Study of the Performance of 24 X 7 PHCs in the ‘C’ Category Districts of Karnataka

Karnataka State Health System Resource Centre (KSHSRC) assigned GRAAM to conduct an in-depth assessment of the factors, positive as well as negative, affecting the performance of 24 X 7 PHCs in the 'C category' districts (Bagalkote, Bidar, Vijayapura, Kalaburagi, Koppal, Raichur and Yadgir) of Karnataka and suggest measures, both at policy and operational levels, to improve their performance. The evaluation was conducted on a sample of 37 24x7 PHCs across the 7 ‘C districts. The study used 'live deliveries reported in PHCs per thousand population per year' as the primary indicator to assess the performance of 24x7 PHCs.

This study has been conducted to study the various factors affecting the performance of 24 X 7 PHCs in the 'C category' districts (Bagalkote, Bidar, Vijayapura, Kalaburagi, Koppal, Raichur  and  Yadgir)  of Karnataka and suggest measures, both at policy and operational levels, to improve their performance.  

1.   H level 24x7 PHCs recorded higher numbers of night and complicated deliveries. This proportion was less in M and L level 24x7 PHCs. The average infant deaths in the PHC areas in 2013-14 was 9 in H level PHCs, 7.11 in M level PHCs and 12.38 in L level PHCs. However, these averages weren't statistically significant to draw conclusions.

2.   H level 24x7 PHCs recorded higher numbers of night and complicated deliveries. This proportion was less in M and L level 24x7 PHCs. The average infant deaths in the PHC areas in 2013-14 was 9 in H level PHCs, 7.11 in M level PHCs and 12.38 in L level PHCs. However, these averages weren't statistically significant to draw conclusions

3.   H level PHCs were significantly better staffed than M and L level PHCs. The proportion of H level PHCs a) having lady doctors, b) having more than 2 doctors and c) having 3 or more staff nurses was higher in comparison to other levels. In 50% of the cases, doctors in H level PHCs were reported to be staying in head-quarters (This ratio was about 22% and 15% respectively).

4.   The   study   found   that   PHCs   with   lady   doctors   had considerably higher average deliveries per thousand per year and hence, this affect was visible in H level PHCs, since the proportion of H level PHCs with lady doctors was high.

5.   Staff  nurses  of  H  level  PHCs  were  technically  more competent in recalling issues to be observed during ANC checkups and were slightly