A case study of outsourced primary healthcare services in Sind : Is this a real reform
Location
Auditorium Pond Side
Start Date
26-2-2014 10:30 AM
Abstract
Background: Since a decade, low and middle income countries have a rising trend of contracting out their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services.
Objectives: To assess the quality of healthcare services at contracted out Basic Health Units (BHUs) through People`s Primary Health care Initiative compared to district government administered BHUs of Sindh.
Methods: A cross-sectional survey was conducted in November 2011. Two BHUs each were selected from Karachi and Thatta in Sind based on the difference in their administrative authorities. BHUs were selected randomly and Purposive sampling technique was used to recruit study participants from selected study sites. Focus group discussions & in-depth interviews were conducted using a semi-structured questionnaire and a resource availability checklist was used to record observations.
Results: PPHI administered BHUs as compared to district administered BHUs showed significant differences regarding infrastructure and the availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. Unlike PPHI administered BHUs, medication stocks in district administered BHUs were scarce, medicalequipments were limited and services were poor with no provision of referral facilities at all. PPHI administered BHUs were found to have sufficient number of trained clinical staff while staff punctuality and retention were major issues in district government administered BHUs.
Conclusion: Out-sourcing of primary healthcare services has resulted in significantly improved quality of healthcare services. This strategy seems to achieve equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services.
Keywords: Primary health acare, Reform, Services, outsourcing
A case study of outsourced primary healthcare services in Sind : Is this a real reform
Auditorium Pond Side
Background: Since a decade, low and middle income countries have a rising trend of contracting out their primary healthcare services to NGOs. In Pakistan, public sector often lacks capacity to effectively & equitably manage the healthcare services. It led the government to outsource the administration of primary health care services.
Objectives: To assess the quality of healthcare services at contracted out Basic Health Units (BHUs) through People`s Primary Health care Initiative compared to district government administered BHUs of Sindh.
Methods: A cross-sectional survey was conducted in November 2011. Two BHUs each were selected from Karachi and Thatta in Sind based on the difference in their administrative authorities. BHUs were selected randomly and Purposive sampling technique was used to recruit study participants from selected study sites. Focus group discussions & in-depth interviews were conducted using a semi-structured questionnaire and a resource availability checklist was used to record observations.
Results: PPHI administered BHUs as compared to district administered BHUs showed significant differences regarding infrastructure and the availability of essential medicines, basic medical appliances, mini-lab facilities and vehicles for referrals. Unlike PPHI administered BHUs, medication stocks in district administered BHUs were scarce, medicalequipments were limited and services were poor with no provision of referral facilities at all. PPHI administered BHUs were found to have sufficient number of trained clinical staff while staff punctuality and retention were major issues in district government administered BHUs.
Conclusion: Out-sourcing of primary healthcare services has resulted in significantly improved quality of healthcare services. This strategy seems to achieve equitable healthcare delivery in low and middle income countries where governments have limited capacity to manage healthcare services.
Keywords: Primary health acare, Reform, Services, outsourcing