Health facility disparities at phc level : A comparitive study between Andhra Pradesh and Bihar

Abstract

The establishment of Primary Health Centres in India started as early as in 1952, and over the last six decades it has undergone several changes to meet the increasing demand for health care services. During the Eighth and subsequent plans the emphasis was mainly on consolidation of existing health infrastructure rather than on expansion. The National Health Policy stressed on the provision of preventive, promotive and rehabilitative health services to the people thereby making a shift from medical care to health care in the rural areas. Services are provided through a network of integrated health and family welfare system and the health programmes have been restructured and reoriented from time to time to meet the objectives of the National Health Policy. Data were drawn from INDIA FACILITY SURVEY (Under Reproductive and Child Health Project) Phase – II, conducted during 2003. Totally 1225 sampled PHCs were considered for this study at Andhra Pradesh (380) and Bihar (845). In line with this, the Ministry of Health and Family Welfare (MoHFW), Government of India (GoI) is implementing a Reproductive and Child Health (RCH) programme in the country. The primary aim of the RCH Programme is to bring all the RCH services within easy reach of the community. Primary Health Centres (PHCs) comprise the second tier in rural healthcare structure envisaged to provide integrated curative and preventive healthcare to the rural population with emphasis on preventive and promotive aspects. PHCs are established and maintained by State Governments under the Minimum Needs Programme (MNP)/Basic Minimum Services Programme (BMS) There were 23,236 PHCs functioning in September 2005 compared to 23,109 a year earlier, according to the Ministry of Health. Though the numbers appear to be increasing there is still a shortfall of about 16 per cent when compared to the required norms for PHCs.The parameters of availability of infrastructure, staff, equipment, training and supplies have an impact on utilization levels and health outcomes in these States. In this regard, demand as well as supply side constraints are observed (on staff, infrastructure, equipment, training and supplies) which restrain the optimum utilization of existing health services in Bihar when compare to Andhra Pradesh state.