Facilitators and barriers of service utilization: Perspectives of stakeholders in a family health center of central Kerala - A qualitative study.

Family Health Center Kerala health model health service utilization

Journal

Indian journal of public health
ISSN: 0019-557X
Titre abrégé: Indian J Public Health
Pays: India
ID NLM: 0400673

Informations de publication

Date de publication:
Historique:
entrez: 17 6 2021
pubmed: 18 6 2021
medline: 16 10 2021
Statut: ppublish

Résumé

Transformation of Primary Health Centers to Family Health Centers (FHC) in Kerala is a new movement. It is important to study the perspectives of stakeholders about it so that strengthening of the facilitators and tackling the barriers can be done. The objectives of this study were to understand the perspectives of patients and health-care workers on the facilitators and barriers of service utilization in a FHC in Central Kerala. Descriptive qualitative study was done for a period of 3 months at FHC, Mundur, Thrissur district, Kerala. In-depth interview of medical officer, health supervisor, and accountant was conducted. Two focus group discussions at the FHC among Accredited Social Healthcare Activists (ASHAs) and patients and one among community members were done. The Attride-Stirling's thematic network analysis framework was followed for data analysis. The findings are reported in accordance with Consolidated Criteria for Reporting Qualitative Research guidelines. The facilitators identified for service utilization are good behavior of staff, evening outpatient department and special clinics, improved infrastructure and clean premise, trust in ASHA workers, subsidized laboratory service, local self-government involvement, funds, and rewards. The barriers of service utilization are staff shortage and workload, lack of awareness among general population about some services, and shortage of medicines. The concept of FHC is agreeable to both the health-care workers and the community. The barriers can be tackled at this stage, and there is a scope to improve health-care quality if this model is introduced across the country.

Sections du résumé

BACKGROUND BACKGROUND
Transformation of Primary Health Centers to Family Health Centers (FHC) in Kerala is a new movement. It is important to study the perspectives of stakeholders about it so that strengthening of the facilitators and tackling the barriers can be done.
OBJECTIVES OBJECTIVE
The objectives of this study were to understand the perspectives of patients and health-care workers on the facilitators and barriers of service utilization in a FHC in Central Kerala.
METHODS METHODS
Descriptive qualitative study was done for a period of 3 months at FHC, Mundur, Thrissur district, Kerala. In-depth interview of medical officer, health supervisor, and accountant was conducted. Two focus group discussions at the FHC among Accredited Social Healthcare Activists (ASHAs) and patients and one among community members were done. The Attride-Stirling's thematic network analysis framework was followed for data analysis. The findings are reported in accordance with Consolidated Criteria for Reporting Qualitative Research guidelines.
RESULTS RESULTS
The facilitators identified for service utilization are good behavior of staff, evening outpatient department and special clinics, improved infrastructure and clean premise, trust in ASHA workers, subsidized laboratory service, local self-government involvement, funds, and rewards. The barriers of service utilization are staff shortage and workload, lack of awareness among general population about some services, and shortage of medicines.
CONCLUSION CONCLUSIONS
The concept of FHC is agreeable to both the health-care workers and the community. The barriers can be tackled at this stage, and there is a scope to improve health-care quality if this model is introduced across the country.

Identifiants

pubmed: 34135181
pii: IndianJPublicHealth_2021_65_2_136_318370
doi: 10.4103/ijph.IJPH_995_20
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

136-141

Déclaration de conflit d'intérêts

None

Auteurs

Sajna Mathumkunnath Vijayan (SM)

Associate Professor, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.

Safa Puliyakkadi (S)

Senior Resident, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.

Swathi Chalil (S)

Junior Resident, Department of Community Medicine, Government Medical College, Thrissur, Kerala, India.

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Classifications MeSH