Health care facility vulnerability in developing nations: strengthening health care policy-making and implementation
- 52 Downloads
In developing countries such as India, inadequate importance and consideration given to assessment of health care facilities negatively affects progress towards achieving health targets. India has focused on developing Primary Health Centres (PHCs) for rural basic laboratory and curative services. The local decision-makers do not have any national-level framework to evaluate the vulnerability of PHCs which are not meeting national PHC standards, nor do they have resources to meet national PHC standards.
The study proposed a framework to assess the public health care facilities for vulnerability.
A cross-sectional questionnaire survey was performed. The study used PHC laboratory services of 42 PHCs of Osmanabad District, India as a case study for proposed framework. The data assessment was carried out at district level, block level, PHC cluster level, and PHC level to provide flexibility to local decision-makers in taking remedial measures.
Staff workload (73.17%), physician’s need (51.22%), and organization structure (36.59%) are the most prevalent challenges across PHCs. Multiple challenges are prevalent in the PHCs across districts. The PHCs with poor medical doctor (MD) capability or many challenges have shown poor laboratory performance.
Governance need to be strengthened in PHCs, followed by sustained support in resources and financing. Poor health status in developing nations necessitates a public health response based on health systems. Therefore, an assessment of health facility vulnerability in the form of laboratory services is essential in primary health care facilities.
KeywordsHealth care facility Vulnerability assessment Laboratory services Primary Health Centre India
Community Health Centre
District Health Office
high prevalence rate
Indian Public Health Standards
low prevalence rate
Maternity and Child Hospital
National Rural Health Mission
Primary Health Centre
Rogi Kalyan Samiti
World Health Organization
We would like to acknowledge the support provided by Dr. Prashant Narnaware, District Collector, Osmanabad, Maharashtra for granting us permission and providing support during our stay in Osmanabad. We would also like to acknowledge the support of District Health Office, Osmanabad, Maharashtra and all the respondents.
Compliance with ethical standards
Conflict of interest
Author Rahi Jain declares that he has no conflict of interest. Author Bakul Rao declares that she has no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors. The respondents themselves were not the focus of the study; rather, the focus of the study was the framework to adopt for quality assessment and improvement activity. No personal identifying information was collected, and response was voluntary. Nevertheless, oral informed consent was obtained from all individual participants included in the study.
- Abimbola S, Olanipekun T, Igbokwe U, Negin J, Jan S, Martiniuk A, Ihebuzor N, Aina M (2015) How decentralisation influences the retention of primary health care workers in rural Nigeria. Glob Health Action 8:1–11Google Scholar
- Bhore J, Amesur R, Banerjee A (1946) Report of the Health Survey and Development Committee. Government of India, DelhiGoogle Scholar
- Jain R, Rao B (2016) Taxonomy of challenges in medical laboratory diagnostic services. In: 22nd International Academic Conference. International Institute of Social and Economic Sciences, LisbonGoogle Scholar
- MoHFW (Ministry of Health and Family Welfare) (2005) National Rural Health Mission: framework for Implementation (2005–2012). Government of India, New DelhiGoogle Scholar
- MoHFW (Ministry of Health and Family Welfare) (2012a) Indian Public Health Standards (IPHS) for primary health centres revised guidelines 2012. Government of India, New DelhiGoogle Scholar
- MoHFW (Ministry of Health and Family Welfare) (2012b) Indian Public Health Standards (IPHS) guidelines for sub-centres revised 2012. Government of India, New DelhiGoogle Scholar
- Office of Registrar General and Census Commissioner (2011) Census 2011: Population Enumeration Data. Ministry of Home Affairs (India), New Delhi. http://www.censusindia.gov.in/2011census/population_enumeration.html. Accessed 11 Jan 2016
- Planning Commission of India (1999) Report of working group on requirements for supportive and diagnostic services at primary, secondary and tertiary level. Planning Commission of India, New DelhiGoogle Scholar
- WHO (2010) Key components of a well functioning health system. WHO, GenevaGoogle Scholar
- WHO (2013) Arguing for universal health coverage. WHO, GenevaGoogle Scholar
- World Bank (2017) World Development Indicators: Health expenditure (% of GDP). http://data.worldbank.org/indicator/SH.XPD.PUBL.ZS?year_high_desc=false. Accessed 23 Aug 2017