Interpersonal Challenges Faced By Community Health Officers at Health and Wellness Centres in Delivery of Comprehensive Primary Health Care in Tribal Setting of Gujarat: A Mixed Methods Study

Introduction: Multi skilling and expansion of the team members involved in operationalizing Sub-Health Centres (SHCs) to Sub-health Centres-Health and Wellness Centres (SHC-HWCs) in India tends to be a challenge. New roles are being assigned to Community Health Officer (CHO) in an exponential manner. Objective: To identify the team-based interpersonal challenges encountered by Community Health Officers (CHOs)in terms of human relations in professional forefront and extract probable solutions from them for overcoming these challenges. Method: It was a sequential type of mixed method done in two-step process, quantitative survey of the defined indicators at SHC-HWCs followed by group discussion among CHOs for qualitative data. Quantitative survey was aimed at finding utilization of services. (Triangulation of both the data) whereas qualitative survey was aimed at finding out interpersonal challenges faced for adequate service delivery. Authors targeted to collect data from all the SHC-HWCs (N=53) in Dahod block for quantitative and qualitative survey. Results: The service utilization related to Maternal health and child health; childhood and adolescent health were found in range of 90-95%, followed by community participation (70%). The qualitative analysis of data revealed that CHOs were overburdened by their superiors and perceived lack of co-operation, dedication, and accountability from fellow team members. Conclusion: Utilization of certain services like non-communicable diseases (NCD), palliative care, mental health was found to be suboptimal. Significant lack of motivation and coordination were possibly some of the contributors.