Functioning of PHCs

Healthcare Delivery System (prior to VHAI’s takeover)

1. PHCs were almost dysfunctional, so, people had to shoulder a great deal of financial burden due to high morbidity.
2. PHCs might be having Medical Officer in record but no one was living in duty station. Doctors those were drawing salaries from respective PHCs used to visit their PHCs hardly for a day or two in a month.
3. Staffing was insufficient in all five PHCs. PHCs were literally run by very few Paramedical Staff
4. Few PHCs had Microscope but no pathological and bio-chemical investigations were conducted due to lack of staff.
5. Poor maintenance of PHC building and there was no concept of ownership among the staff or community. PHCs were quite dirty.
6. No Ambulance service was available in these PHCs.
7. Severe shortage of drugs and most of the time it was mentioned as out of stock
8. Indoors were not at all functioning.
9. Very few Sub Centres had staff.
10. Outreach services were not reaching to the community in nearly 90% of the villages.
11. 24-hour duty system was not prevailing in a single PHC to attend emergency cases.
12. Health Information System was totally paralyzed, so, whatever reports had been generated might not credible.
13. Little or no supervision by Health Administrators further aggravating the problems at PHCs.

People’s Health Status (prior to VHAI’s takeover)

1. Health seeking behaviour of community was not satisfactory.
2. Routine Immunization was hardly reaching to 10% of the beneficiaries.
3. ANC and PNC services were very low and so as the registration of pregnancies.
4. At least 75% of the pregnant women were anaemic.
5. Nearly 80% of the deliveries were conducted by untrained personnel.
6. Unmet need of the eligible-couple was high due to the unavailability of family welfare services.
7. Prevalence of communicable diseases was quite high among common people mainly due to lack of curative and preventive services.
8. Most of the people had inadequate knowledge and attitude on preventive and promotive aspects of healthcare.
9. Non-availability of proper primary healthcare services was forcing people to approach the quacks most of the time, so, irrational drug use increased to a large extent.

Healthcare Delivery System (After 33 months’ functioning of VHAI)

• Adequate number and trained staff has been recruited in all the PHCs.
• Out Patient Departments (OPD) are fully functional.
• Emergency services are available round-the-clock.
• Indoor is fully functional.
• All VHAI-managed PHCs have Ambulance service.
• Drugs and other pharmaceutical products are supplied to the PHCs in appropriate quantity.
• PHC Laboratories are fully equipped for conducting necessary pathological and bio-chemical investigations.
• Routine Immunisation has improved significantly.
• Moderate improvement in Ante Natal Care and Post Natal Care services for the eligible women.
• Increase in the Institutional Deliveries in PHCs by Doctors and Nurses
• Microscopy Centre and DOTS service in selected PHCs under RNTCP.
• Active involvement of PHC Management Committees.
• Detailed survey, from primary-health-care point of view carried out in almost all the villages of our operational area.
• A hygienic environment created in all the PHCs.
• Health Education Service started at community level.
• Disease-surveillance system has improved due to team members’ presence in PHCs and Sub Centres as well as regular house visits. Monthly reports of PHCs are prepared and submitted to the state authorities.
• Minor OTs have been made functional in all PHCs.
• Necessary equipments have been supplied to all PHCs for Indoor, OT, Labour Room, Laboratory and other departments.
• Traditional Systems of Medicine integrated in PHC.
• PHCs are properly monitored by competent professionals.
• Staff turn over has minimised.
• Community residents, officials and leaders are happy with VHAI’s inputs vis-à-vis progress made in 33 months period.
• Efforts towards demand generation for quality healthcare.
• Nine Sub Centres have been made fully functional by VHAI.