A Study to Explore the Attitude and the Perception of the Health Care Recipients Towards Health Care Services Provided By the CHO’s At Selected Health and Wellness Centers of Krishna Dist. Andhra Pradesh

Abstract

Introduction: Community Health Officers (CHOs) are a cornerstone of the Ayushman Bharat–Health and Wellness Centres (AB-HWC) initiative, designed to expand access to Comprehensive Primary Health Care (CPHC) across India. Positioned at sub-centres and primary care facilities, CHOs are trained mid-level health providers responsible for delivering promotive, preventive, curative, and rehabilitative services. In rural and underserved regions like Krishna District, Andhra Pradesh, their role is critical in reducing disparities in health service delivery. Understanding the attitudes and perceptions of the community toward CHO-led services is vital for assessing service effectiveness, identifying gaps, and planning targeted improvements. This study aimed to explore the attitudes and perceptions of health care recipients toward CHO services at selected Health and Wellness Centres (HWCs) in Krishna District.

Methodology: A descriptive cross-sectional survey design was adopted to capture a snapshot of current community opinions. A total of 200 health care recipients attending selected HWCs were recruited using convenience sampling. Data were collected using a structured questionnaire consisting of: Socio-demographic details (age, gender, educational status, occupation, distance from health facility, awareness about CHO services). Attitude scale (Likert - based) assessing agreement with CHO roles, responsibilities, approachability, and clinical skills. Perception scale assessing service quality, accessibility, trust, and satisfaction Statistical analysis involved descriptive statistics (mean, standard deviation, frequency distribution) to assess overall levels, and Chi-square tests to identify associations between socio-demographic variables and attitudes/perceptions. Pearson’s correlation coefficient was used to examine the relationship between attitude and perception scores.

Results:  Attitude: 48% of respondents agreed and 12% strongly agreed with the effectiveness of CHOs in fulfilling their roles. The mean attitude score (3.66 ± 0.63) suggested a moderately positive orientation toward CHO services. Perception: 42% of participants demonstrated a positive perception, and 14% had a very positive perception toward CHO-led healthcare. The mean perception score (89.5 ± 8.2) reflected a favourable community outlook. Associations: Occupational status and distance from the PHC were significantly associated with attitude (p < 0.05), suggesting that employment demands and geographic accessibility influence opinions toward CHOs. Awareness of CHO services was significantly associated with perception (p < 0.05), indicating a direct link between information dissemination and favorable service impressions. A moderate positive correlation (r = 0.64, p < 0.01) was found between attitude and perception, meaning that individuals with a more positive attitude toward CHOs consistently held more favorable perceptions of their services. Conclusion: Overall, the community demonstrated positive attitudes and perceptions toward CHO services at HWCs in Krishna District, reflecting approval of their role in the Ayushman Bharat initiative. To sustain and enhance these outcomes: The study provides evidence that CHOs are a promising workforce innovation for primary care strengthening in India and should be supported through strategic training, policy reinforcement, and community engagement measures.