# Assessment of the Functioning of Health and Wellness Centers in Kurud Block, Dhamtari District, Chhattisgarh: A Facility-Based Cross-Sectional Study

## TL;DR

This study evaluates the performance of health and wellness centers in rural Chhattisgarh, finding significant gaps in staffing and resources.

## Contribution

The study provides a detailed assessment of HWC functionality in a specific rural region using a cross-sectional approach.

## Key findings

- 41.2% shortfall in community health officers and inadequate infrastructure were observed in most centers.
- Only 17.6% of SHC-HWCs met diagnostic standards, and teleconsultation was available in 70% of HWCs.
- Performance was significantly linked to staffing and teleconsultation facilities, with 52.9% of SHC-HWCs classified as high-performing.

## Abstract

Background

Ayushman Bharat - Health and Wellness Centers (HWCs), now renamed as Ayushman Arogya Mandir, are envisioned to provide an expanded range of healthcare services. This study was conducted to assess the functioning of HWCs in the rural field practice area of the All India Institute of Medical Sciences, Raipur.

Materials and methods

This was a facility-based analytical cross-sectional study conducted in the Kurud block of Dhamtari District, Chhattisgarh. Half of the HWCs in the Kurud block were selected using stratified random sampling. Data on inputs and outputs from the selected 20 HWCs were collected using an observation checklist and analyzed using IBM SPSS Statistics for Windows, Version 21.0 (Released 2012; IBM Corp., Armonk, NY, USA).

Results

There was a significant shortfall (41.2%) in the availability of community health officers (CHOs). Most centers lacked adequate infrastructure, and none had the full complement of essential equipment and medicines. Only 17.6% of Sub-Health Center-HWCs (SHC-HWCs) and none of the primary health centers met the diagnostic standards outlined in the operational guidelines. Teleconsultation facilities were available in 70% of HWCs, and yoga sessions had been initiated in 85% of them. All HWCs had started screening for hypertension and diabetes. Based on performance grading, 52.9% of SHC-HWCs were classified as high-performing, while 47.1% were low-performing. Performance was found to be significantly associated with the presence of a CHO, availability of a laptop, webcam, and teleconsultation facilities.

Conclusions

To improve overall performance, all HWCs should address human resource gaps, ensure logistics align with operational guidelines, strengthen teleconsultation infrastructure - including uninterrupted internet access - and enhance information, education, and communication coverage and screening services.