Availability of Swasthya Vahan Sewa (102 services) and constraints in its utilization in a rural block of Haryana, India

Sir,

The lack of proper transport facility severely affects the access to emergency services. The Government of Haryana thus launched a service branded as “Haryana Swasthya Vahan Sewa No.102” on 14 November 2009, with the main objective of providing assured referral transport for pregnant women in labor or newborns, as well as attending to other emergencies.

We carried out a cross-sectional study to look out for the availment of Swasthya Vahan Sewa (102 services) and constraints in its utilization in a rural block of Haryana, India from January to April 2013. The Primary health centre (PHC) Chiri (five sub-centers and five villages) was chosen for the purpose with population of 24,567 as on March 2013. A list of all the Janani surakshya yojana (JSY) beneficiaries who had children between 0-6 months was obtained from the Auxiliary Nurse Midwifery (ANM). A total of 120 subjects were interviewed. A set of pre-tested semi-structured questionnaire was given to the respective beneficiary after visiting her house. The pie chart in Figure 1a shows knowledge about the Swasthya Vahan Seva among the study subjects and the Figure 1b shows the level of knowledge as well as the use of the 102 services by the beneficiaries. Table 1 shows the association of the socio-demographic factors with knowledge and avail of the ambulance services.

Figure 1.

(a) Knowledge about the Swasthya Vahan Seva among the study subjects. (b) Knowledge as well as use of the 102 services among the beneficiaries

Table 1.

Association of knowledge and utilization of 102 services with the socio-demographic details of beneficiaries

Reduction of maternal mortality rate (MMR) needs easy accessibility to emergency obstetric care (EmOC) facilities for all women having obstetric complications which require a well-functioning referral transport system.[1] Study by Mavalankar et al.,[2] found out that improvement in referral services led to an increase in institutional deliveries from 36% to 55%. National Rural health Mission (NRHM) since its inception in 2005 has taken fast striding steps in building up the infrastructure for good referral services. Reasons of non-utilization of referral services were found to be maximum because subjects said they did not know about it (40%) followed by long time taken for response (25%). Poor knowledge about the processes to avail it and poor quality of services provided ranked next each contributing 12% approximately. Bhat et al.,[3] also observed that poor quality and long time for response accounted for most of the reasons why people did not avail the government services. Private partnership needs to be more emphasized more ardently and supervision and accountability needs to be strictly increased.

Education status was, however, significantly associated with both the factors. Similar association was shown by Mavalankar et al., in his study in Gujrat.[2] Larger families had better knowledge and utilization of the referral services. A family earning more and where beneficiary was a working mother, the level of use and knowledge was also more.[4] Poor people or people below poverty line hardly get time to think anything other than their survival and so prefer doing deliveries at home since they feel that is the easiest way out. So health functionaries should target these groups specifically so that they are most benefitted out of the government services provided to them free of cost.