Human Resource Compliance with Indian Public Health Standards 2022: An Assessment of Health and Wellness Centers in a District of Northwestern India

Since 1952, basic health care in India has been provided through primary health centers (PHCs). Recently, the government has expanded services with health and wellness centers (HWCs) to offer comprehensive primary care. The Indian Public Health Standards (IPHS) were last updated in 2022 to guide these enhancements. Despite concerns about insufficient human resources, no studies have assessed HR compliance with the 2022 IPHS in Punjab's border district. An observational cross-sectional study was conducted among eight urban primary health centers (UPHCs), 17 rural PHCs (R-PHC), and 28 sub-health centers (SHCs) of Amritsar district (selected by simple random sampling), where available human resource was assessed using a checklist developed on basis of IPHS 2022. Data were collected by observation, record review and interview with medical officer and community health officer. Based on the checklist, overall scores were calculated where availability/nonavailability of HR was scored as 1 and 0, respectively. The HWCs were then classified into very good (>80%), good (60-80%), average (40-60%), poor (<40%). 24 * 7 UPHCs showed only 7% deficiency compared to 48% in non-24 * 7 UPHCs. SHCs demonstrated just 3% overall deficiency, while R-PHCs faced significant challenges about 45-46% deficiency in both 24 * 7 and non-24 * 7 facilities. Overall, 66% of all centers were rated very good or good. 24 * 7 UPHCs and SHCs were generally performing better than non-24 * 7 UPHCs and RPHCs. Targeted efforts should be made to address HR shortages in underperforming centers, with emphasis on equitable distribution of human resources between urban and rural areas.