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 effi ciency 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 fi nd out solutions to address these bottlenecks. Materials and Methods: This crosssectional study was carried out in Cuttack district during Dec 2010 and January 2011 using a semi-structured pre-tested questionnaire. Data regarding various diffi culties 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 offi cer, AYUSH medical offi cer, Maternal Child Health co-coordinators and Block Programme Offi cers). Data were analyzed manually using content analysis. Results: Diffi culty in vaccine delivery, inadequate infrastructure and lack of suffi cient manpower for smooth functioning of JSY, diffi culty in card updation and diffi culty in retrieval of defaulter of alcoholic TB patients for Directly Observed Treatment Shortcourse (DOTS) are some of the problems identifi ed in general. Conclusion: The study identifi ed 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. Identifi cation of loop holes and bridging the gap by corrective action will make the journey towards Millenium Development Goal (MDG) easier.

Availability of Village Health and Nutrition Day services in Uttarakhand, India

“…National Rural Health Mission (NRHM) was launched by Government of India in 2005 to improve health outcomes for millions of rural people, especially those belonging to marginalized and vulnerable communities that encompassed health, nutrition and sanitation services to provide health care to all in equal proportions. [ 1 2 3 ] Village Health and Nutrition Day (VHND) was identified as an important tool to provide a unique platform at village level to bring about the convergence of health, nutrition and sanitation services at primary care level. [ 4 ] Ministry of Health and Family Welfare, Government of India (MOHFW, GOI) issued a guideline for its effective implementation in 2007.…”

Planning and preparation of VHND through convergence: Sharing experiences from Uttarakhand

“…To ensure improved health outcomes for millions rural people, especially those belonging to marginalized and vulnerable communities, National Rural Health Mission (NRHM) was launched by Government of India in 2005 encompassing health, nutrition and sanitation services to provide health care to all people in equal proportions. [1][2][3] After six decades of independence, though there has been a substantial improvement in the health and well-being of the people, yet undernutrition remained in the background as a silent emergency as half of all the children under the age of three are underweight, one-thirds are born with low birth weight; half of the women and three-fourths of the children are anaemic. Hence, nutrition has been brought as a centre stage element under NRHM program.…”