Bottlenecks identified in the Implementation of components of national health programmes at PHCs of Cuttack district of Odisha

Abstract

Introduction: Primary health care is the nucleus of country's health care delivery system. Bottlenecks in delivery of services at PHC level leads to decreased efficiency of health system and indirectly affects health of the citizens of a country. Keeping these issues in mind a study was carried out with the objectives i)To identify constraints/bottlenecks in implementation of elements of primary health care ii)To find out solutions to address these bottlenecks. Materials and Methods: This cross-sectional study was carried out in Cuttack district during Dec 2010 and January 2011 using a semi-structured pre-tested questionnaire. Data regarding various difficulties faced while delivering health care services at PHC was collected from participants attending district level IMNCI (Integrated Management of Neonatal and Childhood Illness) training after getting verbal consent. All 72 respondents who had attended the training during the above mentioned period were included in this study (Medical officer, AYUSH medical officer, Maternal Child Health co-coordinators and Block Programme Officers). Data were analyzed manually using content analysis. Results: Difficulty in vaccine delivery, inadequate infrastructure and lack of sufficient manpower for smooth functioning of JSY, difficulty in card updation and difficulty in retrieval of defaulter of alcoholic TB patients for Directly Observed Treatment Shortcourse (DOTS) are some of the problems identified in general. Conclusion: The study identified the need for strengthening infrastructure and manpower to provide quality care for institutional delivery. It also emphasized the need for construction of more number of sub centre buildings which forms the backbone of rural health care delivery system. Identification of loop holes and bridging the gap by corrective action will make the journey towards Millenium Development Goal (MDG) easier.