Impact of college of physicians’ and surgeons’ courses run by government facilities on the utilization of mother and child health services and outcomes: a mixed method study

Background:“College of Physicians and Surgeons”, (CPS) is two-year diploma course for medical graduates in various subjects like Obstetrics and gynecology (OBGY), Pediatric, Ophthalmology, Orthopedics, Anesthesia etc., with the purpose to provide specialist services at village level
Methods: This study was conducted to assess the impact of CPS courses on healthcare services and their outcomes. A Mixed method study; utilizing Qualitative and Quantitative method was employed. Sampling frame included various centers in which CPS courses were initiated in 2018-19. The current study reports impact of CPS course run by two centers of a state based on feasibility. The participants interviewed were; Key Health Personnel, Facility Staff, Community Leaders, Beneficiaries, CPS Students, Bonded CPS Employees.
Observations & Conclusions; Quantitative; The number of deliveries conducted at facility had increased after starting the CPS course but the ratio of LSCS surgery conducted out of total deliveries decreased. The Percentage of referrals (in) out of total admissions, Proportion of complication in ANC cases managed and Number of new born admitted at NBSU/SNCU decreased. Beneficiaries were aware of and were utilizing obstetrics and gynecology services available in the hospital. People from the upper middle class were also availing the services. The clients were fully satisfied with the services available at the facility. Funds from the government were adequate and properly utilized.
Recommendations: There is a need of a specified curriculum and increase in remuneration for the teaching faculty to retain them. Human resources should be increased and vacant posts of specialists be filled so that due to lack of skilled and specialized staff the learning of CPS student is not compromised. The infrastructure needs improvement like doctors’ room should be made in labor room. ICU set-up is required to manage the critical patients.