State Health Resource Centre, Chhattisgarh, Raipur, India.
BMC Prim Care. 2024 Mar 19;25(1):91. doi: 10.1186/s12875-024-02343-2.
The policy attention to primary health care has seen a global upswing in recent years, including in India. Earlier assessments had shown that a very small proportion of Indian population used the government primary health facilities. Starting in 2018, Indian government has established more than 100,000 Health and Wellness Centres (HWCs) to increase rural population's access to primary health care. It is crucial to know how useful people find the services of HWCs.
A qualitative inquiry was made to understand the perceptions, experiences and expectations of the rural communities regarding HWCs in Chhattisgarh state. Fourteen focus group discussions were conducted with community members. The study areas were chosen to include both the central and remote districts of the state. The study used accessibility, availability, acceptability and quality (AAAQ) framework to assess HWCs.
Community members felt that the most important change brought about by HWCs was to offer a wider range of curative services than previously available. Services for noncommunicable diseases such as hypertension and diabetes were seen as a key value addition of HWCs. People felt improvements in services for acute ailments also. The services people found missing in HWCs were for injuries, dental care and mental health. In people's experience, the availability of essential medicines and point-of-care tests at HWCs was satisfactory and the treatment was effective. People appreciated the supportive behaviour of health workers in HWCs. They did not find the referrals from HWCs as excessive but often faced difficulties in receiving necessary services at higher facilities.
The assessment based on community perceptions showed that the services of HWCs matched well with people's needs of curative primary care. It shows that people are willing to use the government facilities for primary health care if the services are relevant, adequately functional and accessible.
近年来，全球对初级卫生保健的政策关注度有所上升，印度也不例外。早期评估显示，印度只有极少数人使用政府初级卫生保健设施。自 2018 年以来，印度政府已经建立了超过 10 万个健康与保健中心（HWCs），以增加农村人口获得初级卫生保健的机会。了解人们对 HWCs 服务的满意度至关重要。
为了了解农村社区对恰蒂斯加尔邦 HWCs 的看法、经验和期望，我们进行了一项定性研究。与社区成员进行了 14 次焦点小组讨论。研究区域的选择包括该邦的中心和偏远地区。该研究使用可及性、可用性、可接受性和质量（AAAQ）框架来评估 HWCs。
社区成员认为，HWCs 带来的最重要的变化是提供了比以前更多的治疗服务。高血压和糖尿病等非传染性疾病的服务被视为 HWCs 的一个重要价值主张。人们还认为急性疾病的服务也有所改善。HWCs 中缺失的服务是外伤、牙科保健和心理健康。人们认为 HWCs 中基本药物和即时检测的供应是令人满意的，治疗效果也是有效的。人们赞赏 HWCs 中卫生工作者的支持性行为。他们并不认为 HWCs 的转诊过多，但往往在更高层次的医疗机构中难以获得必要的服务。
基于社区认知的评估表明，HWCs 的服务与人们对初级治疗保健的需求相匹配。这表明，如果服务具有相关性、充分的功能和可及性，人们愿意使用政府的初级卫生保健设施。
