Paper from ATM Study Published on BMC Health Services Research

Paper from ATM Study Published on BMC Health Services Research

by | Aug 30, 2016 | Latest Updates

ATM study-paper

Improving access to medicines for non-communicable diseases in rural India: a mixed methods study protocol using quasi-experimental design:-  Paper from ATM Study Published on BMC Health Services Research

Abstract

Background: India has the distinction of financing its healthcare mainly through out-of-pocket expenses by individual families contributing to catastrophic health expenditure and impoverishment. Nearly 70 % of the expenditure is on medicines purchased at private pharmacies. Patients with chronic ailments are especially affected, as they often need lifelong medicines. Over the past years in India, there have been several efforts to improve drug availability at government primary health centres. In this study, we aim to understand health system factors that affect utilisation and access to generic medicines for people with non-communicable diseases.

Methods: This study aims to understand if (and how) a package of interventions targeting primary health centres and community participation platforms affect utilisation and access to generic medicines for people with non-communicable diseases in the current district context in India. This study will employ a quasi-experimental design and a qualitative theory-driven approach. PHCs will be randomly assigned to one of three arms of the intervention. In one arm, PHCs will receive inputs to optimise service delivery for non-communicable diseases, while the second arm will receive an additional package of interventions to strengthen community participation platforms for improving non-communicable disease care. The third arm will be the control. We will conduct household and facility surveys, before and after the intervention and will estimate the effect of the intervention by difference-in-difference analysis. Sample size for measuring effects was calculated based on obtaining at least 30 households for each primary health centre spread across three distance-based clusters. Primary outcomes include availability and utilisation of medicines at primary health centres and out-of-pocket expenditure for medicines by non-communicable disease households. Focus group discussions with patients and in-depth interviews with health workers will also be conducted. Qualitative and process documentation data will be used to explain how the intervention could have worked.

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‘Even doctors feel generic drugs are sub-standard’- IPH staff quoted in the Hindu

‘Even doctors feel generic drugs are sub-standard’- IPH staff quoted in the Hindu

by | Mar 28, 2016 | Latest Updates

ATM-Hindu-news

 

‘Even doctors feel generic drugs are sub-standard’

 

Many patients are denied affordable treatment, as they prefer to buy branded drugs that sometimes cost as much as 7 to 8 times more and deny

A 67-year-old woman in Tumakuru visited a private doctor for a chronic ailment. She was advised some expensive drugs. Even though she was short on funds and struggling to make ends meet, she set aside money to buy medication for two months. Two months later, when she ran out of money, she stopped taking the medicines and discontinued treatment.

Another woman in her fifties in K.G. Halli, Bengaluru, takes her medicine for hypertension only when ‘her legs swell’, something she has noticed happens every time her blood pressure shoots up. Once the swelling stops, she stops taking medicines, because she cannot afford them regularly.

Branded drugs sometimes cost as much as 7 to 8 times as generic drugs. But in spite of their low cost, the public remains suspicious of the effectiveness of generic medicines.

“There is a strong perception among the public, and to our surprise, even practitioners and pharmacists, that generic medicines are of sub-standard quality,” said Praveenkumar Aivalli, Research Officer, Institute of Public Health (IPH), Bengaluru. A team of researchers from IPH, including Dr. Aivalli, have conducted a three-year study on access to generic medicines for non-communicable diseases, the results of which will be published shortly.

As part of the study, three taluks in Tumakuru district were randomly chosen and around 1,000 to 1,200 houses surveyed. The team found that public awareness of generic drugs was very low and people hesitated to visit primary health centres (PHCs), preferring private hospitals even when they could barely afford to. They found a similar poor perception of generic drugs among residents in K.G. Halli, Bengaluru.ÿ Comparing figures from 2013 to 2016, the availability of drugs in PHCs had greatly improved in the period.

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