A Situational Analysis of Cleanliness, Infection Control and Facility Readiness in Urban Primary Health Centres of Western India

Abstract Background: Urban Primary Health Centres (UPHCs) underpin urban primary care in India, yet cleanliness, infection prevention and statutory reliability remain uneven. We assessed readiness across a municipal corporation using national quality frameworks. Methodology: Cross-sectional census of 23 UPHCs (January–February 2025) using a checklist mapped to Indian Public Health Standards, Kayakalp and National Quality Assurance Standards. Data sources were structured observation, staff interviews and register review. Indicators were summarised as percentages; interpretation used visuals (regulatory compliance, documentation and facility-by-domain heat map). Results: Core logistics were widely available: housekeeping – 100%, infection prevention and control – 95.7% and full color-coded segregation – 82.6%. Governance and practice reliability were mixed: infection-control committees – 82.6%, quality committees – 69.6%, regular mock drills – 56.5% and patient feedback ≥10/month – 43.5%. Laboratory readiness was high for point-of-care items, but semi-autoanalyser uptime was 47.8%. Regulatory compliance was strong for biomedical-waste authorisation (95.7%) and acceptable for the External Quality Accreditation Commission (EQAC). However, spirit availability – 13.0% and valid spirit license – 8.7% were notable gaps. Documentation was near-universal for core registers, while referral documentation – 52.2% and medicolegal registers – 8.7% lagged. Heat map indicated high laboratory/documentation readiness, heterogeneity in cleanliness and the widest dispersion in regulatory compliance. Conclusions: At the UPHCs, structural readiness was strong, with adequate housekeeping, infection control supplies, diagnostics, and registers in place. However, practice fidelity remained weak - evident from irregular drills, suboptimal committee functioning, limited feedback mechanisms, inadequate referral and medico legal documentation, and gaps in analyzer availability and spirit licensing. National frameworks drove inputs; translating them into reliable routines needs monthly audits, licensing dashboards, pooled maintenance and supportive supervision to strengthen safety, compliance and patient-centred quality.