A study to evaluate the functioning of primary health care workers at the village level in rural Amritsar, Punjab, India

Abstract

Background: About 68% of the total population lives in rural India; which makes it important to focus on rural areas. The only way to avoid poverty in these areas; induced by healthcare expenditures, is to strengthen the public healthcare system. Here the role of primary health care workers becomes imperative in order to facilitate the community participation and to address various social and cultural barriers in the etiology of health and disease.

Methods: The present cross-sectional study was carried out in village Nagkalan, Amritsar, where the eldest adult member present in the house at the time of the visit was interviewed. Every house of the village was visited during the period of January 2017 to December 2017, and a total of 1123 families were included in the final analysis. Thereafter, data was compiled and analyzed.

Results: Majority of the families (72.7%), were visited by the ASHA occasionally; whereas 13.7% were never visited by her. Out of 969 families visited by ASHA worker, 73.4% were visited for imparting knowledge regarding immunization services while 29.9% and 14.1% were visited for maternal and child health services and treatment of minor ailments respectively. The association between socio-economic status and home visits performed by ASHA was found to be statistically significant. The study also revealed that only 8.3% and 1% of the families were ever visited by the female and male multipurpose health workers respectively. Out of total 1123 families, 99.1% were aware about the existence of Anganwadi centres in their village. However, out of those who knew, 69.4% ever visited the centre. Out of those who ever visited the Anganwadi centre, 68.8%, reported that the food availability there was occasional and mostly irregular.

Conclusion: The present study concluded that the home visits were mostly carried out by the ASHA workers (that too on occasional basis) while the contribution made by the multipurpose health workers was very less. The main reasons cited for the visits by ASHA worker were immunization of children, MCH related activities and for the treatment of minor ailments. Most of the families were aware about the existence of Anganwadi centre in the village; however majority of them reported that the food availability at the centre was occasional and mostly irregular.