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The role of BHUs in treating common diseases among local population cannot be ignored. BHUs
are the first level care facilities to provide healthcare to local communities. Pakistan having population of
more than 200 million people has extensive network of BHUs. Pakistan is a nation that has made progress
towards economic development but is struggling towards sustainable development.
Most of these BHUs have not been fully utilized with average number of only 10 to 20 patient reporting
per day due to reasons like administrative, infrastructure problems, non-availability of medicine, problems
with attitudes of health professionals and inaccessible locations. Health system now focuses on their
primary health services through clinical and financial aspects to get better results and in turn whole health
system becomes sustainable. For provision of high quality of primary health care services there is a dire
need to develop methods for quality assessment and monitoring system.Physical structure of these
centers should incorporate availability of all required equipment and continuous supply of drugs to meet
needs of population. In addition to this, availability of staff and their behavior is also important to
strengthen the role of these facilities in the provision of health services.
China has made large investments in health by upgrading its primary health care level by making it
more affordable, accessible and according to the needs of people. Patient’s experience at a health facility
is a major determinant of trust and satisfaction with services provided. Countries having strong primary
health care systems have reduced morbidity, increased longevity of people and increased equity in health
outcomes.
This study is aimed to assess the service provisions of Basic health units of Bannu district. This
will improve our understanding about the service provision in these facilities and will alert the
governmental agencies about the deficiencies identified.
Data Collection
A simple questionnaire form was used to collect information regarding the utilization and availability of healthcare at the
Basic Health Unit . Before interviewing, the individuals were briefed about each question in the form. Keeping in view the
education level of the respondents, the questions, originally framed in English, were asked in local language i.e. Pushto.
Emphasis was laid to get information in a friendly atmosphere and in privacy, so that the respondent may not feel
embarrassed and hesitate answering in the presence of others. The data was collected during a period of three months.
A thorough analysis of BHUs was done in three domains which were staff attitude, availability of essential drugs , and
facilities available at these health centers. Likert scale was used to assess these domains and questionnaires were filled
by patients or their attendants.
Data Analysis
The collected data was analyzed using computer software (Ms Excel). The percentages of answers of each question
were determined and presented in tables.
RESULTS
Availability of clean water
Regarding availability of water, 75% of the patients said that clean drinking water was
available during their stay at health unit, while 50% of patients said that there was no electricity at
BHU during their visit. The number of patients per day was calculated (during working hours from 8
am to 2 pm) after consulting the respondents and by taking record of medical registers and average
number of patients was 15 to 20 per day.
Timely appointment
Regarding the staff, results were mostly positive with 90% of respondents claiming that their appointment was on time
and claiming that the staff was cordial and welcoming as present in table 2.
35 )
“ I can not afford to go to a private clinic, so I rely on healthcare in BHU. Therefore, I have to wait until the start of
last month.” ( Male respondent, age 28) The respondents further disclosed that the medicine given was of low quality.
Accessibility of BHU
When asked about accessibility of BHU, 65% of respondents claimed that BHU was accessible to them and 35% raised
their concerns about the inconvenient location of BHU ( table 5) . Due to long distances from home to BHU and lack of
transport , the use of BHU services are hindered , particularly by the women. The women face accessibility problems due
to lack of transportation facilities. Moreover, their access to BHU becomes more problematic because their
unaccompanied travel to health facilities is not seen as honorable in local society.
BHUs Satisfied
Yes %age No %age
Bizen Khel 0 0% 20 100%
Jando Khel 5 25% 15 75%
Azim Kila 12 60% 8 40
Khalifa Gul Nawaz 13 65% 7 35
Nizam Bazar 5 25% 15 7
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Project Area 35 35% 65 65%
Tab2. Response
towards wait time
BHUs Wait Time
Short %age Long %age
Bizen Khel 18 90% 2 10%
Jhando Khel 17 85% 3 15%
Azim Kila 19 95% 1 5%
Khalifa Gul Nawaz 19 95% 1 5%
Nizam Bazar 17 85% 3 3%
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Project area 90 90% 10 10%
BHU Accessibility