Baseline Assessment of Primary Healthcare Delivery Through Subcenters of Northern India.

Abstract

BackgroundOur study assessed the status of facilities and services available at the subcenter level and identified the gaps that deter the realization of universal health coverage.MethodsA cross-sectional observational study design was used for assessing the subcenters of the Ambala district, Haryana, India with a predesigned, semi-structured tool containing 88 items marked on an ordinal scale. The subcenters were assessed and scored as per their functioning and delivery of various services, their coverage, and quality in terms of various national health programs.ResultsWe found that the essential infrastructure of most of the buildings was average. The types of equipment for antenatal examination, vital medicines, and prominent display boards in the local language were present in all subcenters. The majority of the health workers (n = 27; 93%) successfully demonstrated proper handwashing techniques; 65% correctly measured blood pressure during an objective structured clinical examination (OSCE), and 48% could correctly estimate hemoglobin with a hemoglobinometer. Sound knowledge regarding maternal and child healthcare practices and guidelines was noted in 89% of the health workers.ConclusionsThe health system of Haryana has scope for improvement in terms of health centers. It is pertinent for the realization of universal health coverage. Therefore, internal audits similar to what we performed must be planned and executed as a regular activity within the framework of existing health systems.