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Improving access to medicines for non-communicable diseases in rural India: a mixed methods study protocol using quasi-experimental design

Overview of attention for article published in BMC Health Services Research, August 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • Good Attention Score compared to outputs of the same age and source (75th percentile)

Mentioned by

news
1 news outlet
twitter
11 tweeters

Citations

dimensions_citation
10 Dimensions

Readers on

mendeley
103 Mendeley
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Title
Improving access to medicines for non-communicable diseases in rural India: a mixed methods study protocol using quasi-experimental design
Published in
BMC Health Services Research, August 2016
DOI 10.1186/s12913-016-1680-3
Pubmed ID
Authors

N. S. Prashanth, Maya Annie Elias, Manoj Kumar Pati, Praveenkumar Aivalli, C. M. Munegowda, Srinath Bhanuprakash, S. M. Sadhana, Bart Criel, Maryam Bigdeli, Narayanan Devadasan

Abstract

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. 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. By taking into consideration several health system building blocks and trying to understand how they interact, our study aims to generate evidence for health planners on how to optimise health services to improve access to medicines. Protocol registered on Clinical Trials Registry of India with registration identifier number CTRI/2015/03/005640 on 17(th) March 2015.

Twitter Demographics

The data shown below were collected from the profiles of 11 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 103 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
India 2 2%
Unknown 101 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 20 19%
Researcher 17 17%
Student > Doctoral Student 11 11%
Student > Ph. D. Student 7 7%
Student > Bachelor 7 7%
Other 18 17%
Unknown 23 22%
Readers by discipline Count As %
Nursing and Health Professions 18 17%
Medicine and Dentistry 17 17%
Social Sciences 7 7%
Business, Management and Accounting 5 5%
Pharmacology, Toxicology and Pharmaceutical Science 5 5%
Other 20 19%
Unknown 31 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 17. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 May 2018.
All research outputs
#1,494,645
of 19,156,856 outputs
Outputs from BMC Health Services Research
#568
of 6,459 outputs
Outputs of similar age
#29,411
of 274,855 outputs
Outputs of similar age from BMC Health Services Research
#3
of 8 outputs
Altmetric has tracked 19,156,856 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,459 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.2. This one has done particularly well, scoring higher than 91% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 274,855 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 8 others from the same source and published within six weeks on either side of this one. This one has scored higher than 5 of them.