An Analysis of Awareness and Satisfaction of Primary Health Centre in Thoothukudi District

International Journal of Research ISSN NO:2236-6124

AN ANALYSIS OF AWARENESS AND SATISFACTION OF PRIMARY HEALTH CENTRE IN THOOTHUKUDI DISTRICT

M.Selvakumari Ph.D Research Scholar in Economics, V.O.C. College, Thoothukudi Affiliated to Manonmaniam Sundaranar University, Abishekapatti, Tirunelveli – 627012, Tamil Nadu, India.

Abstract The study examines the satisfaction of health input availability in primary health centres of the users of Primary Health Centre in six blocks of Thoothukudi District. The objectives of the present study are: 1. To identify the occupational background of the users of Primary Health Centre in six blocks of Thoothukudi District 2. To know the degree of awareness of primary health centre 3. To find out the types of services availed 4. To evaluate the satisfaction of health input availability in primary health centres

The present study has covered the users of Primary Health Centre in six blocks of Thoothukudi District. The present study built on both primary and secondary data covered. The total household sample is 300 — the secondary data collected from books and journals and websites. Percentage analysis, tabulation, averages, standard deviation and t test, are used for the analysis. It revealed that in Udankudi Block 70 % of the respondents had availed the curative service and 30 % of the respondents have availed the preventive service. Whereas in Srivaikuntam block, 64 % have availed the curative service and 36% of the respondents have availed the preventive service. While in Kayathar block, 58 % have availed the curative service and 42% of the respondents have availed the preventive service. Whereas in Kovilpatti block, 76 % have availed the curative service and 24% of the respondents have availed the preventive service. While in Tiruchendur block, 68 % have availed the curative service and 32% of the respondents have availed the preventive service. In Alwarthirunagiri Block 66 % of the respondents have availed the curative service, and 34 % of the respondents have availed the preventive service. This point to the fact that, people do not prefer primary health centres for preventive care. The activities of primary health centres involve curative, preventive, promotive and family welfare services.

Keywords: Primary Health Centre, life expectancy, aggregate expenditure, curative service, preventive service. INTRODUCTION Health considered as the most important thing for a human being. The constitution of the WHO says, “Enjoyment is one of the important rights of every human being without difference of race religion, political belief, economic and social condition.1 Man is the primary feature of production. Basic standards of health and developments thereof provide an entry point to change agents.

1World Health Organisation (WHO), Health Economics – Report of a Seminar held in Moscow, June-July, 1968.

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2 Health care can define as those activities that undertaken with the objective of restoring, preserving or enhancing the physical and mental well-being”.3 The need for health facilities for the growing population has recognised, and there has also been a significant infrastructural development in the health sector. However, the high population growth rate has led to constraints and even contributed to the deterioration of the quality of health4. In India, the expenditure on health comprises 5.2 per cent of GDP with public health investment at 0.9 per cent in 20075. The aggregate expenditure in the health sector is 5.2 per cent of the GDP. Out of this about 17 per cent of the aggregate expenditure is for public health spending and the balance being out of pocket expenditure.6 In Tamil Nadu, the life expectancy at birth goes up to 67.0 for males and 69.75 for females during the period 2001-20077. The study examines the satisfaction of health input availability in primary health centres of the users of Primary Health Centre in six blocks of Thoothukudi District.

OBJECTIVES OF THE PRESENT STUDY The objectives of the present study are: 1) To identify the occupational background of the users of Primary Health Centre in six blocks of Thoothukudi District 2) To know the degree of awareness of primary health centre 3) To find out the types of services availed 4) To evaluate the satisfaction of health input availability in primary health centres

METHODOLOGY The present study has covered the users of Primary Health Centre in six blocks of Thoothukudi District. The present study built on both primary and secondary data covered. Primary data collected through an interview schedule. The total household sample is 300. A separate interview schedule designed, pilot tested and used for data collection.

2Shanmughasundaram, Yasodha, “Nature and Significance of Economics of Health”, Paper presented at the Conference on Economics of Health held under the auspices of Tamil Nadu Economics Association and Madras Medical College Research Society, 13-14, April 1979.

3Victor R. Fuchs, The Health Economy, Harward University Press, Cambridge Massachusetts and London, England, 1986, pp. 41-46.

4 Government of India, “Sample Registration Bulletin”, The office of the Registrar General of India, Vol.XXI, New Delhi, 1 June, 1987.

5 Economic Survey 2007-08 Government of India, New Delhi.

6 www.mohfw.nic.in

7 Website: www.tnhealth.org.

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It is purely a descriptive study. The secondary data collected from books and journals and websites. Percentage analysis, tabulation, averages, standard deviation and t test used for the analysis.

