Laboratory Services at Primary Health Centers under the Lens: A Need for Overhaul

Devane-Padalkar, Ashwini; Deshpande, Shailesh; Yakkundi, Deepali

doi:10.9734/ijtdh/2016/23001

Cited by 4 publications

(4 citation statements)

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“…Laboratory service is recommended as an important component for good functioning of PHC. Studies have been focused on laboratory service in PHC regarding its type, quality (Jain and Rao, 2015;Devane-Padalkar et al, 2016), functioning (Nanjunda, 2011), utilization (Zunic et al, 2011;Baig et al, 2014) and relevance in disease control (George, 2011;Rizwan et al, 2013;Pakhare et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Role of laboratory services in primary health center (PHC) outpatient department performance: an Indian case study

Jain

Rao

2019

Prim Health Care Res Dev

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Background: In resource-constrained settings, primary health centers (PHCs) are critical for universal health coverage. Laboratory service is one of its important components. While PHC and its performance are focused, its laboratory service has been neglected in developing countries like India. Aim: To determine the role of different level of PHC laboratory services on the overall PHC performance. Methods: Cross-sectional study based on 42 PHCs of Osmanabad District, Maharashtra, India was performed. The study used levels of laboratory services in PHC as independent parameter and PHC outpatient department (OPD) visits per day (≤ 80 versus > 80) as dependent parameter. The control parameters used in the study were number of medical doctors, availability of laboratory technicians (LTs) and population coverage by PHC. Field visit was done to collect data on levels of laboratory services, but secondary source was used for other parameters. The logistic regression analysis was performed in study. Findings: The study found variation in PHC population coverage (10 788–74 702) and OPD visits per day (40–182) across PHC. Strong positive association was observed between levels of laboratory services and number of OPD visits per day in PHC. PHC offering both malaria and tuberculosis in-house testing had higher odds (4.81) of getting more OPDs (≥ 80 OPD visits per day) as compared to PHC not offering in-house testing facility for malaria and tuberculosis. This association was stronger in PHCs with lower population coverage (0–75 quartile) as compared to PHCs with higher population coverage (75–100 quartile). Conclusion: Focus on laboratory services is needed to enhance the existing PHCs performance. Skill-up gradation of existing LT could help in improving the contribution of the existing laboratories in PHC functioning.

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Section: Introductionmentioning

confidence: 99%

Role of laboratory services in primary health center (PHC) outpatient department performance: an Indian case study

Jain

Rao

2019

Prim Health Care Res Dev

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“…Whereas in Devane and Deshpande study, it was less than 50%. 5 In Idris and bayoumi study, around 15% had spill management SOPs in their labs. In our study, only 37.5 percent laboratories were aware that they had standard operative procedures and to be followed.…”

Section: Discussionmentioning

confidence: 95%

“…3,4 The ability of a PHC to provide quality healthcare is determined by the laboratory support along with the infrastructure attached to them. 5 In areas where sufficient physicians and drugs are available, developing laboratory facilities have become a priority. 2 In this regard, National Quality Assurance Standards (NQAS) takes note of all these areas, thereby providing a department wise score card with areas of improvement.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of Quality Aspects of Primary Health Centre (PHCs) Laboratory Using National Quality Assurance Standards (NQAS) Tool in Hassan District, Karnataka

2020

IJPHRD

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The Primary Health Centre (PHC) is the nearest point of contact that should be accessible to the public for availing health care services. The ability of a PHC to provide quality healthcare is determined by the laboratory support along with the infrastructure attached to them.Objectives: To determine various shortcomings in the PHCs laboratory services utilizing National Quality Assurance Standards (NQAS) tool.Method: For the same, National Quality Assurance Standards (NQAS) tool is used in this study. 24 PHCs laboratory (from 134) in Hassan district were selected from 8 taluk as which formed a study population. Various quality factors among 7 domains were subjected to reliability testing and principal component analysis (PCA). Results:The dengue serology was not done in more than 45% of laboratories. Referral pattern was inadequate in more than 90%. Only 37.5% followed SOPs. With reference to testing procedure and charts for biological reference range (0.723) and reporting of tests within given duration was (0.677). Kaiser-Meyer-Olkin measure of sampling adequacy value was 0.417 (P<0.001.). Also, for support service component, three factors yields Cronbach's alpha=0.712 Conclusion:Recruitment of qualified laboratory technician and training them to quality work is very important. Not only that, financial input with maintenance of equipment and work ethics towards quality in diagnostics is imperative for case management in primary health care.

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“…However, in reality, not all PHCs have functional laboratories. Even, when they have laboratories and LT, they may not be able to conduct all the tests mentioned in IPHS 14 . In such a scenario, the complete case of a patient is referred to another public health care facility where the test facility is available 12 .…”

Section: Laboratory Functioning In An Indian Primary Health Centrementioning

confidence: 99%

Reducing Resource Disparity in Healthcare Resource Allocation of Laboratories in Countries with Limited Resources by Empowering Policy-Making and Implementation

Jain¹,

Ajmera

Rao³

2018

Current Science

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In resource constraint settings of developing countries like India, inadequate importance and consideration to resource (re)allocation approach causes resource disparity issues. The Indian public health care system has focused on developing rural primary health centres (PHCs) to reduce rural-urban resource disparity and pressure on urban health care facilities. However, all the resources as recommended in national standards for PHCs' functioning are not completely available in PHCs. Local-level decision-makers are not provided with a policy framework to (re)allocate resources. This study states that empowering local-level decision makers with the ability to (re)allocate resources to reduce resource disparity is critical. The study proposes a new framework for minimizing resource disparity with resource allocation optimization. The study suggests a strategy to improve implementation of policies like the National Rural Health Mission and the National Health Policy. The 42 PHCs in rural areas of Osmanabad District (India) with 23 laboratory technicians (LTs) as resources are considered as a case study to assess the proposed method. The study optimization model showed that reallocating 6 of 23 LTs to different PHCs would reduce disparity in LT workload (from 57.62% to 30.54%) and LT access (from 116.4% to 49.3%). The disparity reduction highlights the impact of resource reallocation according to the proposed framework.

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Laboratory Services at Primary Health Centers under the Lens: A Need for Overhaul

Cited by 4 publications

References 0 publications

Role of laboratory services in primary health center (PHC) outpatient department performance: an Indian case study

Role of laboratory services in primary health center (PHC) outpatient department performance: an Indian case study

An Evaluation of Quality Aspects of Primary Health Centre (PHCs) Laboratory Using National Quality Assurance Standards (NQAS) Tool in Hassan District, Karnataka

Reducing Resource Disparity in Healthcare Resource Allocation of Laboratories in Countries with Limited Resources by Empowering Policy-Making and Implementation

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