Globally, non-communicable diseases (NCDs) account for 41 million deaths annually with most occurring in low- and middle-income countries (1). In India, NCDs contribute to 63% of deaths (2). The North-East Region carries a disproportionate burden, with 66% of deaths due to NCDs (3). Prevalence of diabetes (13.6%) (4) and hypertension (31.6%) (5) in the region is higher than national averages (9.6% and 31.1%) respectively(6,7).
Practice Notes
Better quality of care (QoC) at primary health care facilities is essential for India to achieve Universal Health Coverage (1). Over the past decade, several national quality initiatives including the National Quality Assurance Standards (NQAS), Kayakalp, and Labour room quality improvement initiative (LaQshya)1 have been launched to standardize and elevate quality in healthcare delivery.
Multidisciplinary teams of health workers working together is associated with comprehensive and integrated primary health care (PHC) services. Responding to a wide range of community health needs requires a diverse skill mix among PHC workers. Exemplar PHC delivery models from countries like Brazil, Thailand and Costa Rica incorporate multidisciplinary teams which work as a unit to provide PHC services. Further, global health agencies like the World Health Organization (WHO) emphasize the importance of health worker teams to deliver services.
In the Ayushman Arogya Mandir program (AAM; formerly known as Health and Wellness Centres), primary health care facilities are mandated to deliver 12 service packages that together provides comprehensive health services to communities. Evaluating service readiness of health facilities to deliver these packages provides insights into their functional status and helps identify areas for improvement. In this note, we discuss findings from a service readiness assessment of AAMs in Kalahandi district of Odisha (Figure 1).
Evaluating service readiness of health facilities provides insights into their functional status and helps identify areas for quality improvement. In this note we discuss findings from a service readiness assessment of Sub-health centres in Bhavnagar district of Gujarat. Implications of the study findings for the Health and Wellness Center program to deliver comprehensive primary health care is discussed.
The Ministry of Health and Family Welfare’s ‘Ayushman Bharat’ program aims to strengthen Comprehensive Primary Health Care (CPHC) through Health and Wellness Centers (HWCs, now known as Ayushman Arogya Mandir or AAM). The AB-HWC program seeks to transition from a selective approach to a comprehensive model of delivering primary healthcare services.
Evidence informed decision-making using routine health information systems has been an ongoing challenge due to various factors. In the current context of Health and Wellness Centres (HWCs), information is available across multiple, disease- or program-specific data portals; however, there is no integrated system that can enable facility and block/district managers to make decisions on comprehensive health of the population.
Series #6: Community action for better health: The potential of Village Health Councils in Meghalaya
The state of Meghalaya, in north-eastern India, has been at the forefront of promoting community involvement through Village Health Councils (VHCs). VHCs are elected bodies comprising key village representatives. VHC are mandated to organise efforts around improving nutrition and health in their communities, and thereby bridge the gap between the community and primary health care system.
Team-based models of delivering primary health care services are widely recognized as necessary for providing people with comprehensive and continuous health care. While health policy guidelines in India identify roles and responsibilities of each team member at Sub-Health Centers (now known as Ayushman Arogya Mandir; previously Health and Wellness Centers), there is a need to obtain a grounded understanding of team functions and corresponding team competencies (i.e. key knowledge, skills, abilities, and attitudes) that teams should possess to deliver health services effectively.
Digital health information systems are essential for collecting information on population health. However, data collection challenges including technological barriers and redundant data entry processes increase the workload for data collection. In West Garo Hills in the state of Meghalaya, health workers put significant time and effort into data collection, fragmented data management systems and inefficient processes mean that the data collected is not effectively used to improve service delivery.