LBJ School of Public Affairs, University of Texas at Austin, Austin, Texas, United States of America.
Mechanical Engineering Department, University of Texas at Austin, Austin, Texas, United States of America.
PLoS One. 2021 Jun 4;16(6):e0252705. doi: 10.1371/journal.pone.0252705. eCollection 2021.
Primary healthcare systems worldwide suffer from major gaps in infrastructure and human resources. One key infrastructure gap is access to reliable electricity, absence of which can significantly affect the quantity and quality of healthcare services being delivered at rural primary health facilities. However, absence of granular empirical evidence is a barrier for quantitatively understanding the significance of electricity access as one of the determinants of access to reliable primary healthcare. Using data from India's District Level Household and Facility Survey, we develop zero-inflated negative binomial models with co-variates and state-level fixed effects to estimate the relationship between levels of electricity access and the quantity of basic health services delivered at Primary Health Centers (PHCs). We find that lack of electricity access is associated with a significant and large decrease in the number of deliveries (64 percent), number of in-patients (39 percent), and number of out-patients (38 percent). We further find that lower level of electricity access at primary health centers is disproportionately associated with adverse effects on women's access to safe and quality healthcare.
全球初级医疗保健系统在基础设施和人力资源方面存在重大差距。一个关键的基础设施差距是无法获得可靠的电力，而电力的缺乏会显著影响农村初级卫生保健设施提供的医疗服务的数量和质量。然而，缺乏具体的经验证据是定量理解电力供应作为可靠的初级医疗保健获取的决定因素之一的意义的障碍。利用来自印度的地区级家庭和设施调查的数据，我们开发了带有协变量和州级固定效应的零膨胀负二项模型，以估计电力供应水平与初级保健中心（PHC）提供的基本医疗服务数量之间的关系。我们发现，缺乏电力供应与分娩数量（64%）、住院病人数量（39%）和门诊病人数量（38%）的显著减少有关。我们进一步发现，初级卫生保健中心电力供应水平较低与妇女获得安全和优质医疗保健的机会受到不利影响不成比例地相关。
