Demand Side Assessment of Primary Health Care in Assam
This study has been conducted to assess the demand side dimensions of primary health care in Assam. The study included the determinants like cultural factors, physical access, out of pocket expenditure and the quality of care shape the uptake of public primary health care facilities and examined whether people would choose them over private providers?
Study looked upon status of delivery services in Sub-Centres where the PHCs or secondary services are located further away. Team examined the availability of essential drugs list, need for revision of the list and supply side barrier to uptake the services at sub centres in the study.
Despite successive government's continuous efforts to achieve Universal Health Coverage National Sample Survey Organization (NSSO) data reveals the low rates of utilization of public primary health care. The data shows reliance on private providers where 70% spells of ailment are treated in the private sector.
As per data only 11.5% households in rural areas and only about 4% in urban areas, seek treatment for OPD care - at or below the CHC level primary care facilities, indicating low utilization of the public health systems for other common ailments.
This data has raised the question of why people are not using primary health care or are getting left out.
Thus, this study aims to unravel the demand and supply side factors that interact to shape the utilization of primary health care and focus on a comprehensive range of supply and demand side enablers and barriers.
• Study recommends that medicine supply side barriers like unavailability of even common drugs needs to addressed.
• Villagers feel constrained by the absence of delivery facilities at Sub Centres. Villagers use Health and Wellness centre for basic investigations of NCDs like diabetes and hypertension.
• Enough importance should be given to continuous capacity development of the providers in the areas of communicable diseases and RMNCH+A.
• Procedures and protocols for the management of communicable diseases at primary health care facilities should be made available.
• Delivery services need to be functional and should be prioritised at the sub-centres where the PHCs or secondary facilities are located further away.
• Grievances redressal mechanisms should be strengthen and villagers should possess awareness on such mechanism.