Bridging the Gap: Improving Medication Dispensing Duration for Hypertension and Diabetes through Advocacy and Stakeholder Engagement in Faridabad District, India
1
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, India
Popul. Med. 2026;8(Supplement Supplement 1):A3034
ABSTRACT
INTRODUCTION:
Effective management of Non-Communicable Diseases (NCDs) requires uninterrupted medication supply to ensure adherence and prevent complications. However, frequent refill visits due to short prescription durations often lead to patient attrition. In Faridabad district, Haryana, baseline assessments revealed a service delivery gap where public health facilities prescribed medicines for only 5–15 days, despite the need for continuous care. This study aimed to extend the duration of drug dispensing to 30 days to improve treatment continuity.
METHODS:
We utilised an implementation research approach involving participatory engagement and advocacy strategies. Key stakeholders, including district and state-level decision-makers and technical officials, were engaged to address supply chain bottlenecks and policy barriers. Interventions included: 1) Advocacy meetings to mandate 30-day dispensing, 2) Capacity building of pharmacists in inventory forecasting to prevent stockouts, and 3) Rationalising stock indents based on patient load. Changes in dispensing practices were assessed through serial exit interviews across three phases: October-November 2024 (Baseline), August-September 2025 (Midline), and November 2025-January 2026 (Endline).
RESULTS:
The advocacy strategy resulted in the issuance of state and district directives mandating a minimum 30-day supply for stable NCD patients, supported by a protocol to maintain a two- to three-month buffer stock. Consequently, the proportion of patients receiving a 30-day supply increased significantly over the study period. For hypertension, rates rose from 17.9% (Baseline) to 91.8% (Endline). Similarly, for diabetes, rates improved from 6.5% to 96.5%. This shift was achieved without reporting significant stock-outs at the facility level.
CONCLUSIONS:
Strategic stakeholder engagement and evidence-based advocacy successfully transformed dispensing practices for NCDs in a district health system. By extending the refill interval to 30 days, the health system reduced the burden on patients, potentially improving long-term adherence. This model demonstrates that administrative will, combined with supply chain strengthening, can resolve critical bottlenecks in service delivery in chronic care.
Effective management of Non-Communicable Diseases (NCDs) requires uninterrupted medication supply to ensure adherence and prevent complications. However, frequent refill visits due to short prescription durations often lead to patient attrition. In Faridabad district, Haryana, baseline assessments revealed a service delivery gap where public health facilities prescribed medicines for only 5–15 days, despite the need for continuous care. This study aimed to extend the duration of drug dispensing to 30 days to improve treatment continuity.
METHODS:
We utilised an implementation research approach involving participatory engagement and advocacy strategies. Key stakeholders, including district and state-level decision-makers and technical officials, were engaged to address supply chain bottlenecks and policy barriers. Interventions included: 1) Advocacy meetings to mandate 30-day dispensing, 2) Capacity building of pharmacists in inventory forecasting to prevent stockouts, and 3) Rationalising stock indents based on patient load. Changes in dispensing practices were assessed through serial exit interviews across three phases: October-November 2024 (Baseline), August-September 2025 (Midline), and November 2025-January 2026 (Endline).
RESULTS:
The advocacy strategy resulted in the issuance of state and district directives mandating a minimum 30-day supply for stable NCD patients, supported by a protocol to maintain a two- to three-month buffer stock. Consequently, the proportion of patients receiving a 30-day supply increased significantly over the study period. For hypertension, rates rose from 17.9% (Baseline) to 91.8% (Endline). Similarly, for diabetes, rates improved from 6.5% to 96.5%. This shift was achieved without reporting significant stock-outs at the facility level.
CONCLUSIONS:
Strategic stakeholder engagement and evidence-based advocacy successfully transformed dispensing practices for NCDs in a district health system. By extending the refill interval to 30 days, the health system reduced the burden on patients, potentially improving long-term adherence. This model demonstrates that administrative will, combined with supply chain strengthening, can resolve critical bottlenecks in service delivery in chronic care.
| eISSN: | 2654-1459 |
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