by iphindia | Aug 30, 2016 | Latest Updates
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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by iphindia | Jul 28, 2016 | Latest Updates, Uncategorized
Faculty at Institute of Public Health, Bengaluru, India, Dr. Vijayashree H.Y, was interviewed by Healthcare Executive Magazine recently on spiralling health care cost in India.
by iphindia | Jul 20, 2016 | Latest Updates
Dr Vijayashree Y, faculty and PhD scholar at Institute of Public Health, article titled ”Coping with tuberculosis and directly observed treatment: a qualitative study among patients from South India“, published in “BioMed Central” (BMC). This study carried out to explore the experience and consequences of having Tuberculosis on patients enrolled inDOTS and their caretakers in India.
Background
In India, the Revised National TB control programme (RNTCP) offers free diagnosis and treatment for tuberculosis (TB), based on the Directly Observed Treatment Short course (DOTS) strategy. We conducted a qualitative study to explore the experience and consequences of having TB on patients enrolled in DOTS and their caretakers in Tumkur district, located in a southern state of India, Karnataka.
Methods
We conducted 33 in-depth interviews on a purposive sample of TB patients from three groups: (1) patients who reached RNTCP directly on their own and took DOTS at RNTCP; (2) patients who were referred by private practitioners (PPs) to RNTCP and took DOTS at RNTCP; and (3) patients diagnosed by RNTCP and took DOTS from PPs. Data was analyzed using a thematic approach with the support of NVivo9.
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by iphindia | Mar 28, 2016 | Latest Updates
‘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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by iphindia | Jan 21, 2016 | Blog, Education, ePHM-Advance, Latest Updates
Application of the peer learning principles in the field of education has a long history. Lot of research has been done by psychologists, sociologists and educators on this and results have been positive. Peer learning has been seen as an effective methodology for gain deeper understanding of the concepts by formal or informal interaction among the peers. Peer learning promotes active participation among students and gives them a space to re-enforce their own learning. Since, the students share common educational or professional backgrounds, it creates interest in the topic. It also gives students a platform to build their communication, presentation and teaching skills.
We at IPH, used one of the aspects of peer learning principles, for our e-learning course in Public Health Management (ePHM). Based on their performance in the course, we selected the top ten students of 2015 batch. We invited them to take classroom sessions for their peers. The theme of the classroom session was – “One Challenge – One Public Health Management Principle”. The students had to talk about one challenge they faced at their workplace and how they applied one public health management principle to overcome the same. The objective of this exercise was to give an opportunity to the students to share their experiences from the field with the fellow students and at the same time give them a feel of how we record our online classrooms.
The response from the invited students was amazing. The students who were based in Bengaluru visited our office and recorded a session with us. Others who were residing outside Bengaluru had a hangout or Skype session with us and recorded the classroom. The students took sessions on different topics like community participation, systems thinking, leadership and development, breast feeding and health systems dynamics framework. We converted their sessions into online classrooms and uploaded it on our online platform, Moodle for sharing with their peers.
It was very interesting to see how the students, who are busy professionals also, took out time and prepared Powerpoint presentations and recorded sessions with us. Our next step is to understand from students how they benefited from this learning methodology. Since, this is the era of experimentation, we would love to step ahead and explore other peer learning methodologies in our courses for enhanced learning experience!
You can catch a glimpse of the peer classroom sessions
by clicking on the image:
Dr.Aneesha Ahluwalia is Training Officer at Institute of Public Health, Bengaluru and tutor for the ePHM course.
The response from the invited students was amazing. The students who were based in Bengaluru visited our office and recorded a session with us. Others who were residing outside Bengaluru had a hangout or Skype session with us and recorded the classroom. The students took sessions on different topics like community participation, systems thinking, leadership and development, breast feeding and health systems dynamics framework. We converted their sessions into online classrooms and uploaded it on our online platform, Moodle for sharing with their peers.
