ABSTRACT
Abstracts: Background: Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The aim of this study was to determine the unit cost of maternal and child health (MCH) programme provided at Primary Health Centers (PHCs) and to examine the variation in unit cost in different PHCs. Methodology: The present study was carried out in three PHCs of Ahmedabad district namely Sanathal, Nandej, and Uperdal, between 1 April, 2006 and 31 March, 2007. For estimating the cost of a health program, information on all the physical and human resources that were basic inputs to the PHC services were collected and grouped into two categories, non-recurrent (capital resources vehicles, buildings, etc.) and recurrent resources (salaries, drugs, vaccines, contraceptives, maintenance, etc.). To generate the required data, two types of schedules were developed, daily time schedule and PHC/SC (Subcenter) information schedule. Results: Unit cost for each contact of MCH beneficiaries was Rs. 54.87 at Sanathal PHC, Rs. 87.63 at Nandej PHC and Rs. 70.01 at Uperdal PHC. Conclusion: Even though maternal and child health services are free, utilization of these services at the health centres were low, particularly for delivery, leading to high unit costs.
ABSTRACT
Background: The role of RHTC set up under MCI requirement of medical colleges is rising in implementation of NRHM phase 2 programme (2012 onwards); as private medical colleges are expanding in India and they can be an important supporter in public-private partnership for national health programmes. Objective of current study was to assess the role of rural health training centre as a supporting component to a primary health care system for NRHM programme. Methods: The present study was carried out by comparative evaluation of the rural health and training centre of a private medical college with a sub-centre (Muzaffarnagar) on key RCH services of NRHM: a) Family planning materials distribution, b) ANC services and c) Immunization services. Inclusion criteria: Proper ethical approval from both primary health care system and private medical college authorities were obtained for the study. Study design: Prospective evaluation based study on ANM in SC & SN in RHTC in NRHM programme for 1 year duration from 1st January 2013 to 31st December 2013. Data analysis: The statistical data was analysed by Epi-info version 7.1.3. Results: The ANC services, family planning services and immunization services delivered under NRHM programme was found to statistically significantly contributed (P <0.05) by SN of RHTC as compared to ANM of SC in area of Bilaspur, Muzaffarnagar (Uttar Pradesh). Conclusion: RHTC of a private medical college in Muzaffarnagar (UP) is significantly contributing and supporting in RCH services of NRHM programme for primary health care system. RHTC of medical colleges can be an asset for public private partnership in NRHM programme.
ABSTRACT
Background: Provision of good quality care is the crux of the RCH Programme. Good quality of care ensures satisfied clients, who in turn come back for services and become advocates for others. Quality has not been given adequate attention in Government Health Care facilities, because of which there is underutilization of RCH services. Aims & Objective: The present study is an attempt to assess the perception of clients (women who delivered in last one year) regarding various aspects of maternal and child health care delivery components. Material and Methods: It was a community based cross sectional study carried out in ten primary health centre areas. Study subjects were the women delivered in last one year. Sample size was calculated considering the proportion of pregnant women who received at least three antenatal check-ups in district level household survey – 3. One hundred fifty such women were interviewed using pretested proforma from subcenter of each randomly selected PHC area. Data were entered and analyzed in epi info software version 3.3.2. Results: Majority of the women (80%) opined that the behaviour of health care providers was good while 21% of women felt that the communication skills of attending doctor / FHW were not good. Only two third of the women were satisfied with the quality of services provided to them at health facility. RCH indicators were better among the women who were satisfied with the behaviour and communication skills of the health care providers. Conclusion: Present study revealed that women’s perception about various indicators of quality of care, behaviour and communication skills of the health care providers affect the overall satisfaction of the women and in turn it significantly affects utilization of RCH services.
ABSTRACT
Meeting the needs of HIV‑positive pregnant women and their offspring is critical to India’s political and financial commitment to achieving universal access to HIV prevention, treatment, care and support. This review of the strategy to prevent vertical transmission of HIV in Mysore district, Karnataka, highlights the need to integrate prevention of parent‑to‑child transmission (PPTCT) and reproductive and child health (RCH) services. All key officials who were involved in the integration of services at the state and district levels were interviewed by use of semistructured protocols. Policy documents and guidelines issued by the Department of Health and Family Welfare and Karnataka State AIDS Prevention Society were reviewed, as were records and official orders issued by the office of District Health and Family Welfare Officer and District HIV/AIDS Programme Office, Mysore. Routine data were also collected from all health facilities. This review found that 4.5 years of PPTCT‑RCH integration resulted not only in a rise in antenatal registrations but also in almost all pregnant women counselled during antenatal care undergoing HIV tests. Based on the findings, we propose recommendations for successful replication of this strategy. Integration of PPTCT services with RCH should take place at all levels − policy, administration, facility and community. The increased demand for HIV counselling and testing resulting from service integration must be met by skilled human resources, sufficient facilities and adequate funds at the facility level.