Situation analysis of the quality of primary health care services in Pakistan

Abstract

Background: Primary health care services to promote the mental and physical health of communities include preventive, promotive, curative, general hygiene, and nutritional elements. Aim: To assess the quality of service delivery at primary healthcare settings in Punjab, Pakistan. Methods: Quantitative surveys were conducted at 106 health facilities: 92 basic health units (BHUs) and 14 rural health centres (RHCs) across Punjab in 2020. Data from the survey were supplemented with information from observations by the researchers and all data were analysed using SPSS version 25. Findings: All the 7 district health authorities surveyed had monthly targets for number of normal deliveries and the outpatient department. Systems for safe transportation and storage of medicines were deficient except in 2 districts. Anti-venom and anti-rabies vaccines were either limited or not available at most of the health units visited. Some 14% of clinical equipment examined at the BHUs and RHCs were non-functional, and no BHU had ultrasonic machines to improve the quality of antenatal care. Sterilization of surgical instruments was unsatisfactory at most health units. Several key positions at BHU and RHC were vacant. Most health units did not have fence and their main buildings were in poor condition. Conclusions: Several gaps were identified at the primary healthcare level in Punjab that need to be addressed to improve the quality of service delivery.