Utilization of health facilities at primary health centre by rural community of Pondicherry

Utilization of health facilities at primary health centre ISSN: 2394-0026 (P)Original Research Article ISSN: 2394-0034 (O)Utilization of health facilities at primary health centre by rural community of PondicherryK N Prasad1*, Basavaraj M Ingalgeri1, R Poovitha2, V Suchi3, VVaishnavi3, G Vidya3, G Vignesh3, T Vignesh3, J V Yogeshbabu3, B Vijayalakshmi3 1Professor, 2Biostatistician, 3InternDepartment of Community Medicine, Shri Lakshmi Narayana Institute of Medical Science, Pondicherry, India*Corresponding author email: [email protected] to cite this article: K N Prasad, Basavaraj M Ingalgeri, R Poovitha, V Suchi, V Vaishnavi, G Vidya,G Vignesh, T Vignesh, J V Yogeshbabu, B Vijayalakshmi. Utilization of health facilities at primaryhealth centre by rural community of Pondicherry. IAIM, 2015; 2(2): 71-76.Available online at www.iaimjournal.comReceived on: 23-01-2015 Accepted on: 28-01-2015AbstractBackground: The utilization of services at Primary Health Centre (PHC) by the community differsfrom place to place and changes over the time based on the availability of quality of services. It isalso necessary to evaluate the utilization trend of primary health centre services by the community.Objective: to know the pattern of utilization by rural community on availability, utilization andperception of facilities at primary health centre.Material and methods: A cross sectional, descriptive, community based study was done duringSeptember to November 2014 in selected sample from PHC area by interviewing 300 families onvarious aspects at their doorstep. The date collected from each family on the aspects such asawareness, availability, utilization and perception of facilities at primary health centre.Results: More than 80% were aware about the PHC, its location and more than 75% on availability offree medicines and laboratory investigations. Many preferred to visit PHC for their ailments andwaiting time for treatment was less than 30 minutes and 70% of families visited the PHC at leastonce since last 3 months for some kind of health problems. The common ailments were respiratoryproblems, fever episodes and accidental injuries. Nearly 50% were aware about the contents in thedisplay of posters on various health education topics.Conclusion: Periodic assessment of pattern of utilization of PHC is important to improve the serviceutilization by the community through their involvement.International Archives of Integrated Medicine, Vol. 2, Issue 2, February, 2015. Page 71Copy right © 2015, IAIM, All Rights Reserved.

Utilization of health facilities at primary health centre ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)Key wordsPrimary health centre, Utilization, Pondicherry, Rural, Health.Introduction and 35 rural sub centres catering to a population of 12,44,464. The study period was SeptemberPrimary health care (PHC) is a strategy to November 2014 and sample sizes of 300worldwide for the health and wellbeing of the houses were selected. Ganapathi Chettikulamindividuals. Though the services are catered village belongs to primary health centre havingunder the primary health care vary from country population of 2514 people; situated 15 km fromto country depending on the extent of various the city was selected for the study.health issues. Developing countries focusattention on reducing the death and burden due The houses were selected randomly in theto communicable diseases, MCH and sanitation village. The family members were explained theproblems [1]. The services availability and objective of the study and consent was taken.utilization are two different issues on The information was collected by interviewingeffectiveness of primary health care. the family members in the house on various aspects of questionnaire and answers which areThe different indicators have shown decline in concordance to available family members wereresponse to the participation of the community considered. The questionnaire was pilot testedin seeking help or treatment for their health before the final study. The information in theproblems. The policy makers, program managers questionnaire contained the names, age, andand other related authority have evaluated at sex of each family members, awareness andinternational, national, district and local levels to utilization of various health services available inknow the impact of the service delivery and PHC. The study Proforma included the questionsutilization in terms of both quantitative and on three broad areas such as availability,qualitative ways [2]. utilization and perception of health facilities to the individual. Most of the informants wereIn India the utilization of health services are female members of the family aged between 30varying on topics such as communication, and 50 years.maternity care, communicable disease andnutritional issues in different states [2, 3]. This Resultswill help to focus the delivery of services tosectors that are in most need [3, 4]. The The information was given by female familyfeedback on the periodic evaluation throws light member in majority of the houses (90%). Nearlyon the status of improvement of the indicators 86% householders were aware about theand quality of life [5]. Thus the study is planned presence of primary health centre and 60% werein the rural community in Pondicherry with an able to say the approximate distance as perobjective to analyze the utilization of primary Chart - 1. Many the families were aware abouthealth centre. the availability of free medicine and laboratory investigations. Very small proportions wereMaterial and methods aware about the free availability of Vitamin A and Iron Folic acid tablets. Nearly 72% of theThe union territory Pondicherry has 5 tertiary families preferred to use primary health centrecare level hospitals, 2 community healthcentres, 12 urban and 15 rural PHC, 14 urbanInternational Archives of Integrated Medicine, Vol. 2, Issue 2, February, 2015. Page 72Copy right © 2015, IAIM, All Rights Reserved.

