SCMS SCHOOL OF TECHNOLOGY AND MANAGEMENT

Business Research Methods

RESEARCH PROPOSAL
‘A study on public awareness of
services provided by the public
health centers in Kerala’

Submitted by,
Akhil Raj P M (fm-1921)
Arsha C P (fm-1908)
Andria Benitta Rocha (fm-1958)
Alen Augustine (fm-1952)
Ahmed Ameen (fm-1978)
Denin Joy (fm-1900)
1.1 INTRODUCTION
“It is health that is the real wealth, and not pieces of gold and silver.”
- Mahatma Gandhi

Health is considered to be very important element in life. From a nations point of view
health of individuals is given due importance as it contributes to the strength of the
nation. Good health of individuals are the prerequisite for economic development and
social welfare of a nation. A healthy community is the infrastructure upon which an
economically viable society can be build up as unhealthy people will not be able to make
much contributions to the nation’s progress.
India has a total of 17,149 health centers functioning (2017) for a population above 1.2
billion. This includes 8,801 Primary Health Centre, 6,795 Health Sub- Centre (HSC) and
1,553 Urban Primary Health Centre (UPHCs). For the past six decades Indian states have
varying level of success in healthcare. Especially Kerala, southern Indian state with
about a population of 33.3 million people is consistently coming out with much better
outcomes in health care. The health gains made in Kerala can be attributed to several
factors, this includes the strong emphasis from the state government on public health
and primary health care (PHC), health infrastructure, decentralized governance,
financial planning, girls’ education, community participation and a willingness to
improve systems in response to identified gaps.
Kerala has lower infant mortality rate (12 per1000 live births), lower maternal
mortality rate (66 per 100000 live births) and highest literary rate compared to all
other nations. Kerala rapidly expanded the number of medical facilities, hospital beds,
and doctors. From 1960 to 2010, the number of doctors increased from 1200 to 36,000,
between 1960 and 2004 the number of primary health care facilities from increased
from 369 to 1356. Kerala was praised for its public health programs that were to an
extent very success in preventing contagious deceases.
PHC’s in Kerala are under the control of Kerala Government Health Department. There
are a lot of services provided in the public health centers and compared to other private
health care centers PHC’s provide services at a very minimal cost which a common man
could afford. Every year in the budget of Kerala State Government a large sum of
amount is being spend for this PHC’s. In 2021 Financial Budget of the State Kerala
presented by FM Thomas Isaac has uplifted all spending restrictions to fight against the
Covid-19 pandemic. Information regarding the services provided by the PHC’s are
available in the Health portals of Kerala Government. This study is conducted to know
how much the public is aware about the different services provided by PHC.
1.2 LITERATURE REVIEW

