Department of Community Medicine, K.P.C. Medical College and Hospital, Kolkata, India.
Indian J Public Health. 2011 Apr-Jun;55(2):70-80. doi: 10.4103/0019-557X.85235.
A cross sectional observational study was carried out in three districts of West Bengal by following observational, quantitative and qualitative methods during July to December 2006 to find out the extent of utilization, strengths, weaknesses and gap as well as suggest recommendations in connection with health care delivery system for the state of West Bengal, India. A total of 672 episodes of illnesses were reported (2 weeks recall) by the study population of the three selected districts in three geographically separated divisions of West Bengal. None did seek care from any health facilities for treatment in case of 221 (32.89%) episodes; especially from tribal areas where in case of 76.19% none sought any health care from any facilities depended on their home remedies. In rest of episodes the (451), majority preferred government health facilities (38.58%), followed by Unqualified quacks (29.27%) due to low cost as well as living in close proximity, 27.27% preferred qualified Private practitioners and only 4.88% preferred AYUSH, as a first choice. Referral was mostly by self or by close relatives/families (61%) and not by a doctor. Awareness is required to avoid unnecessary referral. Cleanliness of the premises, face-lift, and clean toilet with privacy and availability of safe drinking water facilities could have an improved client satisfaction in rural health care delivery systems. This could be achieved through community participation with the involvement of PRI. However, as observed in the study RCH services including Family Planning as well as immunization services (preventive services) were utilized much better while there was a strong need of improvement of Post Natal Care, otherwise, Neonatal and Maternal mortality and morbidity will continue to be high.
本研究采用观察性、定量和定性方法，于 2006 年 7 月至 12 月在西孟加拉邦的三个地区进行了一项横断面观察性研究，旨在发现印度西孟加拉邦医疗保健提供系统的利用程度、优势、劣势和差距，并提出相关建议。在三个地理上分隔的地区中，共有 672 例疾病报告（2 周回顾）。在 221 例（32.89%）中，没有一人因疾病前往任何医疗机构接受治疗，特别是在部落地区，有 76.19%的人没有依赖家庭疗法前往任何医疗机构寻求医疗服务。在其余的病例中（451 例），大多数人选择政府卫生机构（38.58%），其次是不合格的庸医（29.27%），因为费用低廉且就近居住，27.27%的人选择合格的私人医生，只有 4.88%的人选择 AYUSH 作为首选。转诊主要是由患者自己或近亲/家人（61%），而不是医生进行。需要提高认识，避免不必要的转诊。改善农村医疗保健提供系统的患者满意度，可以通过社区参与并由 Panchayati Raj Institution（印度地方自治机构）参与来实现，需要改善环境卫生、翻修、带隐私的清洁厕所和提供安全饮用水设施。研究中观察到，包括计划生育和免疫接种服务（预防服务）在内的生殖健康服务得到了更好的利用，而产后护理需要大力改进，否则新生儿和产妇的死亡率和发病率将继续居高不下。
