Effective delivery of primary health care (PHC) services depends on teams of multidisciplinary health workers operating as a unit.
Practice Notes
A key characteristic of comprehensive and effective primary health care (PHC) is the service delivery by multidisciplinary teams functioning as a unit.
Non-communicable diseases (NCDs) have become one of the leading causes of mortality globally, accounting for nearly 43 million deaths in 2021.
Primary health care (PHC) services delivered through multi-disciplinary teams of healthcare workers is global best practice for delivering comprehensive and integrated care. Health policy in India also emphasizes team-based approaches to delivering PHC.
Under the Ayushman Bharat- Health and Wellness Centre (HWC) initiative, primary health care facilities are mandated to deliver 12 service packages aimed at extending comprehensive health services to communities. Ensuring that HWCs are ready to deliver these services is essential to make progress towards universal health coverage.
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).
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.