Urban primary health care delivery system: A study of selected phc clinics in the Dhaka city corporation area

Abstract

Dhaka is the capital and largest urban center of Bangladesh. It is an area of living for about 20 million people. This growing urban population puts extra demands on existing health care facilities. Urban poor people is also a vital factor for promoting Urban Primary Health Care Project (UPHCP) to provide health care facilities. The provision of preventive health and limited curative care as a responsibility of city corporations and municipalities according to the City Corporation Ordinance 1983. But, the public-sector health services were not appropriately equipped with the required infrastructure so that the city corporations and the municipality’s requirements as there were limitations in resources and manpower. Primary health care facilities and services for the urban population at large and, specifically for the urban poor are largely insufficient. The study has been conducted to explore the existing facilities in the selected Urban Primary Health Care centers and type of services they provided and the socio-economic condition of the people who take the treatment from the clinics. The data for this study is taken from the city health care clinics – the PHCCs (Primary health care Centre) and the CRHCCs (Comprehensive reproductive health care Centre). This health care center is run by some NGO with the help of Dhaka City Corporation.Five NGOs providing primary care facilities under the UPHCP has been purposively selected from the list provided by the project office located at the Dhaka City Corporation office. The 200 respondent patients were selected randomly from the five selected primary health care centers. Data collected through questionnaires were processed using SPSS statistical software and presented through different graph, charts, tables and texts. Maps showing the service area of the primary health care centers were prepared using ArcGIS software. The study shows three characteristics like infrastructure and resources of clinics, socio-economic condition of the clients and different services provided by the clinics to the patient as well as their opinion about the problem of services and opinion about the way of developing the standard of services. Clinics have sufficient people for providing health services to the clients. There are ambulance services for emergency treatment providing and medicine supply to the patient. Clinic has generator services during load shading period. Toilet condition is more or less good. Patient pressure in the clinics is huge. Clinics follow medicine reservation system for providing good quality of medicine to the patient and the clinics settlement area is good for the establishment of the clinics.Most of the respondents age is in 16-30 about 78% and female respondents is 96.5%. Married respondents are more about 81% of total respondents. Muslim clients is more about 87%. Educational qualification is more on primary level about 36%. Most of the respondents are housewife about 61% and maid servant and garments worker are the main occupation of respondents. Most of respondent use tap water for drinking and cooking water. Most of the clients use semi pucca house for living about 63.5% and use pucca/ring slab latrine.NGOs clinics of Dhaka city provide a lot of health care services to the clients especially on maternal and child health care delivery system. These services is provided to the nearest patient surrounding place of the clinic with less or free of cost. They do not need to wait for a long a long time to get the treatment. Most of the patient are satisfied with the standard of NGO clinics treatment. They also describe some opinion to develop the standard of services.