Department of Primary Care, CAPHRI, Maastricht University, Maastricht, The Netherlands.
Department of Health Ethics and Society, Research Institute CAPHRI, Maastricht University, Maastricht, The Netherlands.
Int J Health Plann Manage. 2021 Sep;36(5):1533-1552. doi: 10.1002/hpm.3176. Epub 2021 May 6.
Primary healthcare centres (PHCs) form the foundation of the Indian public health system, and thus their effective functioning is paramount in ensuring the population's health. The World Health Organisation (WHO) has set six aspects of performance assessment for general health systems, which are hardly applicable to the PHC setup in a low- and middle-income country. The Primary Health Care Performance Initiative (PHCPI) has prescribed a framework with five domains consisting of 36 indicators for primary healthcare performance assessment from a policy point of view. For the assessment to be realistic, it should include inputs from stakeholders involved in care delivery, so this study examines the perspectives of healthcare providers at PHCs in India.
The authors used qualitative research methodology in the form of responsive evaluations of healthcare provider's interviews to understand the indicators of PHC performance.
The study results showed that healthcare providers considered efficient teamwork, opportunities for enhancing provider skills and knowledge, job satisfaction, effective PHC administration, and good community relationship as PHC performance assessment. These domains of performance could be considered the 'missing link' in PHC assessment, since they are deemed important by providers and did not coincide with the WHO aspects and the PHCPI performance assessment framework.
初级医疗中心(PHC)构成了印度公共卫生系统的基础,因此,其有效运作对于确保民众健康至关重要。世界卫生组织(WHO)为一般卫生系统制定了六个绩效评估方面,这些方面几乎不适用于中低收入国家的 PHC 机构。初级卫生保健绩效倡议(PHCPI)从政策角度规定了一个包含五个领域的框架,其中包括 36 个初级卫生保健绩效评估指标。为了使评估具有现实意义,它应该包括参与医疗服务提供的利益相关者的投入,因此本研究考察了印度 PHC 医疗服务提供者的观点。
作者使用了定性研究方法,对医疗服务提供者的访谈进行了响应性评估,以了解 PHC 绩效的指标。
研究结果表明,医疗服务提供者认为高效的团队合作、提高提供者技能和知识的机会、工作满意度、有效的 PHC 管理以及良好的社区关系是 PHC 绩效评估的指标。这些绩效领域可以被视为 PHC 评估中的“缺失环节”,因为它们被提供者认为很重要,而且与 WHO 方面和 PHCPI 绩效评估框架不一致。