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Context: The government of India has recently decided to upgrade subcenters (SCs) to health and wellness centers (HWCs) for providing comprehensive quality services. Aims: The present study was undertaken to determine workforce- and infrastructure-wise gaps in the SCs for upgradation to HWCs and assess knowledge of the auxiliary nurse midwives (ANMs) regarding services to be delivered through HWCs. Settings and Design: This cross-sectional study was conducted in Bhatar block of Purba Bardhaman district between August and October 2019. Subjects and Methods: Workforce and infrastructure availability was assessed using a checklist in 38 SCs and knowledge was assessed using a questionnaire among ANMs. Statistical Analysis Used: Data entry and analysis was done in Microsoft™ Excel™. Results: No Subcentre had Community Health Officer and 23.7% of Subcentre were without second ANM. 28.9% of the ANMs had adequate knowledge about services to be delivered through HWCs. Infrastructurally, lack of staff residential facility (76.3%), water supply (34.2%), and inadequate civil construction (34.2%) were major barriers. Conclusions: Adequate recruitment of HCWs, infrastructure upliftment, and proper training of HCWs in the SCs are the need of the hour. [ABSTRACT FROM AUTHOR]

Background: Changing trends of privatization and globalization of health care compel the hospitals to practice cost accounting for providing accurate information about the cost of patient care. Objectives: The objectives were to determine unit cost and to identify major cost areas of outpatient department (OPD) services provided by the community health center (CHC) of Bankura district, West Bengal. Materials and Methods: A cross-sectional study was conducted at Amarkanan CHC in 2016. Work sampling (WS) and time motion (TM) study were conducted for assessing the workforce cost, otherwise complete enumeration was done to assess the cost of different service areas such as medicine, logistic, maintenance, transport, electricity, building, equipment, and furniture. A predesigned pro forma and a questionnaire were used for WS and TM study and for interviewing the key informants for collection of information pertaining to different costs. Unit cost of different services as well as overall unit cost was estimated. Results: If a patient received injection, undergone dressing, and had electrocardiogram and X-ray both done in a day, then the total cost of OPD services for workforce was Rs. 85.33/. Cost of logistics per patient per day was maximum in X-ray room. Manpower exerted the maximum cost incurred by the government to conduct OPD in Amarkanan CHC. Overall, the unit cost in OPD incurred by the government was Rs. 44.53/-. Conclusion: Close monitoring is required by aligning the staffing pattern and patient activities and having adequate number of staff with right skill at right place and time for efficiency, productivity, and cost-effectiveness. [ABSTRACT FROM AUTHOR]