ArticlePloS one2023
Improving the availability of antihypertensive drugs in the India Hypertension Control Initiative, India, 2019-2020.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Community health worker-facilitated home visits for hypertension management in urban Nepal: a mixed-methods process evaluation.BMJ open · 2026Trial
- Changing patterns in health-seeking behaviour and prescription practices for treatment of hypertension in nine districts - insights from India Hypertension Control Initiative, 2018-19 and 2023-24.BMC public health · 2025Article
- Preparedness of public & private health facilities for management of diabetes & hypertension in 19 districts in India.The Indian journal of medical research · 2025Article
- Missed opportunities for detection of hypertension in public health facilities of 18 districts in India, 2022.BMC public health · 2025Article
- Effects of medication procurement reforms and extended prescription duration on medication coverage for hypertension in India's public health system: a modelling study.BMJ public health · 2025Article
- Comparing scale up of status quo hypertension care against dual combination therapy as separate pills or single pill combinations: an economic evaluation in 24 low- and middle-income countries.EClinicalMedicine · 2024Article
- India Hypertension Control Initiative: decentralization of hypertension care to health wellness centres in Punjab and Maharashtra, India, 2018-2022.BMC health services research · 2024Article
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAntihypertensive drug supply is sometimes inadequate in public sector health facilities in India. One of the core strategies of the India Hypertension Control Initiative (IHCI) is to improve the availability of antihypertensive drugs in primary and secondary care facilities. We quantified the availability of antihypertensive drugs in 2019-20 and described the practices in supply chain management in 22 districts across four states of India.
methodsTwenty-two districts from 4 states (Punjab, Madhya Pradesh, Telangana, and Maharashtra) were studied. We described the practices and challenges in supply chain management. We collected data on drug procurement from 2018 to 2020 and drug availability from April 2019 to March 2020. Quantity procured, the proportion of facilities with stockout at the end of each quarter, and availability of drugs in patient days were tabulated.
resultsAll states selected drug- and dose-specific protocols with Amlodipine as the initial drug and shifted to morbidity-based forecasting. The total number of antihypertensive tablets procured for the 22 districts increased from 16 million in 2017-2018 to 160 million in 2019-2020. The proportion of facilities with Amlodipine stock-out was below 5% during the study period. Amlodipine stock was available for at least 60 patient days from the third quarter of 2019 onward in all districts.
conclusionsThis study demonstrates that including best practices can gradually strengthen the procurement and supply chain for antihypertensives in a low-resource setting. As the program was rapidly growing, there were still gaps in the procurement and distribution system which needed to be addressed to ensure the adequacy of drugs. We recommend that best practices, including choosing a single protocol, basing supply on projected patient load rather than an increment from historical levels, and using simple stock management tools, be replicated in other districts in India to increase and sustain coverage of hypertension treatment.
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