Review of Selective Primary Health Care Efforts in an Urban Health Center Area in Guntur City of Andhra Pradesh

Soon after the Alma Ata conference, Comprehensive Primary health Care (CPHC) was assailed as not ‘feasible ’and Selective PHC (SPHC) was offered as an intervening option. The UNICEFs GOBI programme included limited interventions of proven efficacy linked with appropriate technology; growth monitoring, oral rehydration, breast feeding, immunisation, food supplementation, family planning and female literacy. Though there has been focus by governments on GOBI related activities over the years, health issues continue unabated even in the area of child health.

A cross sectional study was done from September to December 2012 involving a population of 15000 (2845 families) served by the Israilpet Urban Health Center (UHC)in Guntur City. A house to house search for mothers with children 1–2 years yielded 242 respondents. This group of mothers was selected for the following reasons: Good recall of health related activities of their children and Completion of primary immunisation (6 VPDs). After obtaining consent, a pretested questionnaire was administered to Mothers of 1–2 year children regarding utilization of maternal care services and GOBIFFF activities Findings: Though utilisation of core activities like Immunisation seem good (93.3% fully immunized), in depth knowledge on basic health issues and the demand for health care is poor. Regular house visits by health workers is still necessary to ensure child immunisation. Growth monitoring card was present only with 22.0% of the mothers and entries made in only 9 cards. Many mothers were found to have poor knowledge about ORS and its preparation. The private health sector is being utilized more (71.0% availed antenatal and intra natal care in private sector). Though couple protection rates are improving, the unmet need for family planning is on the rise as only 4.0% were following any spacing methods.

Even among the GOBI activities, only some aspects are occurring in the community. Growth monitoring is still meager. Utilisation of immunisation and tubectomy services are mainly due to the efforts of health workers and continue to depend on their inputs. The increasing role of the private sector and the unmet need of family planning services have to be addressed. On the whole the original spirit of self determination envisioned at Alma Ata has been lost over the years.