Utilization of health facilities at primary health centre ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)for their ailments and seventy percent visited at facilities. This is supported by the few studies,least once during the last 3 months. however the use of PHC for free medicine and availability of medical officer is better in thisLess than 50% of the families preferred injection community [3, 5, 6]. This evidenced by theas treatment and less than quarter of families families suggesting that they prefer to visitwere visited by ANM since last six month and primary health centre than the general hospital60% of families were getting medication when or private hospital as high as 72% and confirmedthere is outbreak of disease. The waiting time by their answer of visiting at least once duringfor seeking treatment was less than 30 minutes, the last 3 months for ailments to their commonwas the opinion of the family members. The minor and emergency conditions. This iscommon ailments which the family members supported by other studies which they focusedwere attending were respiratory infections and mainly on communicable diseases or maternalfever episodes as per Chart - 2. The families child care and immunization services [3, 4, 5, 6].were aware about the importance of display ofcharts and posters on health awareness as per The literacy level and awareness about theChart - 3. presence of local endemic disease plays an important role. In this study, families wereDiscussion aware about the effectiveness of getting or preferring medications through injection forIt is a belief that the primary health care takes limited conditions. As a result less than 50%the responsibility to deliver the services to the preferred to visit PHC for treatment seekingneed of community depending on the demand injection as mode of therapy. This was a gooddisease load and requirements of basic health practice in this community compared to otherfacilities. The first part of the utilization of health studies reported [2, 3, 6].services starts with awareness about theavailable health facilities, such as primary health In many situations the medical officer will not becentre and approximate distance or time to available while preoccupied with theirreach there. It is convincing that nearly 86% of administrative, supervisory or review meetingsfamilies were about the presence of primary etc. in primary health centre as a result thehealth centre. The perception about the patients have to wait for the doctor for fewapproximate distance was to know or cross hours. In our study, the families were satisfiedverify the answer about the awareness about with the availability and competency of thethe PHC location. Total 60% were able to medical officer in treating each patient. Themention the approximate distance to the community members opined that their waitingprimary health centre from their locality in the time to get treatment from medical officer isvillage. less than 30 minutes as mentioned by 72%. ThisThe presence of medical officer and free is not the situation in other part of our countrymedicine are motivational factors for the as reported [2, 3, 4, 7].community to utilize the primary health care. There are various pattern of utilization ofNearly 80% were aware and satisfied about the primary health centres in treating commongood quality free medicine and most of the time ailments prevalent in the community. In thisthe medical officer was attending the family rural community of Pondicherry, the familiesmembers when they visit to seek various health mentioned that the problems to which they visitInternational Archives of Integrated Medicine, Vol. 2, Issue 2, February, 2015. Page 73Copy right © 2015, IAIM, All Rights Reserved.

