Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy?

Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people'...
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Autor*in:	Sudha Ramani [verfasserIn] Muthusamy Sivakami [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	Community health and wellness centers primary health centers qualitative

Übergeordnetes Werk:	In: Journal of Family Medicine and Primary Care - Wolters Kluwer Medknow Publications, 2017, 8(2019), 9, Seite 2837-2844
Übergeordnetes Werk:	volume:8 ; year:2019 ; number:9 ; pages:2837-2844

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.4103/jfmpc.jfmpc_650_19

Katalog-ID:	DOAJ038803186

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allfields	10.4103/jfmpc.jfmpc_650_19 doi (DE-627)DOAJ038803186 (DE-599)DOAJe5f25ec7409b46ac856cec4348d02016 DE-627 ger DE-627 rakwb eng Sudha Ramani verfasserin aut Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care. Community health and wellness centers primary health centers qualitative Medicine R Muthusamy Sivakami verfasserin aut In Journal of Family Medicine and Primary Care Wolters Kluwer Medknow Publications, 2017 8(2019), 9, Seite 2837-2844 (DE-627)769225241 (DE-600)2735275-4 22787135 nnns volume:8 year:2019 number:9 pages:2837-2844 https://doi.org/10.4103/jfmpc.jfmpc_650_19 kostenfrei https://doaj.org/article/e5f25ec7409b46ac856cec4348d02016 kostenfrei http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=Ramani kostenfrei https://doaj.org/toc/2249-4863 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2019 9 2837-2844
spelling	10.4103/jfmpc.jfmpc_650_19 doi (DE-627)DOAJ038803186 (DE-599)DOAJe5f25ec7409b46ac856cec4348d02016 DE-627 ger DE-627 rakwb eng Sudha Ramani verfasserin aut Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care. Community health and wellness centers primary health centers qualitative Medicine R Muthusamy Sivakami verfasserin aut In Journal of Family Medicine and Primary Care Wolters Kluwer Medknow Publications, 2017 8(2019), 9, Seite 2837-2844 (DE-627)769225241 (DE-600)2735275-4 22787135 nnns volume:8 year:2019 number:9 pages:2837-2844 https://doi.org/10.4103/jfmpc.jfmpc_650_19 kostenfrei https://doaj.org/article/e5f25ec7409b46ac856cec4348d02016 kostenfrei http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=Ramani kostenfrei https://doaj.org/toc/2249-4863 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2019 9 2837-2844
allfields_unstemmed	10.4103/jfmpc.jfmpc_650_19 doi (DE-627)DOAJ038803186 (DE-599)DOAJe5f25ec7409b46ac856cec4348d02016 DE-627 ger DE-627 rakwb eng Sudha Ramani verfasserin aut Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care. Community health and wellness centers primary health centers qualitative Medicine R Muthusamy Sivakami verfasserin aut In Journal of Family Medicine and Primary Care Wolters Kluwer Medknow Publications, 2017 8(2019), 9, Seite 2837-2844 (DE-627)769225241 (DE-600)2735275-4 22787135 nnns volume:8 year:2019 number:9 pages:2837-2844 https://doi.org/10.4103/jfmpc.jfmpc_650_19 kostenfrei https://doaj.org/article/e5f25ec7409b46ac856cec4348d02016 kostenfrei http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=Ramani kostenfrei https://doaj.org/toc/2249-4863 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2019 9 2837-2844
allfieldsGer	10.4103/jfmpc.jfmpc_650_19 doi (DE-627)DOAJ038803186 (DE-599)DOAJe5f25ec7409b46ac856cec4348d02016 DE-627 ger DE-627 rakwb eng Sudha Ramani verfasserin aut Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care. Community health and wellness centers primary health centers qualitative Medicine R Muthusamy Sivakami verfasserin aut In Journal of Family Medicine and Primary Care Wolters Kluwer Medknow Publications, 2017 8(2019), 9, Seite 2837-2844 (DE-627)769225241 (DE-600)2735275-4 22787135 nnns volume:8 year:2019 number:9 pages:2837-2844 https://doi.org/10.4103/jfmpc.jfmpc_650_19 kostenfrei https://doaj.org/article/e5f25ec7409b46ac856cec4348d02016 kostenfrei http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=Ramani kostenfrei https://doaj.org/toc/2249-4863 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2019 9 2837-2844
