ISSN: 2578-5001
Authors: Kumari S, Nagarajan S, Sahu S, Choudhury CR, Songara D, Das A and Singh S
Context: To bolster the ambitious Program of Government of India (GOI), to build a strong and resilient healthcare system plans to establish 1,50,000 Health and Wellness Centres (HWCs) across the country by 2024, the GOI gave a clear to its partners to explore options. Aim: Therefore, LEHS | WISH, initiated a baseline study to assess the service availability and service readiness (SARA) status of 18 Sub-centres (SCs) and Primary Health Centres (PHCs) to be upgraded as HWCs to deliver the twelve package of services as envisaged in HWC guidelines to strengthen the primary healthcare system. Settings and Design: Health system resilience, was assessed against the 10 Areas of Concern, elaborated in National Quality Assurance Standards (NQAS) for all the 12 thematic areas of service delivery of HWCs. Methods and Material: A sequential mixed method of design was adopted, which included both quantitative and qualitative components of assessment. The major focus of the study was quantitative in nature to assess HWC facility level gaps across key areas. Qualitative study with stakeholders including that of the community was undertaken to elicit reasons for such gaps and awareness of the community to respond/ engage with health systems better. Statistical Analysis Used: STATA was used a quantitative analysis tool undertake the analysis. Results: on average, both the last mile healthcare delivery system (PHC and SC) and the community are less than 25% resilient, even for disasters. Conclusion: It is not possible to make the system resilient unless focused effort is made. Therefore, there’s a need to clearly define the essential services and its resource requirement to be made available 24X7 for 365 days without fail, offer regular training to the staff to ensure process resilience, create awareness within the community to engage with the health system optimally, strengthen local governance to assure provision of essential services.
Keywords: Health System Resilience; Assam and MP; India
