Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy?
Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people'...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2019-01-01
|
| Series: | Journal of Family Medicine and Primary Care |
| Subjects: | |
| Online Access: | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=Ramani |
| _version_ | 1818150737166729216 |
|---|---|
| author | Sudha Ramani Muthusamy Sivakami |
| author_facet | Sudha Ramani Muthusamy Sivakami |
| author_sort | Sudha Ramani |
| collection | DOAJ |
| description | Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care. |
| first_indexed | 2024-12-11T13:27:41Z |
| format | Article |
| id | doaj.art-e5f25ec7409b46ac856cec4348d02016 |
| institution | Directory Open Access Journal |
| issn | 2249-4863 |
| language | English |
| last_indexed | 2024-12-11T13:27:41Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj.art-e5f25ec7409b46ac856cec4348d020162022-12-22T01:05:28ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632019-01-01892837284410.4103/jfmpc.jfmpc_650_19Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy?Sudha RamaniMuthusamy SivakamiIntroduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=RamaniCommunityhealth and wellness centersprimary health centersqualitative |
| spellingShingle | Sudha Ramani Muthusamy Sivakami Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? Journal of Family Medicine and Primary Care Community health and wellness centers primary health centers qualitative |
| title | Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? |
| title_full | Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? |
| title_fullStr | Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? |
| title_full_unstemmed | Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? |
| title_short | Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? |
| title_sort | community perspectives on primary health centers in rural maharashtra what can we learn for policy |
| topic | Community health and wellness centers primary health centers qualitative |
| url | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=Ramani |
| work_keys_str_mv | AT sudharamani communityperspectivesonprimaryhealthcentersinruralmaharashtrawhatcanwelearnforpolicy AT muthusamysivakami communityperspectivesonprimaryhealthcentersinruralmaharashtrawhatcanwelearnforpolicy |