Utilization of health facilities at primary health centre ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)the PHC were acute respiratory problems time and health education activities. Periodic(55.6%) fever (47%), gastrointestinal problems assessment is required to know the pattern of(8%), animal or insect bites (8%), accident utilization of primary health centre by theinjuries (7%) and non communicable diseases community on their health problems.follow up (6%). The pattern is similar with somereports and the proportion of the conditions Referencesfrom these studies [2, 3, 5, 7]. 1. Silan V, Kant S, Archana S, Misra P,It is high time that the creating awareness about Rizwan S A. Determinants of underthe local endemic and epidemic diseases utilization of free delivery services in anthrough health education aids. The charts or area with high institutional delivery rate:display boards are conventional methods in use A qualitative study. North Am J Med Sci,and take attention of the patients and 2014; 6: 315-20.attendants when they visit primary health 2. Ray S K, Basu S S, Basu A K. Ancentres. The community will utilize their waiting assessment of rural health care deliverytime in primary health centre in getting the system in some areas of West Bengal –contents in the display of charts, boards, posters An overview. Ind Journal of Pub Health,etc. In this study, the family members were 2011; 55(2): 70-81.asked to list the health education messages 3. Rajpurohit A C, Srivastava A K, Srivastavadisplayed on their own language about the V K. Utilizations of primary health centrecontent and diseases as seen by them in the services amongst rural population ofposters. Nearly 45% were able to say on northern India - Some sociodemographicdisplayed charts and posters, remaining 45% correlates. Ind Jr of Com Health, 2013;were able to appreciate the picture and unable 25(4): 445-451.to mention such topic or diseases in the poster. 4. Mane ABhay B, Kahandekar Sanjay V. Strengthening Primary Health careThe family members mentioned that serve through Asha Workers: A novelcommunicable diseases (36%), breast feeding approach in India. Primary Health Care,practice (12%), non communicable diseases 2014; 4(1): 1-3.(10%), nutrition and hygiene (9%), and 5. Mishra A. Trust and Team work matters:immunization services (5%) were the displayed Community health workers experienceeducation issues. It is high time to reach the in integrated service delivery in India.community with regarding the control or Global Public Health, 2014; 9(8): 960-prevention of diseases through displayed 974.posters, charts or boards in local language and 6. Shelah S Bloom, David Wypij, Monicapictorial way to highlight the need adopting the das Gupta. Dimensions of women’sbest practices on daily basis are also autonomy and the influence onrecommended in different studies [2, 3, 5, 8]. maternal health care. Demograph, 2001; 38(1): 67-78.Conclusion 7. Rakesh Ninama, Nilesh Thakor, Mayur Vala, Jayshri Dund, Kadri A M. QualityUtilization of primary health centre in this assessment of facilities available atcommunity is satisfied because of availability of primary health care centres in RajkotMedical Officer and free medicines, less waiting district: A cross sectional study. InterntlInternational Archives of Integrated Medicine, Vol. 2, Issue 2, February, 2015. Page 74Copy right © 2015, IAIM, All Rights Reserved.

Utilization of health facilities at primary health centre ISSN: 2394-0026 (P) Jr of Med Sci Pub Health, 2014; 3(12): ISSN: 2394-0034 (O) Health and Population-Perspectives and 1449-1452. Issues, 1997; 20: 112-25. 8. Kavitha N, Audinarayana N. Utilisation and determinants of selected MCH care services in rural areas of Tamil Nadu.Source of support: Nil Conflict of interest: None declared.Chart – 1: Awareness of available services in primary health centre by the families.100 90 86 86 80 76 72 72 70Percentage 70 60 60 60 50 40 40 30 21 20 20 10 0International Archives of Integrated Medicine, Vol. 2, Issue 2, February, 2015. Page 75Copy right © 2015, IAIM, All Rights Reserved.

Utilization of health facilities at primary health centre ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)Chart – 2: Common ailments listed by families for visiting primary health centre. 60 56 47 50 40Percentage 30 20 10 8 7 5 6 8 0Chart – 3: Contents of display posters as mentioned by families. 40 36 35 30Percentage 25 20 15 12 10 9 10 Nutri & HE 5 5 0 comm. Diseases Non-Comm. Dis. Immunisation Breast FeedingInternational Archives of Integrated Medicine, Vol. 2, Issue 2, February, 2015. Page 76Copy right © 2015, IAIM, All Rights Reserved.