ASSESSING HEALTH EQUITY AND ACCESSIBILITY IN TEHSIL SARAI NAURANG, DISTRICT LAKKI MARWAT, PAKISTAN.

Abstract

This study explores the availability, accessibility, quality, and key issues faced by health services in Tehsil Sarai Naurang, District Lakki Marwat, based on Multi-Sectoral Assessment data facilitated by Kafalah Foundation. A convergent parallel research design was followed, which involved quantitative community-level data, Focus Group Discussions, and transect walks. Chi-square, Pearson correlation analysis, and binary logistic regression were used to determine the relationship between health service availability and perceived mayoral performance in quantitative data analysis. The results show that significant differences exist between the different Village Councils in the services provided, including essential medicine, ambulance and emergency services, maternal and child healthcare, hygiene, safe drinking water, and transportation. Pearson correlation indicated a positive and significant correlation between health service availability and the mayor's performance (r = .706, p < .001), with a large effect size (Cramer's V = .660), and the chi-square test showed that the correlation between the two was significant (χ²(1) = 175.473, p < .001). The binary logistic regression also revealed that the availability of health services was a significant predictor of higher perceived performance of the mayor (OR = 108.401, p < .001; Nagelkerke R² = .532). Qualitative evidence emphasized the interdependencies between unsafe water, poor sanitation, poverty, transportation limitations, and vulnerability to drug abuse within communities on the impact on community health. The overall results show a strong link between the citizens' perceptions of good governance and good healthcare delivery and highlight the importance of multi-sectoral interventions in primary healthcare, essential medicines, emergency services, MCH services, WASH infrastructure, and increasing community awareness about health issues.