MuhammadAmirAslam, et.al., Int. J. Eco. Res., 2011 2(6), 62 - 65 ISSN: 2229-6158

USER’S PERCEPTIVITY OF BASIC HEALTH UNITS IN PAKISTAN: CASE STUDY OF SARGODHA DISTRICT Mumtaz Ali1 Muhammad Amir Aslam2 Sadia Rafi1 1Department of Social work, University of Sargodha, Pakistan 2Home department, Government of Punjab, Pakistan

Abstract Accessibility to primary health care is an essential instrument of human welfare hence it is core of the Millennium Development Goals (MDGs). Health is corresponds in three of the eight goals of MDGs, and makes a significant role to the attainment of all the other goals like elimination of severe poverty and hunger, gender equality and education. The present study investigated the hurdles faced by the respondents related with the functioning of basic health providing the facility of primary health care in Sargodha district. Results showed that there is no association among the use of rural health facilities and higher education of respondents. The major users of basic health facilities are those who are illiterate of have an education level up to primary level. The rate of availability of dispenser in BHU is high as compared with L.H.V, Mid Wife and Doctors. 42.7 percent respondents highlight that the attitude of the staff is not satisfied. 50.1 percent answered that medicines are not available at BHU.

INTRODUCTION The WHO World Health Report 2008, maximizes community and individual self- entitled ‘Primary health care now more than reliance, participation and control; and ever’, has clearly articulated the need to involves collaboration and partnership with mobilize the production of knowledge on other sectors to promote public health. primary care1. In last two decades issue of Comprehensive primary health care provision of primary health care has become includes health promotion, illness very significant domain for state actors, prevention, treatment and care of the sick, think thanks and policy makers as it believes community development, and advocacy and now the state is responsible for equitable rehabilitation”2. Now it is general access to primary medical services to its agreement that availability of primary care is population. Primary health care can be the linchpin of effective health care delivery defined as “ Primary health care is socially and good governance. Primary health care appropriate, universally accessible, systems in developing countries are in their scientifically sound first level care provided infancy and struggling because of by health services and systems with a incompetence and a lack of provider suitably trained workforce comprised of responsiveness to the needs of consumers. multi-disciplinary teams supported by In Pakistan basic health facilities are integrated referral systems in a way that: comprised on Civil Dispensaries, Rural gives priority to those most in need and Health Centers, Basic health Units and Child addresses health inequalities; Health Centers. As far as developing world ______is concerbed Pakistan has one of the largest 1 World Health Organization: The World Health Report health service delivery networks at a basic 2008: primary health care now more than ever Geneva, WHO 2008. healthcare level. This comprises of 5301 2 Definition developed by the Australian Primary Health BHUs, each with a catchment population of Care Research Institute (APHCRI) and cited in Primary 10,000 to 20,000 and 552 Rural Health Health Care Reform in Australia: Report to Support Australia's First National Primary Health Care Strategy Centers (RHC0s – a step above the BHUs. (September 2009). The BHU provides facilities like basic

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health of children and women, a DHQ hospital, T.B hospital, 4 THQ immunization, maternal care, medication, hospitals, 8 dispensaries, 14 RHCs, 117 and implementation of disease eradication BHUs and 7 MCH centers. All these programs. Every BHU has Medical Officer facilities are served by the 407 doctors, 22 (Doctor), Medical Assistant or Medical dentists, 406 nurses, 241 dispensers, 1760 Technician, Lady Health Visitor, Lady LHWs, 156 LHVs, 304 midwives and 20 Health Workers, Midwives and Supporting Dais. Infant child mortality rate per 1000 staff. The Public health facilities in Pakistan birth is 71, child mortality rate under 5 per comprised on hospitals (968), dispensaries 1000 birth is101 and skilled attendant at (4813), BHUs (5345), RCHs (572), MCHs delivery is 45% (MICS 2007-08). (908), and TB Centers (293). The rest balance of paper is designed as: part It is increasingly being recognized that two explains the data and methodology, part simply allocating greater public resources to three presents and interprets the empirical basic health services is not enough to ensure results. Finally, part four presents the that quality services are made available to conclusions and also provides some policy the vast majority of poor citizens in the implications. developing world. The same case is with Pakistan, inspite of such significant DATA AND METHODOLOGY infrastructure, investment and interventions This study used primary data using a in boosting primary health care services at questionnaire, which was developed in order community level, the health outcomes are to meet the objectives of the study. Survey poorer than desirable and are unlikely to was conducted in five rural union councils meet many of the targets set out in the MDG of Sargodha districts. 200 respondents were health related goals. Political instability, interviewed. Chi-square test was utilized in poor policies, poverty and hunger and lack order to check the association among of awareness about health etc are considered dependent and independent variables. as the problems in the way of improving health system in Pakistan. These and other RESULTS AND DISCUSSION similar problems are the responsible of The data shows that 60 percents of inefficient health system in Pakistan. respondents are males, while the females are Keeping in view the nexus of the primary 40 percent. 80 percent respondents are health care services in country, this study married, while 9.1 percent are unmarried especially intends to dig out the user’s and 10.9 percent are divorced and separated. perception towards the availability of health 66 percent respondents are uneducated, services available at basic health units in while 17.3 percent respondents have an Sargodha district. As far as Sargodha is education level up to primary level and 16.9 concerned it is one of the crowded districts have intermediate level education. 22.5 of Punjab. Area of Sargodha is 5854 sq km percent respondents are using under ground with estimated population 3.133 million. sewerage system, while 71.7 percent are Sargodha district comprises of six Tehsils: using open sewerage system. Bhalwal, Kotmomin, Sargodha, Sahiwal, Shahpur and Silanwali. There are 161 union councils and 845 villages in the district. Majority of the population lives in the rural areas. There are 152 public health facilities provided by the government, comprising on