 According to AK Sharma (2009) The National Rural Health Mission aims at

providing accessible, affordable, effective, accountable, and reliable healthcare to
all citizens and in particular to the poorer and vulnerable sections of the
population; consistent with the outcomes envisioned in the millennium
Development Goals and general principles laid down in the national, state and
policies including the National Population Policy,2000.
 In a study conducted by Basu J and Andrews J on Comparative Performance of
Private and Public Healthcare Systems in Low- and Middle-Income Countries.
They noted that Private sector healthcare delivery in low- and middle-income
countries is sometimes argued to be more efficient, accountable, and sustainable
than public sector delivery. Conversely, the public sector is often regarded as
providing more equitable and evidence-based care. They performed a systematic
review of research studies investigating the performance of private and public
sector and in their review they do not support the claim that the private sector is
usually more efficient, accountable, or medically effective than the public sector;
however, the public sector appears frequently to lack timeliness and hospitality
towards patients living in low- and middle-income countries.
 Chaturvedi et al. (2007) conducted a study in the rural areas of Ahmednagar
district in Maharashtra in 2006 to review the maternity services under the public
health system. Fourteen health centres and 3 rural hospitals were selected. The
study used 3 questionnaires in the format prescribed under the Right to
Information Act of the Government of India, 2005.It was found that in 21% of
cases, no iron supplement was available, district headquarters did not receive
iron supplement from higher authority and majority of deliveries took place at
home and at private health care system. Emergency obstetric care services did
not exist. Thus NRHM (National Rural Health Mission) intervention is required to
address the issue of safe motherhood.
 Kermode et al. (2007): did a study in rural Maharashtra with 3 main objectives
1) To explain the factors contributing to mental illness to 32 women respondents
associated with Primary Health Care (PHC) 2) To identify causes of depression,
suicide, violence and review the existing and potential community level
strategies to handle them. 3) To explore the impact of the PHC program on
individuals and community. The perception of respondents was that mental
health was the outcome of socio economic and cultural factors. Poverty, conflicts
with spouse and in-laws, violence etc. contributed to mental illness.
Empowerment of women can be ensured by education, employment, no
discrimination to caste or sex and promotion of mental health of an individual
and of the community
 Devadasan(2009):This study examines various dimensions of Community Health
Insurance (CHI) such as financial security, quality of health care provided and
access to health care. CHI was launched by Government as a component of
National Rural Health Mission (NRHM) so as to reduce out of pocket expenditure
 on health care by households. The study conducted panel survey of ACCORD-
AMS-ASHWINI(AAA) CHI scheme and it was found that with its reliable , effective
and low indirect costs , the poorest could access quality health care with financial
impunity.
 Banerjee (2004): The paper describes the status of healthcare delivery on the
basis of the study conducted on 100 families, largely consisting of the tribal
population with high incidence of female illiteracy in Rural Udaipur. According to
the findings of the survey, the people rely more on private healthcare facility (by
paying Rs.84/visit) and on traditional healer called „BHOPA‟ (by paying Rs,
61/visit) rather than on public healthcare facility (by paying Rs.71/visit, actually
it should be free) .The rich visits public healthcare more than the poor. The sub
centres were largely found to be deficient in their services due to high
absenteeism and low quality of medical service.
 Jan Stjernswa¨rd, MD, PhD, FRCP (Edin), Kathleen M. Foley, MD, and Frank D.
Ferris, MD did a study on The Public Health Strategy for Palliative Care.
A Public Health Strategy (PHS) offers the best approach for translating new
knowledge and skills into evidence-based, cost-effective interventions that can
reach everyone in the population. For PHSs to be effective, they must be
incorporated by governments into all levels of their health care systems and
owned by the community. This strategy will be most effective if it involves the
society through collective and social action. The World Health Organization
(WHO) pioneered a PHS for integrating palliative care into a country’s health
care system.
 William C.L.Hsiao did a study on The Chinese health care system: Lessons for
other nations.This paper examines China's health care from a system perspective
and draws some lessons for less developed nations. A decade ago, Chinese
macro-health policy shifted its health care financing and delivery toward a free
market system. It encouraged all levels of health facilities to rely on user fees to
support their operations. However, China continued its administered prices and
hospitals continued to be operated by the government. These financing, pricing
and organizational policies were not coordinated. The author found these
uncoordinated policies created serious dissonance in the system. Irrational
prices distorted medical practices which resulted in overuse of drugs and high
technology tests. Market-based financing created more unequal access to health
care between the rich and poor. Public control.
 Sarath Chandran and Pankaj Ro(2014)-The main objectives of the present study
were to show the spatial distribution of Primary Health Centres in the Haripad
Block of Kerala and to investigate the patients’ perception regarding the services
provided by the Primary Health Centres. The main factors affecting the
utilization of primary health care services in Haripad Block were easy
accessibility, availability of medicine etc. The major problems of all sampled
Primary Health Centres were the less number of doctors, absence of doctors
from services, the lack of sanitary facilities and other infrastructure such as
inpatients room, lab, bed etc
  Lauri Vuorenkoski(2008)-The Health Systems in Transition (HiT) profiles are
country-based reports that provide a detailed description of a health system and
of policy initiatives in progress or under development. According to various
indicators, the health of the Finnish population has considerably improved over
the last few decades. Average life expectancy has improved throughout the 20th
century, especially during the last three decades, reaching 76 years for men and
83 years for women in 2005. Although overall mortality has fallen, the
socioeconomic inequality in mortality seems to be increasing. In practice in
Finland there are three different health care systems which receive public
funding: municipal health care, private health care and occupational health care
systems. The Finnish health care system offers relatively good quality health
services for reasonable cost with quite high public satisfaction.

1.3 RESEARCH QUESTIONS

Kerala is a state where due importance is given to the primary health of the individuals,
every year a lot of funds are allocated to this sector for its better performance at lower
cost, even after that many people are still depending on private health centers.
1] Are the public aware about the services that are being provided through these public
health centers?
2] Are there sufficient ways to reach out about PHC services to the public?
3] Are the public satisfied with the services of PHC?

1.4 RESEARCH OBJECTIVES

* To analyze how much the public is aware of services provided by PHC
* To assess how successful are new schemes in reaching the public.
* To know how people differentiate between a PHC and a private clinic.
* To analyze the regularity of people visiting PHC.

1.5 RESEARCH DESIGN

Research refers to a search for knowledge on facts. A Research design is a place,
structure and strategy of investigation conceived so as to obtain answers to research
questions and to control variances.
1.51 Nature of study.
This study is analytical in nature.
1.52 Population
The population for the study is taken as people in Kerala
1.53 Sample
The Sample for the study will be taken from 100 Keralite belonging to different age
groups. Convenience sampling method will be adopted for this study.
1.54 Method of data collection
The data for the study will be collected through a well-structured questionnaire and
along with the primary data we also depend on secondary data such as government
portals, google scholar, newspapers and magazines for data collection.