An Analysis of Service Provision Standards in Primary Health Care Facilities of Khyber Pakhtunkhwa, Pakistan

Abstract

This study explores the on-ground facilities available at primary healthcare facilities (PHCFs) against the service quality standards set by the provincial government of Khyber Pakhtunkhwa (KP), Pakistan. Primary data through a structured questionnaire was collected from 109 PHCFs. Two hundred seven responses from patients, 109 responses from PHCFs doctors and medical staff, and 109 researcher’s observations were recorded. Most service provision standards were met in rural health centres (RHCs) and basic health units (BHUs). However, the situation at civil dispensaries (CDs) was very alarming. Patients preferred RHCs on BHUs and CDs because of relatively better quality services provided in RHCs. However, in general, patients prefer to go to secondary or tertiary health care facilities due to the number of reasons identified by this study. Among the areas which demand quality improvement include cultural constraints, lack of following standard operating procedures (SOPs) for referral, no transport facility to referred patients, higher waiting time for patients, and no or fewer health education sessions, and unavailability of cold chain and waste disposal system. By addressing problem areas identified by this study, the KP government can reduce the patient burden on secondary and tertiary health facilities. As a result, service quality at PHCFs will improve access to primary health care, a world health organization’s millennium development goal, and the united nations’ sustainable development goal.