A Study to Assess the Compliance on “Utilization of Selected Government Health Services” Among the Residents of Rural Areas of Dharwad Taluka.

INTRODUCTION

Success is the proper utilization of failure - Carl marks

Health is the precious possession of all human beings as it is an asset for an individual and community as well.Universal access to high quality health care reduces inequalities between the poor and rich. There is evidence that primary care helps to prevent morbid-mortality, being responsible for a more equitable distribution of health among population. The use of epidemiological investigation into the performance and utilization of health services is essential as it produces knowledge about health systems and services and provides subsidies for the design of policies and the improvement in their quality.Millions of women in developing countries experience life threatening and other serious health problems. The situation is even worse in developing countries like India due to inadequate access to essential health services and their poor utilization. Despite the government’s serious commitment to deliver health facilities to the doorsteps of common people through innovative approaches, the utilization of health services is still far below any acceptable standard.

OBJECTIVES:

• To determine the Compliance of Rural residents towards the “Utilization of selected Government Health Services”

• To find an Association between Compliance of rural respondents and selected Socio Demographic Variables.

HYPOTHESES:

All Hypotheses will be tested at 0.05% level of significance

H1. There will be a significant relationship between knowledge of availability of selected government health services and their utilization at 0.05 level of significance.

H2. There will be significant association between compliance of utilization of selected government health services and selected demographic variables of respondents.

DELIMITATION

A study is delimitated to,

• Only selected government health services.

MATERIALS AND METHODS:

Research approach: descriptive survey approachwas used for this study.

Research design: The research design used in this study was descriptive co-relational design.

Settings of the study: The study was conducted in selectedrural areaswere 6 Primary Health Centers in DharwadTaluka.

Population: The population comprised of all the rural residents in selected rural communities of Dharwad Taluka.

Sample and Sampling Technique: The sample for the study comprised of 200 rural residents. Stratified Multistage Non purposive proportionate Random sampling technique.

Source of Data: The data was collected fromall the rural residents in selected rural communities of Dharwad Taluka.

Method of data collection: The structured knowledge questionnaire and structured attitude questionnairewas used to assess the rural residents in selected rural communities of Dharwad Taluka.

Plan for data analysis:

Descriptive and inferentialstatistics

SAMPLING CRITERTIA:

Inclusion Criteria

The study includes the mothers who are

• Head of the family or decision maker of the family.

• Both male and female residents.

• People who are residents since more than five years.

• Residents who are willing to participate in the study.

• People who are available during the study.

• People who are able to read and write Kannada language.

Exclusion Criteria

• People who are not willing to participate in study.

• People who are working in any health care setup.

VARIABLES:

Study variables: Compliance is the independent variable and utilization is dependent variable.

Demographic variable: Were age, gender, religion, type of family, marital status, educational status, occupation, education, source of knowledge, no. of under five children in family, chronic illness, antenatal and postnatal in family, any experience in utilize government health scheme and undergone of any health program

DEVELOPMENT OF THE TOOL:

The tool was developed by the investigator based on

• Research problem

• Extensive review of related literature

• Discussion and Suggestions from the guide and experts

• Based on the level of understanding of the children parents

• Preparation of blue prints Ethical considerations:

• Permission was obtained from the institutional ethical committee to carry out the study.

• The subjects were explained about the purpose and nature of the study

• Written informed consent was obtained from the subjects before preceding the study.

Ethical considerations:

• Permission was obtained from the institutional ethical committee to carry out the study.

• The subjects were explained about the purpose and nature of the study

• Written informed consent was obtained from the subjects before preceding the study.

DESCRIPTION OF THE TOOLS:

The tool designed for the study consists of

Section I – Baseline Proforma

Section II –Structured Knowledge Questionnaire.

Section III–Structured Attitude Questionnaire.

CONTENT VALIDITY OF TOOL:

In order to obtain the content validity of the tool, prepared item along with the problem statement, objectives, operational definition and scoring pattern, were submitted to experts from the field of 15Nursing departments experts there was 100% agreement by all experts on all the items. Content validated by 5 experts such as Doctors, Nursing educators, social worker there was 100% agreement by all experts.

RELIABILITY OF THE TOOL:

The reliability of the tool was computed by usingKarl Pearson Correlation technique and the tool was found to be reliable (r =0.90).

RESULTS:

Data was analyzed by using descriptive and inferential statistics. The analysis of the data organized under theFollowing section

SECTION-1 Descriptive of the baseline variables. Frequency and percentage distribution of the socio demographical variables such asage, gender, religion, type of family, marital status, educational status, occupation, education, source of knowledge, no. of under five children in family, chronic illness, antenatal and postnatal in family, any experience in utilize government health scheme and undergone of any health program.

SECTION-II

The data in the table shows that 66.50% subject had Moderate knowledge, 18.50% had adequate knowledge, and 15% of subjects had inadequate knowledge. The data is also shown in the form of bar diagram.

The data in the table-2 shows that the knowledge score of the mean is 17.85, median is 18.5 and the standard deviation is 13.42 and means percentage is 59.5% respectively. There are 30 knowledge items and the total score is 30.

Data in the table shows that majority of subjects (63%) were utilizing moderate govt. health services, low utilization by 19% and 18% subjects were utilizing highest level of govt. health services.

In this section scores obtained by 3 point likert scale would be categorized into different groups such as high utilization, Moderate (Average) utilization and less utilization.

Figure 5 showing the above participants who are Male had a mean knowledge score is 55.21% and their mean utilization is 73.58%. Where as in Female had a mean knowledge score is 61.72 and their mean utilization score is 76.22%. There was statistically significant difference between knowledge and utilization scores of male and female at 0.05% level of significance.

Figure 6 showing the participants who are married had a mean knowledge score is 61.47% and their mean utilization is 76.2%. Where unmarried had a mean knowledge score is 57.41% and their mean utilization score is 73.76% and widow or widower had a mean knowledge score is 56% and their utilization is 74.22%. There was significant difference within marital status in utilization of govt. health services.

Figure 7: Comparison of any antenatal mother in family with respect to knowledge and utilization scores

Figure 7 showing the participants who are belonged to family with antenatal mother had a mean knowledge score is 63.87% and their mean utilization is 75.57%. Whereas family with no antenatal mother had a mean knowledge score is 58.53% and their mean utilization score is 75.07%. There was significant difference within antenatal mothers in family in knowledge of govt. health services.

The data showing in the above table depict that correlation between percentage of knowledge and utilization score by Karl Pearson’s correlation coefficient. r = 0.0806 and t = 1.1374 and p = 0.02567

Association between Compliance of rural respondents and selected Socio Demographic Variables.

The result showed the gender, educational status, ante natal mothers in the family, previous utilization of government health services and participation in the health program were found significant association with their levels of knowledge at 0.05% levels of significance. There will be significant association between compliance of utilization of selected government health services and selected demographic variables of respondents. There is a significant association between the level of utilization score and gender [x2 =9.8162 at 2 DF. P<0.05% level of significance, however Chi-square value of other variables were not found significant at 0.05% level of significance.

CONCLUSION

Satisfied level of knowledge of the rural respondents towards utilization of govt. health services and satisfied level of utilization of health services but it is necessary to improve the level of knowledge and utilization for their better health especially for the low socio economic status of people.