Challenges Faced by Community Health Officers in Delivering Comprehensive Primary Health Care at Ayushman Arogya Mandir in a Rural Area of West Bengal: A Cross-Sectional Study

Introduction: Community Health Officers (CHOs), play pivotal role in delivering Comprehensive Primary Health Care (CPHC) at Ayushman Arogya Mandir (AAM) are facing several workplace challenges which may hinder their effective functioning and influence service delivery outcomes. Objectives: 1.To find-out challenges faced by CHOs delivering CPHC 2.to assess primary stressor and key areas of improvement of services as reported by them. Method: Cross-sectional study was conducted among 152 CHOs working at sub-centre level AAMs of Howrah Sadar subdivision, West Bengal by complete enumeration method. Data were collected by pretested, semi-structured self-administered questionnaire. Descriptive statistics were used and for analytical part Chi-square test and logistic-regression performed. Results: Among the study participants, 39.5% had residence >10km from workplace, 61.2% reported non-availability of water at working place, 38.2% reported poor sanitation, 44.7% reported net connectivity problem and 30.3% reported scarcity of essential medicines at their AAMs. Around 84% felt that improvement in infrastructure, 72% perceived increased manpower would lead to improvement of services. Primary stressor was reported to be related to health care service delivery by 71%. Primary stressor significantly associated with age group (p<0.0001), education (p=0.003) and residential distance (p=0.02) and age group was significant predictor(p=0.002) of primary stressor. Conclusion: Inadequate infrastructures and lack of logistic supports were major challenges faced by CHOs on delivering health services. Increasing manpower and infrastructure development was to be helpful for improving healthcare services according to CHOs. Work related stress of CHOs was significantly associated with age, healthcare service delivery, educational qualification, and distance from their residence.