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22 views4 pages

Untitled Document

Uploaded by

F Parikh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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INTRODUCTION

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.

MATERIAL AND METHODS


Sample Size and Criteria for Selection
A cross-sectional descriptive study was carried
out to assess the quality of 05 BHUs out of total 35 BHUs
of district Bannu, BHUs were selected through convenient sampling techniques
in the outskirts of Bannu. The unit of study was individual irrespective of age and
sex of the respondent. Looking to the aim of the study and available resources ,
only 20 individuals were randomly selected from each BHU. In this way a total of
100 subjects were selected from 05 BHUs.. Though the sample size may or may
not be enough to represent the whole district, but it can indicate the actual
position of utilization of healthcare at BHUs in Bannu.

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.

Extent of Satisfaction/Dissatisfaction with Existing Health


Facilities
The subjects were also asked about their satisfaction on the overall health
facilities as presented in Table . Out of 100 respondents in the project area, 65
(65%) expressed their dissatisfaction on the health services. They complained
about the shortage of good quality medicines in the Basic Health Unit of their
villages. Moreover, they complained about the unavailability of the qualified
doctors in these health centers. Since there is also scarcity of transport service in
the night time, so in case of emergency it becomes very difficult for them to reach
the general hospitals of the city on time. Therefore, the respondents need 24
hours service in B.H.U’s, or at least 24 hours emergency service that will meet the
requirements of the villagers in case of emergency.

Timely appointment

Regarding the staff, results were mostly positive with 90% of respondents
claiming that their appointment was on time and 89% claiming that the staff was
cordial and welcoming.

Communication with the staff


The respondents raised concerns over the communication and behavior of
Healthstaff at BHU. 50% of respondents claimed that the behavior of staff was
very poor and 50% claimed that the behavior of staff was good, cordial and
welcoming. The analysis of narratives of respondents shows that the unfriendly
attitude and behavior of BHU staff caused negative feelings among those
interviewed.

Availability of Free Medicine


When asked about availability of medicine , 75% claimed that they did not receive
any medicine ( table ). They reported that the incomplete and unavailability of free
medicine is a main factor that pushes them to go for private care. Respondents
raised complains in the following words;
“ The medicines are only given at the beginning of the month. If I need
medical care in the later days of the month, the medicine is not available. The staff
say that the current supply of medicine is not sufficient.” ( female respondent ,age
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. 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.

Use of Family Planning Services


As can be seen in Table , as a whole 65 (65%) respondents in the project area
reported to have practiced family planning methods and have visited the BHU for
family planning services as against 35 (35%) respondents who did not practice
family planning methods. The different contraceptive methods found to use by the
respondents were injections, condoms, and oral pills.

Attitude towards Expanded Programme on Immunization (EPI)


EPI is working against six communicable diseases namely Tuberculosis,
Poliomyelitis, Diphtheria, Whooping cough, Neonatal Tetanus and Measles. The
services of EPI is available free of cost in almost every health centers of the
country. The response and attitude of the villagers reported by the sample
respondents was very encouraging, which can be seen in Table

Lack of laboratory and diagnostic services


At BHU level, it is mandatory to provide laboratory services. However,
unavailability of diagnostic tests for chronic disease such as diabetes, TB and
widal were not available. Out of 5 only one BHU provides laboratory services.

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