Assessment of grassroot level health care service delivery system in a community development block of Haryana: A cross sectional study

Indian J Public Health. 2021 Apr-Jun;65(2):124-129. doi: 10.4103/ijph.IJPH_1325_20.

Abstract

Background: Health-care service delivery is one of the components of six building blocks of World Health Organization Health System Framework. In order to monitor the progress of health-care service delivery, it is necessary to monitor its dimensions.

Objective: The current study aimed to assess the health-care service delivery at the lowest health-care delivery post in Haryana.

Methods: In this cross-sectional observational study conducted in 17 randomly selected subcenters of Block Shahzadpur, Haryana, from July 2019 to March 2020, an Evaluation Framework was developed to monitor health-care service delivery through its three parameters, namely, service delivery, service provision, and facility assessment. The pretested, semi-structured tools were designed on Epi collect online (version 5) application using the available validated tools.

Results: The mean service delivery score for antenatal care assessment, postnatal care assessment, and immunization is 74.9 (78.9%), 24.7 (98.6%), and 40.2 (87.3%), respectively, with an overall score of 139.8 (84.2%). The mean service provision score as assessed by patients and their caregivers through exit interview on five elements was 97%. The mean total score for facility assessment parameter was 81.7 (86.9%). The overall health service delivery score calculated by adding scores of all three parameters was 318.4 (maximum attainable score = 360, 88.4%).

Conclusion: A good correlation was observed between individual parameters with total score, indicating higher performance of health-care delivery system. The future studies should focus on understanding the gaps at grassroot level and lay down the dashboard indicators for objectively evaluating health-care delivery system.

Keywords: Grassroot level health care; North India; health service delivery; primary health care; sub centre.

Publication types

  • Observational Study

MeSH terms

  • Caregivers
  • Cross-Sectional Studies
  • Delivery of Health Care*
  • Female
  • Health Facilities*
  • Humans
  • India
  • Pregnancy