HEALTH CARE SERVICES IN THE BASIC HEALTH UNITS OF PUBLIC AND PUBLIC-PRIVATE PARTNERSHIP SECTOR IN KHYBER PAKHTUNKHWA - A COMPARATIVE STUDY

Abstract

Introduction: Pakistan has a distressing framework of health care delivery, with only 20% population using primary health care facilities due to economic constraints, poor monitoring and surveillance systems, and lack of governmental commitment. The current study was carried out to compare the quality of services and their utilization in Public sector and Public-Private-Partnership (P-P-P) run Basic Health Units (BHUs) of Khyber Pakhtunkhwa (KP).
Materials & Methods: A cross-sectional study was conducted in three Basic Health Units of Nowshera district (Public-Private-Partnership) and three BHUs of Hangu district (Public sector) of KP from September to November 2012. The sample comprised 150 patients visiting the BHUs selected by convenience sampling (25 patients from each BHU for a total of 75 participants per district). Data were collected through an indigenously designed mixed questionnaire. Data analysis for descriptive statistics was done through SPSS 16, using Chi Square test for comparison of frequencies; p≤0.05 denoted significance.
Results: The P-P-P sector BHUs showed significant improvements as compared to Public sector BHUs for Preventive, Mother and Child Health care (MCH), and Health Promotion services, availability of Drugs, Family Planning services, and basic Laboratory Facilities (p<0.001), whereas no significant difference was observed in curative services. Primary Health Care services in public sector were also under-utilized.
Conclusion: The overall quality and utilization of health services at Primary Health Care level through Public sector is low as compared to Public-Private-Partnership run BHUs. Special attention is needed to improve the framework of primary health care services.