Background:The outcome of any disease is influenced by the decisions to seek care, timely arrival at appropriate diagnostic and treatment services and the receipt of adequate care from service providers. Satisfaction in service provision is increasingly being used as a measure of health system performance. Satisfaction manifests itself in the distribution, access and utilization of health services. Objectives: To determine the areas and causes of low satisfaction among the patients and suggest methods for improvement.Materials and Methods:Multistage stratified random sampling was used to select the government allopathic health facilities of Lucknow district and systematic random sampling for the selection of the patients for the interview.Results:The accessibility was difficult in 42% patients and waiting time more than 30 min for 62.5% of those attending the tertiary level health facility. The satisfaction with the duration of the outpatient department (OPD) (64.6%) and the presence of signboards (46.6%) was also found to be low. The overall satisfaction regarding the doctor-patient communication was more than 60% at all the levels of health care facilities but that with the examination and consultation was less than 60% at the primary level as compared to more than 80% elsewhere. The most important motivating factor for the visit to the tertiary (48.2%) and secondary level (71.9%, 67.1%) of health facilities was the faith on doctors or health facility.Conclusions:The level of patient satisfaction is severely deficient in several areas and needs improvement for the achievement of optimal health of the people.

Objectives:To study the prescription pattern at the different levels of public health facilities of Lucknow district and to assess the average cost of drugs prescribed.Methods:Multi-stage stratified random sampling was done to select 1625 prescriptions of the patients attending the different level of public health facilities in Lucknow district, from August 2005 to September 2006, which was used for the development of study tools, collection of data and analysis.Results:The important components of prescription viz. examination findings, weight of the child, follow up visit and the signatures of the prescribers were absent in the prescriptions at the primary level. Polypharmacy was common (3.1 ± 1.6 drugs per prescription). The prescription of drugs by generic name was low (27.1%). The prescriptions at the secondary level health facilities were incomplete with respect to mentioning the suffix/prefix of the drug, full name, dose, frequency and strength of the drugs, and directions specifying the route and duration of the treatment. The average cost of drugs/prescription/day in US$ (Mean, SD) was found to be the highest at the tertiary level (0.34, 0.43), which decreased significantly at the primary level health facilities.Conclusion:The pattern of prescription in terms of completeness and rationality was poor. There is an urgent need to improve the standards of drug prescription.

Background:Under National Rural Health Mission (NRHM), ASHA (accredited social health activist) has been identified as an effective link to address the poor utilization of maternal and child health (MCH) services by rural pregnant women.Objective:To study the factors influencing utilization of ASHA services in relation to maternal health.Study Design:Cross-sectional.SettingPrimary Health Centre (PHC), Sarojininagar, Lucknow and its rural field area.Study Period:September 2007 to August 2008.Study Unit:RDW (recently delivered women) were considered as those who delivered a live newborn at PHC Sarojininagar, within a week of interview and belonged to villages within the confines of the PHC being served by ASHA.Materials and Methods:350 RDW were interviewed at their bedside, by a preformed and pretested schedule and then were followed-up after six weeks.Results:Utilization of ASHA services for early registration was significantly associated with age and religion of RDW. Young, educated and socio-economic class III RDW utilized ASHA services the maximum for early registration. Utilization of ASHA services for adequate ANC or antenatal care (100 iron and folic acid tablets, 2 tetanus toxoid injection and ≥3 antenatal visits) was also inversely associated with age of RDW. Young, Hindu, scheduled caste, middle school pass, Class III RDW and those with birth order one had high odds for utilization of ASHA services for adequate ANC. With regard to postnatal check-up, again young RDW with birth order one, Hindu RDW in reference to Muslim and RDW in socio-economic class III had higher likelihood for utilization of ASHA services. Caste-wise scheduled caste (SC) and other backward caste (OBC) RDW had higher odds for utilization of ASHA services. Educated RDW and those with educated husband had higher odds for utilization of ASHA services for postnatal check-up.Conclusion:Young, educated RDW with low parity, educated husband and belonging to higher socio-economic class had higher odds of utilization of ASHA services.

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To address poor utilization of maternal and child health services by the rural community, the National Rural Health Mission (NRHM) was launched in 2005 in India. Under NRHM, ASHA (Accredited Social Health Activist) was identified as an effective link between the government and poor pregnant women.  The aim of the present study was to examine the utilization of ASHA services under NRHM in relation to maternal health by the Recently Delivered Women (RDW) in the study area. A cross-sectional study was conducted at PHC Sarojini Nagar, Lucknow and its rural field areas. A sample of 350 RDW, chosen by simple random sampling, were interviewed at bedside by a preformed schedule and then were followed up after six weeks. Antenatal registration was reported by 97% RDW of which 73% registered early. About 53% RDW had three or more antenatal care visits. Two dose Tetanus Toxoid coverage was 92.9%. Receipt and consumption of iron and folic acid was low. ASHA was the major facilitator for higher utilization of antenatal care services, except for Iron and Folic Acid receipt/consumption.  Low utilization of postnatal care (21.5% RDW had at least one postnatal check-up) is a matter of concern. Knowledge and awareness of ASHA on importance of postnatal care needs to be enhanced via hands on training by specialists and regular orientation programs. Better and intense advocacy in the community regarding importance of availing services of ASHA in relation to maternal health needs to be addressed.South East Asia J Public Health | Jan-June 2012 | Vol 2 Issue 1 | 24-27 DOI: http://dx.doi.org/10.3329/seajph.v2i1.15261