Assessment of availability of free diagnostic services in public health facilities of Chhattisgarh

Abstract

Introduction: Appropriate diagnostics are critical for providing comprehensive healthcare services. India launched the Free Diagnostics Service Initiative (FDSI) in July 2015 to address the need for accessible and quality diagnostics in public health facilities. In October 2019, the 2nd edition of the guidelines was launched with an expanded basket of tests.

Objective: To assess the availability of free diagnostic services at public health facilities (PHFs) of Chhattisgarh (CG)

Methodology: A cross-sectional study covering 105 PHFs of CG was carried out using multi-stage sampling. Three districts from different divisions were selected randomly. Thirty-five PHFs from each district were selected randomly (one DH, 4 CHCs, 10 PHCs & 20 SCs).

Results: Most of the PHFs (94%) provided diagnostic services for 6 days/week. Overall, 49% to 72% of tests were performed at different levels of PHFs with respect to the number of tests suggested as per the FDSI 2019 norm (SC - 72%, PHC - 49.4%, CHC - 58.5%, DH - 62.2%). The hub and spoke model was present in more than half of the PHFs (55%). About 45% of SC, 33% of DH, 25% of CHC, and 20% of PHC were performing satisfactorily (provided >75% of tests), and more than half of PHCs were poor performing. About 63% and 47% of visited PHFs had reagent and equipment problems, respectively. The manpower problem was present in 5% of all PHFs.

Conclusion: Better performance was found at SC, DH than at CHC, PHC. Commonly needed tests were mostly available at each level of PHFs.

Keywords: Free diagnostic services, Public health facilities, Chhattisgarh