ArticleBMC health services research2024
India Hypertension Control Initiative: decentralization of hypertension care to health wellness centres in Punjab and Maharashtra, India, 2018-2022.
Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Change in cascade of care among individuals with hypertension - India hypertension control initiative, 2018-2024.American journal of preventive cardiology · 2026Article
- Integration of Cardiovascular Disease Services within Primary Health Care Systems: Insights from South Asia.Current atherosclerosis reports · 2026Review
- Clustering of hypertension and clustering of diabetes at the household level and variations in disease awareness within households in India: findings from a nationally representative household survey.BMJ global health · 2026Article
- Article
- Functionality of Ayushman Arogya Mandirs for hypertension & diabetes care in nine districts of 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
- Unlocking health equity by eliminating copayments for essential antihypertensive medications.EClinicalMedicine · 2025Review
- Improving follow-up visits among individuals with hypertension: Quality Improvement project in the District Hospital, Seoni, Madhya Pradesh, India, 2021-2022.BMJ open quality · 2025Article
- Fourth UNHLM on noncommunicable diseases 2025: An opportunity to bridge the transcending priorities for impact in global south.PLOS global public health · 2025Article
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Authors and funding
25 authors.
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Abstract
introductionThe India Hypertension Control Initiative (IHCI) emphasizes decentralized patient-centric care to boost hypertension control in public healthcare facilities. We documented the decentralization process, enrolment pattern by facility type, and treatment outcomes in nine districts of Punjab and Maharashtra states, India, from 2018-2022.
methodsWe detailed the shift in hypertension care from higher facilities to Health and Wellness Centres (HWCs) using the World Health Organization (WHO) health system pillar framework. We reviewed hypertension treatment records in 4,045 public facilities from nine districts in the two states, focusing on indicators including registration numbers, the proportion of controlled, uncontrolled blood pressure (BP), and missed visits among those under care.
resultsThe decentralization process involved training, treatment protocol provision, supervision, and monitoring. Among 394,038 individuals registered with hypertension from 2018-2021, 69% were under care in 2022. Nearly half of those under care (129,720/273,355) received treatment from HWCs in 2022. Care of hypertensive individuals from district hospitals (14%), community health centres (20%), and primary health centres (24%) were decentralized to HWCs. Overall BP control rose from 20% (4,004/20,347) in 2019 to 58% (157,595/273,355) in 2022, while missed visits decreased from 61% (12,394/20,347) in 2019 to 26% (70,894/273,355) in 2022. This trend was consistent in both states. HWCs exhibited the highest BP control and the lowest missed visits throughout the study period compared to other facility types.
conclusionWe documented an increase in decentralized access to hypertension treatment and improved treatment outcomes over four years. We recommend operationalizing hypertension care at HWCs to other districts in India to improve BP control.
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