OCCUPATIONAL BACKGROUND OF USERS OF PRIMARY HEALTH CENTRE Number of Respondents Sl. Occupational Srivai Tiruc Alwar Udan Kayat Kovil No. Background kunta hendu thirun Total kudi har patti m r agiri 13 15 10 12 11 14 75 1. Agricultural labourers (26.0) (30.0) (20.0) (24.0) (22.0) (28.0) (25.0) 11 9 9 12 9 9 59 2. Private Employee (22.0) (18.0) (18.0) (24.0) (18.0) (18.0) (19.67) 9 9 9 10 8 7 52 3. House Wife/ Students (18.0) (18.0) (18.0) (20.0) (16.0) (14.0) (17.33) 7 8 7 8 7 7 44 4. Business (14.0) (16.0) (14.0) (16.0) (14.0) (14.0) (14.67) 5 5 6 5 6 5 32 5. Cooley (10.0) (10.0) (12.0) (10.0) (12.0) (10.0) (10.67) 3 3 5 2 5 4 22 6. Retired/Unemployed (6.0) (6.0) (10.0) (4.0) (10.0) (8.0) (7.33) 2 1 4 1 4 4 16 7. Government Employee (4.0) (2.0) (8.0) (2.0) (8.0) (8.0) (5.33) 50 50 50 50 50 50 300 Total (100) (100) (100) (100) (100) (100) (100) Source: Primary data. Note: Figures in brackets represent percentage to the total. In this table the occupational background of the respondents in Udankudi block 13% of them having the important occupation as agricultural labourers, followed by 22% having an occupational background as a private employee. 18% of the respondents are housewife/ students. 14%, 10% and 6% of the respondents are worked as business, Cooley and retired/unemployed respectively. Only 4% of them have government jobs. While in the case of Srivaikuntam block the main occupational background agricultural labourers are 30%, followed by 18% having an occupational background as a private employee. 18% of the respondents are housewife/ students. 16%, 10% and 6% of the respondents are worked as business, Cooley and retired/unemployed respectively. Only 2% of them have government jobs. Whereas, in the case of Kayathar block, out of 50 respondents, a majority of 20% of the respondents are agricultural labourers, followed by 18% of respondents with private employee 18% respondents are housewife/ students and 14% 12% and 10% of the respondents worked as business, Cooley and retired/unemployed respectively. 8% of the respondents are government Employee. While in the case of Kovilpatti block the main occupational background agricultural labourers are 24%, followed by 24% having an occupational background as a private employee. 20% of the respondents are housewife/ students. 16%, 10% and 4% of the respondents are worked as business, Cooley and retired/unemployed respectively. Only 2% of them have government jobs.

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Whereas, in the case of Tiruchendur block, out of 50 respondents, a majority of 22% of the respondents are agricultural labourers, followed by 18% of respondents with private employee 16% respondents are housewife/ students and 14% 12% and 10% of the respondents worked as business, Cooley and retired/unemployed respectively. 8% of the respondents are government Employee. While in the case of Alwarthirunagiri block the main occupational background agricultural labourers are 28%, followed by 18% having an occupational background as a private employee. 14% of the respondents are housewife/ students. 14%, 10% and 8% of the respondents are worked as business, Cooley and retired/unemployed respectively. Only 8% of them have government jobs. Thus, it is concluded from the study area, the majority of the respondents having an occupational background as a private employee.

DEGREE OF AWARENESS OF PRIMARY HEALTH CENTRE Degree of Number of Respondents Sl. awareness Udank Srivaiku Kayatha Kovilpat Tiruchendu Alwarthir No. Total udi ntam r ti r unagiri 39 41 42 45 40 38 245 1. Aware (78.0) (82.0) (84.0) (90.0) (80.0) (76.0) (81.67) 11 9 8 5 10 12 55 2. Not aware (22.0) (18.0) (16.0) (10.0) (20.0) (24.0) (18.33) 50 50 50 50 50 50 300 Total (100) (100) (100) (100) (100) (100) (100) Source: Primary data.

