Abstract of Dissertation

Keyword : Sexual & Reproductive Health Services; Indian Public Health Standards; 24x7 Primary Health Centres

Objective : Objectives of the study are to assess the availability of sexual and reproductive health services at 24x7 PHCs, to identify the gaps in and to compare the sexual and reproductive health services at 24x7 PHCs of HPDs and NHPDs.

Background : The main aim of the study was to assess 24x7 primary health centres (PHCs) in terms of availability of sexual and reproductive health services with respect to Indian Public Health Standards (IPHS). Despite having tiered healthcare system to improve access for the basic healthcare needs including obstetric care at the community level, significant proportion of population in rural areas do not have round the clock access.

Methodology : Data were collected from service providers at24x7 PHCs through well-structured questionnaire developed by referring the IPHS for PHCs prescribed by the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. The study was conducted at four districts (i.e. Banswara, Rajsamand, Baran and Pratapgarh) of Rajasthan state of India. 17 PHCs (24x7) of these four districts were included in the study.

Findings : Findings depict that only three PHCs out of ten have medical officers trained in both BemOC and RTI/STI in (High priority districts) HPDs. However, services such as RTI/STI management, tubectomy, and manual removal of placenta, family planning services like availability of contraceptives and drugs and equipments were poorer at 24x7 PHCs in high priority districts as compare to non high priority districts, which need to be addressed for further strengthening of primary health centres. According to study, condition of sexual and reproductive health services at 24x7 PHCs in HPDs is not good when we compared it with 24x7 PHCs in NHPDs. The study findings revealed that 24 × 7 PHCs should be provided adequate manpower and equipment’s as recommended by the IPHS so as to become effective and functional to provide sexual and reproductive health services in the rural areas.

Recommendations : Group housing for health workers living in remote areas particularly in high priority districts and short duration training programs for BemOC and RTI/STI. There is a need to improve supply chain management to address the shortage of drugs and other supplies related to sexual and reproductive health with more emphasis on HPDs.