PDF(Pubmed)
Abstract：
UNASSIGNED: India launched a national initiative named Health and Wellness Centres (HWCs) in 2018 to provide population-based primary care including for the non-communicable diseases (NCDs) in rural areas. The current study assesses whether operationalization of HWCs improved the detection of NCDs and increased the share of public sector facilities in providing NCD services.
UNASSIGNED: Two rounds of household surveys were conducted in rural Chhattisgarh in 2019 and 2022. With a focus on NCDs, the household survey covered a representative sample of individuals above the age of 30 years - 2760 individuals in 2019 and 2638 in 2022. Multi-variate regression analysis was carried out to determine effects of HWCs on identification of NCDs and utilization of public sector services.
UNASSIGNED: The population covered by HWCs had 25% greater chance of being identified with NCDs as compared to the population without HWCs (AOR = 1.25, P = 0.03). The NCD patients living in areas covered by HWCs had 70% greater chance of utilizing the public healthcare facilities (AOR = 1.70, P = 0.01). In the population covered by HWCs, the share of the public sector in NCD care increased from 41.2% in 2019 to 62.1% in 2022, whereas the share of informal private providers dropped from 23.5% in 2019 to 8.4% in 2022.
UNASSIGNED: The HWCs showed effectiveness in increasing detection of NCDs at the population level and bringing a larger share of NCD patients to utilize public sector services. They can prove to be a crucial architectural correction for improving primary care service delivery for NCDs and other population health needs in India.
UNASSIGNED: Two rounds of household surveys were conducted in rural Chhattisgarh in 2019 and 2022. With a focus on NCDs, the household survey covered a representative sample of individuals above the age of 30 years - 2760 individuals in 2019 and 2638 in 2022. Multi-variate regression analysis was carried out to determine effects of HWCs on identification of NCDs and utilization of public sector services.
UNASSIGNED: The population covered by HWCs had 25% greater chance of being identified with NCDs as compared to the population without HWCs (AOR = 1.25, P = 0.03). The NCD patients living in areas covered by HWCs had 70% greater chance of utilizing the public healthcare facilities (AOR = 1.70, P = 0.01). In the population covered by HWCs, the share of the public sector in NCD care increased from 41.2% in 2019 to 62.1% in 2022, whereas the share of informal private providers dropped from 23.5% in 2019 to 8.4% in 2022.
UNASSIGNED: The HWCs showed effectiveness in increasing detection of NCDs at the population level and bringing a larger share of NCD patients to utilize public sector services. They can prove to be a crucial architectural correction for improving primary care service delivery for NCDs and other population health needs in India.
摘要：
■印度于2018年发起了一项名为“卫生与健康中心”（HWC）的国家倡议，以提供基于人群的初级保健，包括农村地区的非传染性疾病（NCDs）。本研究评估了HWC的运营是否改善了非传染性疾病的检测，并增加了公共部门设施在提供非传染性疾病服务方面的份额。
■2019年和2022年在恰蒂斯加尔邦农村进行了两轮家庭调查。重点关注非传染性疾病，家庭调查涵盖了30岁以上个人的代表性样本-2019年为2760人，2022年为2638人。进行了多元回归分析，以确定HWC对非传染性疾病识别和公共部门服务利用的影响。
与没有HWC的人群相比，被HWC覆盖的人群被鉴定为非传染性疾病的机会增加了25%(AOR=1.25，P=0.03)。生活在HWC覆盖地区的NCD患者使用公共医疗设施的机会增加了70％（AOR=1.70，P=0.01）。在HWC覆盖的人群中，公共部门在非传染性疾病护理中的份额从2019年的41.2%增加到2022年的62.1%，而非正规私营提供者的份额从2019年的23.5%下降到2022年的8.4%。
HWC在增加人群非传染性疾病的检测方面显示出有效性，并使更多的非传染性疾病患者利用公共部门服务。它们可以证明是改善印度非传染性疾病和其他人口健康需求的初级保健服务提供的关键架构调整。
■2019年和2022年在恰蒂斯加尔邦农村进行了两轮家庭调查。重点关注非传染性疾病，家庭调查涵盖了30岁以上个人的代表性样本-2019年为2760人，2022年为2638人。进行了多元回归分析，以确定HWC对非传染性疾病识别和公共部门服务利用的影响。
与没有HWC的人群相比，被HWC覆盖的人群被鉴定为非传染性疾病的机会增加了25%(AOR=1.25，P=0.03)。生活在HWC覆盖地区的NCD患者使用公共医疗设施的机会增加了70％（AOR=1.70，P=0.01）。在HWC覆盖的人群中，公共部门在非传染性疾病护理中的份额从2019年的41.2%增加到2022年的62.1%，而非正规私营提供者的份额从2019年的23.5%下降到2022年的8.4%。
HWC在增加人群非传染性疾病的检测方面显示出有效性，并使更多的非传染性疾病患者利用公共部门服务。它们可以证明是改善印度非传染性疾病和其他人口健康需求的初级保健服务提供的关键架构调整。
