Facilitators and Barriers of Service Utilization in the Ayushman Arogya Mandirs of Tripura: A Qualitative Study

Introduction: In order to deliver comprehensive primary health care, the existing Sub Health Centres were converted into Health and Wellness Centre (HWC) now known as Ayushman Arogya Mandirs under the twin pillars of Ayushman Bharat Scheme. However, Universal Health Coverage (UHC) remains an elusive aim due to various shortcomings in the quality and availability of services. Objective: To identify the facilitators and barriers of utilization of the services of Health and Wellness Centres of Tripura. Methods: This was a Qualitative study, using In-depth Interview method where 35 key informants’ in-depth interviews were conducted in different health and wellness centre areas from the districts of Tripura and data were analysed using the Thematic network analysis framework. Results: Unavailability of services (like medicines and functioning equipment), lack of accessibility, lack of satisfaction, lack of awareness and poor health seeking behaviour were identified as major barriers of utilization of the services. On the other hand, positive working attitudes of the staff, availability of MCH services, friendly environment and good communication of staffs were found as facilitators in the utilization of services. Conclusion: The study highlighted that poor accessibility of health centres, unavailability of medicines, equipment etc., were acting as barriers whereas availability of the MCH services and staff behaviour were facilitating the service utilization.