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A study on the utilization of healthcare services of Mobile Health Vans (MHVs) in the state of Uttarakhand

Student Name: Ms Achla Behl Khanna
Guide: Dr Sapna Arora Narula
Year of completion: 2019

Abstract:

Access to essential healthcare services was acknowledged as a fundamental human right by the Declaration of Alma-Ata in 1978 (Declaration of Alma-Ata, 1978). As a solution, the planners in India came up with a comprehensive mission-oriented approach to revamp the rural healthcare delivery system by launching the concept of Mobile Medical Units in a large number of districts of the country for delivery of healthcare services to difficult areas. The state of Uttarakhand in India which has been considered for this research work is predominantly a mountainous state, and the rural settlements are widely scattered making difficult to cater to the health needs of the population through existing fixed health facilities. It is also one of the priority states by National Rural Health Mission (NRHM) and has a good network of MMUs operating. This research study is based on understanding the user perception regarding the utilization of services of mobile health vans on the basis of four parameters naming accessibility, availability, affordability and quality of healthcare services. The descriptive and Cross-sectional research design was followed in this study wherein the data have been collected across the different regions of the Uttarakhand state. The respondents were the Patients/ beneficiaries using the services of Mobile Health Vans (either first time or more than one time). The outcome variables considered for this study are accessibility, availability, affordability and quality. The Independent Variables considered in this research study are socioeconomic variables, including occupation, BPL cardholder status, education level, and demographic variables, including caste, gender and age. From data analysis point of view, district wise tables were generated to come up with the significant findings from users’ point of view. Then the key outcome variables were analyzed using selected background variables using chi-square tests. Indexes for accessibility, availability, affordability and quality generated on the basis of specific indicators/ variables as per the definitions. Finally, the logistic regression analysis was done to find out quantitative relationships and the odds of overall utilization by selected background variables. The logistic regression was done considering the categorical and qualitative nature of the outcome variable. Though few studies are there where logistic regression has been used for data analysis, but to the best of the researcher’s knowledge in this study the logistic regression of the parameter indices in case of mobile health units has been done for the first time. Also, to study the feedback of other stakeholders (Government officials, Project Coordinators and Staff of MHVs) regarding the implementation of the MHV scheme in the state of Uttarakhand, personal interviews were conducted using interview schedule. The Conclusions & Recommendations, in the end, summarize the Practical implications, Policy recommendations & Research Implications derived from the present study.

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