Capacity Evaluation of Primary Health Centres - Health and Wellness Centres for Delivering Non-communicable Disease Services in Jehanabad District, Bihar: A Cross-sectional Study

Background: The escalating burden of Non-Communicable Diseases (NCDs) in low- and middle-income countries like India and their substantial contribution to global mortality and morbidity, necessitate the need to assess primary healthcare delivery systems. This study evaluates the capacity of Primary Health Centers-Health and Wellness Centers (PHC-WHC) in Jehanabad district, Bihar, to deliver NCD services. Materials and Methods: A cross-sectional facility assessment was conducted across 21 randomly selected PHC-HWCs (10, 24×7 PHCs and 11, non-24×7 PHCs) out of 35 total operational facilities (representing 60% of the centers) in Jehanabad district. A 60% sampling fraction provides a robust estimate with an acceptable margin of error.) for domain-wise descriptive assessments, aligning with the World Health Organization (WHO)’s Service Availability and Readiness Assessment (SARA) sampling guidelines for subnational facility surveys. A piloted structured facility assessment checklist was developed based on standard tools like the Indian Public Health Standards (IPHS), WHO Package of Essential Non-communicable Diseases (PEN), and the Service Availability and Readiness Assessment tool by WHO. Descriptive statistical analysis was performed using Jamovi 2.2.2 software. Results: The study found that around 2/3 of the 24×7 PHCs serve a population above the recommended 30,000 norm. None of the PHCs had adequate manpower. There was no separate NCD clinic in any of the PHCs. The most commonly available diagnostic services in primary health centers were the estimation of blood sugar (90.5%) and hemoglobin estimation (71.4%). Ambulances were not present in two-thirds of the PHCs, thus posing a challenge to providing referral services. Conclusion: This study proposes evidence-based recommendations to enhance the services offered by PHCs. PHCs should be strategically distributed based on population norms to ensure equitable access. To offer quality healthcare services, staffing must align with the IPHS guidelines.