Performance Of Primary Health Centres, Provider's Perspective Of Wellbeing, And Patient's Assessment Of The Centres Using A New Tool In Bangalore, India: An Empirical Study

BACKGROUND: Primary Health Centres (PHC) in India have evolved over the last seven decades to meet the healthcare needs of communities aligned to the epidemiological transitions the country has undergone. It is a well understood fact that the performance of PHCs is vital for overall improvement in the general health of the population of any nation. The relationship between the performance of PHCs, patients' perspectives of PHC perform ance and provider perspective of well-being is not well understood. This research aimed to test a new tool for patients' assessment of PHC performance and to explore the relationships between the centre's performance and the provider's well-being across centres with different workloads.METHODOLOGY: PHC workload was assessed based on the number of babies delivered to the population covered by the facility. Three PHCs with high, medium and low workloads were selected for the study in Bengaluru (Bangalore), Karnataka, India. The centres were assessed based on the Indian Public Health Standards. A new tool 'Questionnaire for Patient's Perspective on Performance of Primary Health Centres' (Q4PHC) was developed and tested for reliability. A total of 298 patients assessed the performance of these PHCs using Q4PHC by an 'exit survey'. 36 Provider's perspective on one's well-being were studied using the Quality of Life (WHO QoL Bref) tool and the work engagement tool (The Utrecht Work Engagement Survey -UWES). The data were analysed across the three centres using the ANOVA test.RESULTS: Q4PHC was found to be reliable with have high internal consistency. Patients assessed the 'low' workload PHC as the best-performing among the three centres (p<0.000). Provider's well-being was found better in 'medium' workload PHC but was not statistically significant.CONCLUSION: Q4PHC is found to be a useful instrument to assess PHC performance from patients' perspective in the Indian context. The study results suggest that there is a trade-off between the provider's perspective on well-being and maximum PHC performance.