allfieldsSound	10.4103/jfmpc.jfmpc_650_19 doi (DE-627)DOAJ038803186 (DE-599)DOAJe5f25ec7409b46ac856cec4348d02016 DE-627 ger DE-627 rakwb eng Sudha Ramani verfasserin aut Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care. Community health and wellness centers primary health centers qualitative Medicine R Muthusamy Sivakami verfasserin aut In Journal of Family Medicine and Primary Care Wolters Kluwer Medknow Publications, 2017 8(2019), 9, Seite 2837-2844 (DE-627)769225241 (DE-600)2735275-4 22787135 nnns volume:8 year:2019 number:9 pages:2837-2844 https://doi.org/10.4103/jfmpc.jfmpc_650_19 kostenfrei https://doaj.org/article/e5f25ec7409b46ac856cec4348d02016 kostenfrei http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=Ramani kostenfrei https://doaj.org/toc/2249-4863 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2019 9 2837-2844
language	English
source	In Journal of Family Medicine and Primary Care 8(2019), 9, Seite 2837-2844 volume:8 year:2019 number:9 pages:2837-2844
sourceStr	In Journal of Family Medicine and Primary Care 8(2019), 9, Seite 2837-2844 volume:8 year:2019 number:9 pages:2837-2844
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Community health and wellness centers primary health centers qualitative Medicine R
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container_title	Journal of Family Medicine and Primary Care
authorswithroles_txt_mv	Sudha Ramani @@aut@@ Muthusamy Sivakami @@aut@@
publishDateDaySort_date	2019-01-01T00:00:00Z
hierarchy_top_id	769225241
id	DOAJ038803186
language_de	englisch
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author	Sudha Ramani
spellingShingle	Sudha Ramani misc Community misc health and wellness centers misc primary health centers misc qualitative misc Medicine misc R Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy?
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topic_title	Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy? Community health and wellness centers primary health centers qualitative
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title	Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy?
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title_full	Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy?
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title_sort	community perspectives on primary health centers in rural maharashtra: what can we learn for policy?
title_auth	Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy?
abstract	Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care.
abstractGer	Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care.
abstract_unstemmed	Introduction: Primary Health Centers (PHCs) are intended to be the “backbone” of the Indian public health system. Yet, these do not get utilized as frontline institutions for basic curative care. As we embark on comprehensive primary health care initiatives, it is important to understand people's perceptions on PHCs; and design services that cater to their felt needs. Aim: In this paper, we examine explanations that communities give for the use or bypass of PHCs. From these perspectives, we derive some policy directions for improving basic curative care services at PHCs. Methods: This qualitative study is based on data from 14 Focus Group Discussions in a rural area in Maharashtra in the catchment area of 8 PHCs (total 91 community participants). The discussions were coded and analyzed thematically with the aid of a qualitative software. Results: PHCs were not viewed as first-access points for health care, though these were valued for specific services. The limited use of PHCs was attributed to the lack of availability of drugs/services of perceived relevance to communities; prevalent healing norms that mismatched with PHC services; doctor-patient interactions that were colored with mistrust; and widespread poor opinions of public-sector services in health. Conclusions: Currently, there seems to be little in the design of PHC services- that appeals to the “felt” needs of communities. Thus, the proposed Health and Wellness Centers (HWC) initiative resonates with people's expectations. In addition, staff at the periphery must provide “attentive” care and be prepared to contend with pre-existing poor expectations of care.
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title_short	Community perspectives on primary health centers in rural Maharashtra: What can we learn for policy?
url	https://doi.org/10.4103/jfmpc.jfmpc_650_19 https://doaj.org/article/e5f25ec7409b46ac856cec4348d02016 http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2837;epage=2844;aulast=Ramani https://doaj.org/toc/2249-4863
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