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Barriers to the delivery of obstetric care within Primary Health Centres (PHC) in India- a scoping review
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  • Vigneshwar Raj Veerappan,
  • Shreenik Kundu,
  • Harshit Arora,
  • Sargun Kaur Virk,
  • Nobhojit Roy,
  • Rakhi Ghoshal,
  • Anita Gadgil,
  • Nakul Raykar
Vigneshwar Raj Veerappan
University of Leeds Faculty of Medicine and Health

Corresponding Author:hs23vrv@leeds.ac.uk

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Shreenik Kundu
Harvard Medical School Program in Global Surgery and Social Change
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Harshit Arora
Brigham and Women's Hospital
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Sargun Kaur Virk
Weill Cornell Medicine
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Nobhojit Roy
Karolinska Institutet Institutionen for medicin Solna
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Rakhi Ghoshal
CARE USA
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Anita Gadgil
The George Institute for Global Health India
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Nakul Raykar
Harvard Medical School Program in Global Surgery and Social Change
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Abstract

India faces significant obstetrics related morbidity and mortality. This burden is largely addressed through the healthcare delivery via Primary Health Centres (PHCs). This scoping review aims to identify challenges in delivering obstetrics care within PHCs in India, using the WHO healthcare building blocks. A literature search covered PubMed, MEDLINE databases, and Google Scholar. Studies published from 2012 to 2022 were included based on predefined criteria. Study screenings were conducted using Covidence. Data extraction of included studies were done by 4 authors. Twenty-two studies were included for final review, mostly cross-sectional (59%), mainly from the state of Bihar (23%). Service delivery (77%) and health workforce (73%) were the most extensively discussed building blocks. Leadership and governance were the least discussed (14%). Challenges in service delivery encompassed limited antenatal care uptake, inadequate emergency obstetrics care and adjunct services, inadequate infrastructure, equipment and space and poor transport, and onward referral services. Health workforce issues included staffing levels and competency and training deficiencies in existing staff. This review highlights challenges in obstetrics care delivery within PHCs in India, primarily related to service delivery and health workforce. PHCs play a crucial role in the delivery of obstetrics services. Developing obstetrics healthcare strategy or policy needs to acknowledge the role of PHCs and address the challenges faced by PHCs in order to improve maternal health outcomes.
17 Jul 2024Submitted to Public Health Challenges
12 Aug 2024Submission Checks Completed
12 Aug 2024Assigned to Editor
26 Sep 2024Reviewer(s) Assigned
18 Dec 2024Review(s) Completed, Editorial Evaluation Pending