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ORIGINAL ARTICLE
Year : 2021  |  Volume : 65  |  Issue : 3  |  Page : 275-279

What and how much do the community health officers and auxiliary nurse midwives do in health and wellness centres in a block in Punjab? A time-motion study


1 Project Coordinator, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Field Coordinator, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3 Additional Professor, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
4 Lead Consultant (Health and Wellness Centres), Department of Health and Family Welfare, National Health Mission, Punjab, India
5 Economic Evaluation Specialist, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
6 Professor, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Shankar Prinja
Postgraduate Institute of Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.IJPH_1489_20

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Background: The Government of India introduced a new cadre of Community Health Officers (CHOs) in the primary health-care system through the Ayushman Bharat Health and Wellness Centres (HWCs) program. Objectives: The study aimed to assess the activities performed and time spent by the existing and new primary health-care team members at the HWC level. Methods: A time and motion study was undertaken in four HWCs in Punjab over a period of 3 months, to assess the time spent by auxiliary nurse midwives (ANMs) and CHOs on different services and activities. Data were collected through direct continuous observation of four CHOs and four ANMs during working hours for a period of 6 consecutive days of a week, along with structured time allocation interviews of all participants. Results: The CHOs spent 5.7 (5.6–5.9) hours per day on duty of which 57% was productively involved in service delivery. The average time spent by ANMs was 4.9 (4.5–5.3) hours per day, with nearly 62% productive time. While the CHOs spent nearly 40% of their time on services for non-communicable diseases (NCDs), the ANMs spent 51% of their time on maternal, infant, child, and adolescent health services. Conclusion: The introduction of HWCs and CHOs has nudged the health system toward comprehensive primary health care by placing a renewed emphasis on NCDs. The study provides useful evidence for staff, program implementers, and policymakers, to aid informed decision-making for human resource management.


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