Project Coordinator, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Field Coordinator, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Public Health. 2021 Jul-Sep;65(3):275-279. doi: 10.4103/ijph.IJPH_1489_20.
The Government of India introduced a new cadre of Community Health Officers (CHOs) in the primary health-care system through the Ayushman Bharat Health and Wellness Centres (HWCs) program.
The study aimed to assess the activities performed and time spent by the existing and new primary health-care team members at the HWC level.
A time and motion study was undertaken in four HWCs in Punjab over a period of 3 months, to assess the time spent by auxiliary nurse midwives (ANMs) and CHOs on different services and activities. Data were collected through direct continuous observation of four CHOs and four ANMs during working hours for a period of 6 consecutive days of a week, along with structured time allocation interviews of all participants.
The CHOs spent 5.7 (5.6-5.9) hours per day on duty of which 57% was productively involved in service delivery. The average time spent by ANMs was 4.9 (4.5-5.3) hours per day, with nearly 62% productive time. While the CHOs spent nearly 40% of their time on services for non-communicable diseases (NCDs), the ANMs spent 51% of their time on maternal, infant, child, and adolescent health services.
The introduction of HWCs and CHOs has nudged the health system toward comprehensive primary health care by placing a renewed emphasis on NCDs. The study provides useful evidence for staff, program implementers, and policymakers, to aid informed decision-making for human resource management.
印度政府通过阿育王保健和健康中心（HWCs）计划，在基层医疗保健系统中引入了新的社区卫生官员（CHOs）。
本研究旨在评估 HWC 一级现有和新的基层医疗保健团队成员所开展的活动和所花费的时间。
在旁遮普邦的四个 HWCs 中进行了一项时间和运动研究，以评估辅助护士助产士（ANMs）和 CHO 花费在不同服务和活动上的时间。通过在一周内连续六天的工作时间内对四名 CHO 和四名 ANM 进行直接连续观察，以及对所有参与者进行结构化的时间分配访谈，收集数据。
CHO 每天值班 5.7（5.6-5.9）小时，其中 57%的时间用于提供服务。ANM 每天的平均工作时间为 4.9（4.5-5.3）小时，其中近 62%的时间是有效工作时间。CHO 花费近 40%的时间用于非传染性疾病（NCDs）服务，而 ANM 花费 51%的时间用于孕产妇、婴儿、儿童和青少年健康服务。
HWCs 和 CHO 的引入通过重新强调非传染性疾病，推动卫生系统向综合初级卫生保健发展。该研究为工作人员、项目实施者和政策制定者提供了有用的证据，有助于做出有关人力资源管理的知情决策。
