Stakeholder Analysis for Hypertension Management in the Context of the Indian Public Health System.
Journal
Indian journal of public health
ISSN: 0019-557X
Titre abrégé: Indian J Public Health
Pays: India
ID NLM: 0400673
Informations de publication
Date de publication:
01 Jan 2023
01 Jan 2023
Historique:
received:
15
05
2023
accepted:
19
08
2023
medline:
1
1
2023
pubmed:
1
1
2023
entrez:
27
6
2024
Statut:
ppublish
Résumé
Hypertension (HTN) portends a significant public health burden in India and calls for multi-stakeholder action. We aimed to analyze the role of key stakeholder constituencies implicated in managing HTN across different levels of care within the public health system in India, alongside the enablers and barriers for effective program implementation. We reviewed 45 articles and policy documents, and 17 consenting stakeholder representatives scored the stakeholder constituencies for "power," "position" and "interest." They ranked enablers and barriers to noncommunicable disease programs in each of the six building blocks of the WHO Health System Strengthening Framework. Data were analyzed on Jamovi 2.2.2. Policymakers/program managers emerged as the most critical stakeholder in influencing policy implementation (score for power: 23.3 ± 8.5, position: 25.4 ± 6.9, and interest: 22.1 ± 8.3). Beneficiaries ranked lowest (power: 10 ± 5.1, position: 12.3 ± 4.5, and interest: 19.4 ± 4.2). Effective "on-ground" implementation ("service delivery") was the most important enabler (17.9 ± 3.3) as well as a barrier (17.6 ± 9.2). The health workforce (19.2 ± 4.8) emerged as a top barrier. To bring around impactful efficiency in the health system, provider-side interventions, especially those at the point of delivery, emerged as the need of the hour. Policymakers and program managers could lead using a top-down leadership and Governance Approach, focusing on deploying an adequately trained and motivated health workforce to deliver HTN services. For ensuring better performance of the health system for HTN care, the health workforce/seemed to be the "obligatory pivot." Health-care providers could serve as the "point of convergence" of efforts made by all the stakeholder constituencies.
Sections du résumé
BACKGROUND
BACKGROUND
Hypertension (HTN) portends a significant public health burden in India and calls for multi-stakeholder action.
OBJECTIVES
OBJECTIVE
We aimed to analyze the role of key stakeholder constituencies implicated in managing HTN across different levels of care within the public health system in India, alongside the enablers and barriers for effective program implementation.
METHODS
METHODS
We reviewed 45 articles and policy documents, and 17 consenting stakeholder representatives scored the stakeholder constituencies for "power," "position" and "interest." They ranked enablers and barriers to noncommunicable disease programs in each of the six building blocks of the WHO Health System Strengthening Framework. Data were analyzed on Jamovi 2.2.2.
RESULTS
RESULTS
Policymakers/program managers emerged as the most critical stakeholder in influencing policy implementation (score for power: 23.3 ± 8.5, position: 25.4 ± 6.9, and interest: 22.1 ± 8.3). Beneficiaries ranked lowest (power: 10 ± 5.1, position: 12.3 ± 4.5, and interest: 19.4 ± 4.2). Effective "on-ground" implementation ("service delivery") was the most important enabler (17.9 ± 3.3) as well as a barrier (17.6 ± 9.2). The health workforce (19.2 ± 4.8) emerged as a top barrier.
CONCLUSION
CONCLUSIONS
To bring around impactful efficiency in the health system, provider-side interventions, especially those at the point of delivery, emerged as the need of the hour. Policymakers and program managers could lead using a top-down leadership and Governance Approach, focusing on deploying an adequately trained and motivated health workforce to deliver HTN services. For ensuring better performance of the health system for HTN care, the health workforce/seemed to be the "obligatory pivot." Health-care providers could serve as the "point of convergence" of efforts made by all the stakeholder constituencies.
Identifiants
pubmed: 38934879
doi: 10.4103/ijph.ijph_694_23
pii: 01586002-202367001-00005
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S27-S34Informations de copyright
Copyright © 2023 Copyright: © 2024 Indian Journal of Public Health.
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