Assessment of Accessibility, Availability, and Need of Cardiac Care at Primary Health Care Centres in Vadodara District of India: The CardioGram Pilot Project

Abstract

AbstractBackgroundThere has been an increase in the burden of Cardiovascular Diseases (CVD), especially in rural India. Integrating screening and treatment for CVDs at the primary healthcare level has now become a necessity. Hence, this study was conducted to assess the accessibility, availability, and need for cardiac care with a special focus on ECG at Primary Healthcare Centers (PHC) in the Vadodara district of Gujarat.MethodsA cross-sectional pilot study was carried out in 34 PHCs of the Vadodara District of Gujarat, India between January to March 2022. Data regarding the accessibility of PHC, distance from the nearest Tertiary Health Centre (THC), availability of ECG, drugs, treatment protocols, competency of staff, and burden of CVD, hypertension, and diabetes was collected by interviewing the medical officer of the PHC. Distances were measured in kilometers (km) and Travel times were measured in minutes (min). Descriptive analysis was performed using MS Excel.ResultsThe average distance to reach a PHC, a Tertiary Care Center, and a Cardiac Care Center (CCC) is 14.8km, 37.1 km, and 55.5km, respectively, which accounts for 22.59 minutes, 62.3 minutes, and 85.5 minutes. Moreover, only 58% of the surveyed PHCs have the availability of ECGs, with a lesser percentage of healthcare workers(HCWs) who knew how to operate and/or read an ECG. 44.11% of the surveyed PHCs had functional ECGs and employed them where indicated. Most of the CVD cases were referred to higher centers. Six PHCs had an urgent need for ECG deployment.ConclusionAccessibility and availability of cardiac care services, especially ECGs is poor in PHCs of Vadodara district. There is an urgent need not only for services but also for efficient training of medical officers for performing, interpreting as well as managing cases of acute myocardial infarction.