Assessment of grassroot level health care service delivery system in a community development block of Haryana: A cross sectional study.

Abstract

Health-care service delivery is one of the components of six building blocks of World Health Organization Health System Framework. In order to monitor the progress of health-care service delivery, it is necessary to monitor its dimensions. The current study aimed to assess the health-care service delivery at the lowest health-care delivery post in Haryana. In this cross-sectional observational study conducted in 17 randomly selected subcenters of Block Shahzadpur, Haryana, from July 2019 to March 2020, an Evaluation Framework was developed to monitor health-care service delivery through its three parameters, namely, service delivery, service provision, and facility assessment. The pretested, semi-structured tools were designed on Epi collect online (version 5) application using the available validated tools. The mean service delivery score for antenatal care assessment, postnatal care assessment, and immunization is 74.9 (78.9%), 24.7 (98.6%), and 40.2 (87.3%), respectively, with an overall score of 139.8 (84.2%). The mean service provision score as assessed by patients and their caregivers through exit interview on five elements was 97%. The mean total score for facility assessment parameter was 81.7 (86.9%). The overall health service delivery score calculated by adding scores of all three parameters was 318.4 (maximum attainable score = 360, 88.4%). A good correlation was observed between individual parameters with total score, indicating higher performance of health-care delivery system. The future studies should focus on understanding the gaps at grassroot level and lay down the dashboard indicators for objectively evaluating health-care delivery system.