Note: Figures in brackets represent percentage to the total. In Udankudi Block 78.00 per cent of the respondents are aware of the functioning of primary health centres and only 22 per cent are not aware of it. Whereas in Srivaikuntam block, 82.00 per cent of the respondents are aware of the functioning of primary health centres and only 18.00 per cent are not aware of it. While in Kayathar block, 84.00 per cent of the respondents are aware of the functioning of primary health centres and only 16.00 per cent are not aware of it. Whereas in Kovilpatti block, 90.00 per cent of the respondents are aware of the functioning of primary health centres and only 10.00 per cent are not aware of it. While in Tiruchendur block, 80.00 per cent of the respondents are aware of the functioning of primary health centres and only 20.00 per cent are not aware of it. Whereas in Alwarthirunagiri block, 76.00 per cent of the respondents are aware of the functioning of primary health centres and only 24.00 per cent are not aware of it. Thus from the analysis, it can be determined that a majority of the sample respondents are aware of the functioning of primary health centres. TYPES OF SERVICES AVAILED Types of Number of Respondents Sl. Services Udank Srivaiku Kayatha Kovilpat Tiruchendu Alwarthir No. Total Availed udi ntam r ti r unagiri 35 32 29 38 34 33 201 1. Curative (70.0) (64.0) (58.0) (76.0) (68.0) (66.0) (67.0) 15 18 21 12 16 17 99 2. Preventive (30.0) (36.0) (42.0) (24.0) (32.0) (34.0) (33.0) 50 50 50 50 50 50 300 Total (100) (100) (100) (100) (100) (100) (100) Source: Primary data. Note: Figures in brackets represent percentage to the total.

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It revealed that in Udankudi Block 70 % of the respondents had availed the curative service and 30 % of the respondents have availed the preventive service. Whereas in Srivaikuntam block, 64 % have availed the curative service, and 36% of the respondents have availed the preventive service. While in Kayathar block, 58 % have availed the curative service and 42% of the respondents have availed the preventive service. Whereas in Kovilpatti block, 76 % have availed the curative service, and 24% of the respondents have availed the preventive service. While in Tiruchendur block, 68 % have availed the curative service and 32% of the respondents have availed the preventive service. In Alwarthirunagiri Block 66 % of the respondents have availed the curative service, and 34 % of the respondents have availed the preventive service. This point to the fact that, people do not prefer primary health centres for preventive care.

SATISFACTION OF HEALTH INPUT AVAILABILITY IN PRIMARY HEALTH CENTRES Satisfaction Group Mean Sl. of Health Udankudi Srivaikuntam Kayathar Kovilpatti Tiruchendur Alwarthirunagiri No. Input Mea S. T-test Mea S.D T- Mea S. T- Mea S. T- Mea S. T- Mea S. T- Availability n D n test n D test n D test n D test n D test Own 3.17 1.2 3.02* 2.86 1.42 1.2 1.7 1.2 1.8 1.5 1.9 1.8 1.7 1. 1.64 building 8 4.21 6 1* 2.96 8 3 3.52 3 1* 3.79 4 6 Toilet 2.21 1.2 0.27 3.82 3.07 1.7 1.0 1.5 1.3 1.7 1.0 1.7 1.8 2. 1.04 facility 2 * 2.79 3 8 3.76 2 4 2.46 3 9 2.72 3 8* Drinking 2.04 1.6 1.17 3.27 2.48 1.6 3.0 1.6 1.9 1.9 1.8 1.0 1.7 3. 1.52 water 3 3.79 4 3* 2.14 7 2 2.51 4 2 3.66 8 6* 3.28 1.1 3.16* 1.51 1.4 1.2 1.6 1.5 1.8 1.6 1.0 1.7 4. Electricity 3.62 1.25 5 2.76 8 9 3.82 4 7* 3.16 4 2 3.12 3 4 3.64 1.8 3.21* 0.35 1.4 1.3 1.2 1.3 1.2 1.4 1.5 1.4 5. Labour room 2.57 1.63 3 3.81 7 6* 3.43 4 7* 2.03 9 4 2.87 2 3 2.19 1.7 2.08* 3.36 1.7 1.2 1.1 0.8 1.4 1.1 1.5 1.8 6. Laboratory 4.12 1.96 3 * 2.43 6 4 1.79 1 3 3.14 2 3* 3.03 2 5* Telephone 3.24 1.4 3.03* 2.34 1.0 1.4 1.6 1.2 1.4 1.5 1.2 1.0 7. 2.63 1.52 facility 3 * 3.12 4 3* 3.52 7 4* 3.84 7 4* 2.49 2 4 Vehicle in 2.41 0.24 - 1.4 8. running 3.47 1.29 0.24 1.2 1.0 1.0 1.0 1.7 1.2 1.5 1.1 6 condition 2.16 2 6 2.74 8 6 2.68 1 2 3.46 1 2* In-patient 2.37 1.2 2.02 3.14 1.0 1.1 1.9 1.2 1.0 1.8 1.6 1.5 9. 3.15 0.61 beds 8 * 3.62 4 1 2.47 1 2 3.71 4 1* 2.15 5 1 Medical 2.01 1.3 2.12 1.72 1.3 1.2 1.0 1.5 1.8 1.3 1.0 1.4 10. 2.73 1.45 officer 1 3.14 8 4 3.41 5 5* 2.19 2 5 3.46 8 5* At least one female 11. medical 1.5 1.1 1.5 1.5 1.8 1.2 1.0 1.7 1.8 officer 2.63 4 0.04 2.38 1.62 1.51 3.46 7 9* 3.18 2 3* 3.03 2 7 3.19 6 3* Stock of vaccines, contraceptiv 12. es and prophylactic 1.4 1.0 1.4 1.5 1.6 1.6 1.3 1.0 1.4 drugs 2.24 7 0.38 3.05 1.67 1.86 2.81 4 4 2.66 4 2 3.11 7 8* 2.31 7 1 * Significant at 5 per cent level. According to Table 5.37 in Udankudi block, the satisfaction of health input availability of respondents was found low in the variables namely satisfaction of availability of medical officer, drinking water, laboratory and toilet facility. The mean values of these variables are 2.01, 2.04, 2.19 and 2.21 respectively. The satisfaction of health input availability of respondents was found high in the variables namely satisfaction of availability of own building, telephone facility, electricity and labour room. The mean values of these variables are 3.17, 3.24, 3.28 and 3.64 respectively.

