packaging environmental performance, and providing ecodesign recommendations to the pharmaceutical sector. The proposed ecodesign approach consists of five phases. I) The most representative packaging of medicines in the market (blister, bottle, and sachet), with different sizes, materials and weights, were investigated. II) Three ecodesign strategies were selected to analyze with LCA: i) weight and/or volume reduction, ii) alternative types of packaging, and iii) transportation with less environmental impact. III–IV) A cradle-to-gate life cycle model has been implemented, including transport to pharmacies. Alternative transportation modes (truck, train, airplane, and ship) and different packaging production locations have been considered. Thirteen environmental categories have been analyzed. V) Ecodesign recommendations for improving the environmental performance of pharmaceutical packaging are presented in two stages: i) specific recommendations based on LCA, illustrated in sheets with examples of ecodesign, quantifying the environmental impact reduction of an ecodesign solution compared to the original; and ii) generic recommendations for different packaging life cycle phases. Ecodesign recommendations highlight the use of smaller-size packaging, avoiding superfluous elements and empty spaces, which reduces material and production costs, and transportation impacts; the selection of modes of transportation with less environmental impact, considering the packaging production location; and the use of electric vehicles for pharmacy distribution. This ecodesign approach based on LCA allows quantifying environmental impacts robustly to support the incorporation of environmental information from the design, material selection, and packaging production to distribution till the final consumer. This article emphasizes the importance of developing specific packaging ecodesign based on LCA to improve environmental performance and provide more informed recommendations to stakeholders.

Application of hot compress technique with Chinese herbal medicine package in a patient with knee osteoarthritis and related nursing management

Application of hot compress technique with Chinese herbal medicine package in a patient with knee osteoarthritis and related nursing management

Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS)

BackgroundThe monitoring framework for evaluating health system response to noncommunicable diseases (NCDs) include indicators to assess availability of affordable basic technologies and essential medicines to treat them in both public and private primary care facilities. The Government of India launched the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) in 2010 to strengthen health systems. We assessed availability of trained human resources, essential medicines and technologies for diabetes, cardiovascular and chronic respiratory diseases as one of the components of the National Noncommunicable Disease Monitoring Survey (NNMS - 2017-18).MethodsNNMS was a cross-sectional survey. Health facility survey component covered three public [Primary health centre (PHC), Community health centre (CHC) and District hospital (DH)] and one private primary in each of the 600 primary sampling units (PSUs) selected by stratified multistage random sampling to be nationally representative. Survey teams interviewed medical officers, laboratory technicians, and pharmacists using an adapted World Health Organization (WHO) – Service Availability and Readiness Assessment (SARA) tool on handhelds with Open Data Kit (ODK) technology. List of essential medicines and technology was according to WHO - Package of Essential Medicines and Technologies for NCDs (PEN) and NPCDCS guidelines for primary and secondary facilities, respectively. Availability was defined as reported to be generally available within facility premises.ResultsTotal of 537 public and 512 private primary facilities, 386 CHCs and 334 DHs across India were covered. NPCDCS was being implemented in 72.8% of CHCs and 86.8% of DHs. All essential technologies and medicines available to manage three NCDs in primary care varied between 1.1% (95% CI; 0.3–3.3) in rural public to 9.0% (95% CI; 6.2–13.0) in urban private facilities. In NPCDCS implementing districts, 0.4% of CHCs and 14.5% of the DHs were fully equipped. DHs were well staffed, CHCs had deficits in physiotherapist and specialist positions, whereas PHCs reported shortage of nurse-midwives and health assistants. Training under NPCDCS was uniformly poor across all facilities.ConclusionBoth private and public primary care facilities and public secondary facilities are currently not adequately prepared to comprehensively address the burden of NCDs in India.