Performance of Primary Health Centres, Provider’s Perspective of Wellbeing, and Patient’s Assessment of the Centres Using a New Tool in Bangalore, India: An empirical study

Abstract

Background: Primary healthcare in India comprises health promotion and preventive health interventions at the population level, which are rendered at dedicated centres called Primary Healthcare Centres (PHCs). The performance of PHCs is vital for overall improvement in the general health of the population, specifically in a low- and middle-income country like India. It is unknown how performance at the centre level is related to performance at the provider and patient levels. The aim of this study is to explore patterns in the performance of three PHCs with a low, medium and the high number of babies delivered.
 Methodology: Primary and secondary data from the three selected PHCs were collected. Two questionnaire studies were done: one on the well-being of providers (Quality of Life and Engagement), and another on PHC performance as assessed by patients using the newly developed tool ‘Questionnaire for Patient’s Perspective on Performance of Primary Healthcare Centres’. The data from the centre, provider and patient levels were compared across the three centres using ANOVA tests.
 Results: The new tool had high internal consistency at Cronbach’s alpha score of 0.938. It was found that the PHC with the least delivery had significantly higher PHC performance in comparison with high and medium-delivery PHCs (p<0.000).
 Conclusion: The PHC performance assessment from multiple perspectives offers a realistic insight into the centres, which is valid even though agreement on the various perspectives could not be obtained. The new Q4PHC is a reliable instrument to assess PHC performance from the patient’s perspective.