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Table 1: Descriptive statistics of the data percent respondents agreed that doctors are Percentage available. The rate of availability of Gender 100 dispenser in BHU is high as compared with Male 60.0 L.H.V, Mid Wife and Doctors. Results are Female 40.0 in line with Abbas et al., 2011. Type of houses 100 Airy 80.8 Table 3: Availability of the staff Closed 19.2 Availability of the staff Marital status 100 Category Percentage Married 80.1 Availability of Staff Unmarried 9.1 Doctor 4.9 Divorced 5.0 Dispenser 40.9 Separated 5.1 L.H.V 10.3 Education 100 Mid Wife 9.6 Never attended school 65.8 No Response 43.3 Primary level 17.3 Total 100.0 Inter level 16.9

Sewerage system 100 Most of the respondents are not satisfied Underground 22.5 with the behavior of the staff of BHU, as Open system 71.7 42.7 percent respondents highlight that the No sewerage system 5.8 attitude of the staff is not satisfied.

Results of the study show that there is no Table 4: Attitude of the Staff association among the use of rural health Attitude of the Staff facilities and higher education of respondents. These results are in line with Category Percentage Batool, 2005. The major users of basic Attitude of Staff health facilities are those who are illiterate Satisfactory 30.5 of have an education level up to primary Good 26.8 level. These results are in line with Awan, Bad 42.7 1990 and Batool, 2005. Total 100.0 Very few respondents are agreed that Table 2: Use of health facilities medicines are available at BHU (35.9 %), Use of health facilities while 14.0 percent answered that the Education Rarely Often Very medicine are often available at BHU and level often 50.1 percent answered that medicines are Illiterate 46 45.9 7.1 not available at BHU. Primary 52 41.8 2.8 Matric 33 70.3 9.1 Table 5: Availability of the medicine F.A and 80 27 6.7 Availability of the medicine above Responses Yes Total 47.3 46.7 6.0 Really 35.9 ∞= 8.256 α= 5% or 0.05 Often 14.0 Not 50.1 Under the availability of staff the worst Total 100.0 condition is with the doctors, only 4.9 X2= α= 5% or 0.05

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CONCLUSION AND POLICY IMPLICATIONS The intension of this study was to take insights of users about the faclities available in the BHUs of their localities. Results showed that there is no association among the use of rural health facilities and higher education of respondents. The major users of basic health facilities are those who are illiterate of have an education level up to primary level. The rate of availability of dispenser in BHU is high as compared with L.H.V, Mid Wife and Doctors. 42.7 percent respondents highlight that the attitude of the staff is not satisfied. 50.1 percent answered that medicines are not available at BHU. The study concludes with this striking feature that Pakistan would benefit from is institutional infrastructure arrangements and can provide the basic health services at community level by accountability at the local government level.

REFERENCES Awan, K.A., 1990. Socio-economic and demographic profile, Pakistan Institute of Development Economics (PIDE), Islamabad. Batool, Z., Afzal, Amina., Hussain, S., 2005. Perception of the beneficiaries of basic health units in rural areas. Journal of agriculture and social sciences, 1(1), 62-63. Abbas, T., Awan, M. S., Aslam, M.A., Waqas, M., 2011. Analyzing the efficiency differences among basic health units in Sargodha District. Journal of Economics and Behavioral Studies , 3(1), 42-50.

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