Facilitators and Barriers to Service Utilization for Beneficiaries of 12 Service Packages Provided Under Comprehensive Primary Health Care (C-PHC) in India: A Qualitative Study

Abstract

Introduction: In February 2018, the Government of India announced that 150,000 Health & Wellness Centres (HWCs) (renamed as Ayushman Aarogya Mandir (AAM) in November 2023) will be created by transforming existing Sub-Centres (SC) and Primary Health Centres (PHCs) for Comprehensive Primary Health Care (C-PHC) delivery under Ayushman Bharat Yojana. The study aims to understand the barriers and facilitators influencing the eligible beneficiaries’ perspectives on the utilization of C-PHC services offered at AAM.

Materials & Methods: A qualitative study was conducted in Gandhinagar district, and in-depth interviews (IDIs) were conducted with the eligible beneficiaries for C-PHC services at AAM. The data obtained was transcribed to identify codes, and subsequently, themes were merged with those codes.  

Results: The results showed that ASHAs were key to building awareness about AAMs amongst the beneficiaries. Trust in staff and social network influence were facilitators for service uptake. Beneficiaries undergoing TB treatment chose private clinics over AAM due to stigma. Due to lack of infrastructure beneficiaries had privacy concerns in consulting the service provider of opposite gender.

Conclusion: Further strengthening of the initiative can be done by addressing challenges such as infrastructure issues, physical access, and shortage of medicines. Facilitators such as beneficiaries’ trust in the system, and patient-centric behavior of the staff can be considered for implementation in line with the regional context.