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The significant difference among the satisfaction of health input availability of respondents after getting treatment is found high in all aspects of satisfaction of primary health centre’s except the satisfaction of availability of own building, electricity, labour room, laboratory and telephone facility since its respective ’t’ statistic are significant at 5 per cent level. In the case of Srivaikuntam block, the satisfaction of health input availability of respondents was found low in the variables namely satisfaction of availability of at least one female medical officer, labour room, telephone facility, medical officer and own building. The mean values of these variables are 2.38, 2.57, 2.63, 2.73 and 2.86 respectively. The satisfaction of health input availability of respondents was found high in the variables namely satisfaction of availability of laboratory, toilet facility, electricity and a vehicle in running condition. The mean values of these variables are 4.12, 3.82, 3.62 and 3.47 respectively. The significant difference among the satisfaction of health input availability of respondents after getting treatment is found high in all aspects of satisfaction of primary health centre’s except the satisfaction of availability of toilet facility, laboratory, telephone facility and in-patient beds since its respective ’t’ statistic are significant at 5 per cent level. In the case of Kayathar block, the satisfaction of health input availability of respondents was found low in the variables namely satisfaction of availability of stock of vaccines, contraceptives and prophylactic drugs, toilet facility, electricity, laboratory and a vehicle in running condition. The mean values of these variables are 2.81, 2.79, 2.76, 2.43 and 2.16 respectively. The satisfaction of health input availability of respondents was found high in the variables namely satisfaction of availability of own building, labour room, drinking water, in-patient beds and at least one female medical officer. The mean values of these variables are 4.21, 3.81, 3.79, 3.62 and 3.46 respectively. The significant difference among the satisfaction of health input availability of respondents after getting treatment is found high in all aspects of satisfaction of primary health centre’s except the satisfaction of availability of own building, drinking water, labour room, telephone facility and at least one female medical officer since its respective ’t’ statistic are significant at 5 per cent level. In the case of Kovilpatti block, the satisfaction of health input availability of respondents was found low in the variables namely satisfaction of availability of laboratory, drinking water, in-patient beds, the stock of vaccines, contraceptives and prophylactic drugs and a vehicle in running condition. The mean values of these variables are 1.79, 2.14, 2.47, 2.66 and 2.74 respectively. The satisfaction of health input availability of respondents was found high in the variables namely satisfaction of availability of electricity, toilet facility, telephone facility, medical officer and at least one female medical officer. The mean values of these variables are 3.82, 3.76, 3.52, 3.41 and 3.18 respectively. The significant difference among the satisfaction of health input availability of respondents after getting treatment is found high in all aspects of satisfaction of primary health centre’s except the satisfaction of availability of electricity, labour room, telephone facility, medical officer and at least one female medical officer since its respective ’t’ statistic are significant at 5 per cent level. In the case of Tiruchendur block, the satisfaction of health input availability of respondents was found low in the variables namely satisfaction of availability of a vehicle in running condition, drinking water, toilet facility, medical officer and labour room. The mean values of these variables are 2.68, 2.51, 2.46, 2.19 and 2.03 respectively. The satisfaction of health input availability of respondents was found high in the variables namely satisfaction of availability of telephone facility, in-patient beds, own building, electricity, laboratory and stock of vaccines, contraceptives and prophylactic drugs. The mean values of these variables are 3.84, 3.71, 3.52, 3.16, 3.14 and 3.11 respectively.

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CONCLUSION The Primary health centre is the basis of the medical system in India. It is the first contact point among the village community, and the medical officer acts as a referral unit for subcentres and provides for hospitalisation and other medical treatment for patients. The activities of primary health centres involve curative, preventive, promotive and family welfare services. The preference for PHC is mainly by the poor community because of its inability to afford secondary and tertiary hospitals.

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