To find out implications of the healthcare structure on diagnosis and management of Hypertension in Rural India.Design and method:
A door to door survey with a questionnaire and measurement of blood pressure (BP) in adults. Villages were classified as “hospital” and “no Hospital” on basis of availability of healthcare facility. Villages from districts of Maharashtra state of India were included. India currently has Health workers, Primary Health Centre (PHC), Rural Hospitals (RH),District Hospitals, Medical Colleges and tertiary referral centers in the healthcare structure.Results:
n = 7168. Villages = 24, Districts = 3. Eighteen (75%) villages had “no hospital”, there were 3 PHCs and 3 RHs. Population in PHC and RH were included in “hospital” group. Population in “no hospital ” group was 40.75%. Prevalence of hypertension was similar irrespective of presence or absence of healthcare facility (mean = 29.5%). 52.44% population never checked their BP in villages in “hospital” group. Only 7.57 % population ever checked BP in villages with “no hospital”. The prevalence of uncontrolled hypertensive's was 48.09% in villages with “no hospital” as compared to villages with “hospital” (46.09%). Women had more chances of getting BP measured and had more prevalence of hypertension than men. Men had half the chances of getting diagnosed with hypertension than women in villages with “hospital.Conclusions:
Our study shows major number of population is yet to get BP checked first ever in their life.. The basic healthcare is not provided in all villages as we found 75 % villages without hospital. Hypertensive's in villages with hospital had more BP controlled than in villages with no hospital. Probably, measures by government under various programs like Ante natal checkups are causing a beneficial effect on women while screening for hypertension during their pregnancies. Male population needs to aware for checking the BP and should be promoted to do it.