Report on Quality of Reproductive Health Service provided at PHCCs in Nepal

Abstract

Background: Reproductive health is a crucial part of overall health so it has been taken as a fundamental human right and its importance has been mainly focused from 1994, International Conference on Population and Development (ICPD) held in Cairo. This study has mainly focused to explore the quality and status of reproductive health service at PHC level. Methods: It was a cross-sectional/descriptive study which includes both qualitative as well as quantitative data. Six districts were chosen purposively which includes Kathmandu, Bhaktapur, Lalitpur, Kavre, Chitwan and Kanchanpur. From these districts, total 15 primary Health Care Centers were selected as convenient to the researcher. Structured questionnaire and observation checklist were used to collect information. Results: Most of the Primary Health Care Centers have fulfilled the sanctioned posts of health personnel except few, where the staff were in study leave or deputed temporarily to other place, but regarding medical officers only 20% of them were present in the Primary Health Care Centers. For providing reproductive health service mainly staff nurse and ANMs were involved. Most of the services were found to be conducted regularly except abortion service which was only conducted by 13% of the Primary Health Care Centers. Likewise, Norplant and IUCD services were still not available in 33% of these Primary Health Care Centers. Necessary infrastructures were available in most of the visited Primary Health Care Centers but operation theatre and post operation room were found only in 27% of the Primary Health Care Centers. Similarly lab service did not seem to be well established in the visited Primary Health Care Centers. Reproductive health protocol was not used in most of the Primary Health Care Centers by the service providers. Although outreach clinic were regularly conducted by the Primary Health Care Centers, but only 67% were providing the family planning service and 40% were providing Antenatal Care service. It was found that only 53% of the visited Primary Health Care Centers have provided support for conducting home deliveries. Complicated pregnancy cases were not found to be handled in the visited Primary Health Care Centers. Likewise only 60% of the Primary Health Care Centers had initiated cost sharing scheme. For providing RTI/STI service, only 33% of the Primary Health Care Centers were found to be providing lab based diagnosed service. Most of the Primary Health Care Centers had conducted awareness program on the reproductive health issues. Reproductive health programs conducted by the Primary Health Care Centers were regularly monitored and supervised by the District Public Health office and other responsible concerned bodies. Similarly it was found that Primary Health Care Centers were also being supported by the communities for conducting the service effectively. Conclusions: The reproductive health services provided from the Primary Health Care Centers still needs to be strengthened in various aspects as it exist in present situation so that it will be able to cover the unmet demand of the population and can provide quality service at the community level. Keywords: primary health care centers; reproductive health service; quality.