scholarly journals Availability and readiness to provide sexually transmitted infections and HIV testing and counselling services in Nepal: evidence from comprehensive health facility survey

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040918
Author(s):  
Kiran Acharya ◽  
Rajshree Thapa ◽  
Navaraj Bhattarai ◽  
Kiran Bam ◽  
Bhagawan Shrestha
Keyword(s):  
Quality Assurance ◽  
Sexually Transmitted Infections ◽  
Health Facility ◽  
Health Facilities ◽  
Sexually Transmitted ◽  
Health Facility Survey ◽  
Service Readiness ◽  
Hiv Testing And Counselling ◽  
Facility Survey ◽  
Facility Readiness

ObjectiveWe assessed the availability and readiness of health facilities to provide sexually transmitted infections (STI) and HIV testing and counselling (HTC) services in Nepal.DesignThis was a cross-sectional study.SettingWe used data from the most recent nationally representative Nepal Health Facility Survey (NHFS) 2015. A total of 963 health facilities were surveyed with 97% response rate.Primary and secondary outcome measuresThe primary outcome of this study was to assess the availability and readiness of health facilities to provide STI and HTC services using the WHO Service Availability and Readiness Assessment (SARA) manual.ResultsNearly three-fourths (73.8%) and less than one-tenth (5.9%) of health facilities reported providing STI and HTC services, respectively. The mean readiness score of STI and HTC services was 26.2% and 68.9%, respectively. The readiness scores varied significantly according to the managing authority (private vs public) for both STI and HTC services. Interestingly, health facilities with external supervision had better service readiness scores for STI services that were almost four points higher than compared with those facilities with no external supervision. Regarding HTC services, service readiness was lower at private hospitals (32.9 points lower) compared to government hospitals. Unlike STI services, the readiness of facilities to provide HTC services was higher (4.8 point higher) at facilities which performed quality assurance.ConclusionThe facility readiness for HTC service is higher than that for STI services. There are persistent gaps in staff, guidelines and medicine and commodities across both services. Government of Nepal should focus on ensuring constant supervision and quality assurance, as these were among the determining factors for facility readiness.

scholarly journals Health system’s readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey

2020 ◽  
Author(s):  
Umesh Ghimire ◽  
Nipun Shrestha ◽  
Bipin Adhikari ◽  
Suresh Meheta ◽  
Yashashwi Pokharel ◽  
...  
Keyword(s):  
Health Facility ◽  
Health Facilities ◽  
Public Hospitals ◽  
World Health ◽  
Related Services ◽  
The Public ◽  
Public Facilities ◽  
Health Facility Survey ◽  
Service Readiness ◽  
Facility Survey

Abstract Background: The burgeoning rise of non-communicable diseases (NCDs) is posing serious challenges in resource constrained health facilities of Nepal. The main objective of this study was to assess the readiness of health facilities for cardiovascular diseases (CVDs), diabetes and chronic respiratory diseases (CRDs) services in Nepal. Methods: This study utilized data from the Nepal Health Facility Survey 2015. General readiness of 940 health facilities along with disease specific readiness for CVDs, diabetes and CRDs were assessed using service availability and readiness assessment manual of the World Health Organization (WHO). Health facilities were categorized into public and private facilities. Results: Out of a total of 940 health facilities assessed, private facilities showed higher availability of items of general service readiness, except for standard precautions for infection prevention, compared to public facilities. The multivariable adjusted regression coefficients for CVDs (β=2.87, 95%CI: 2.42-3.39), diabetes (β =3.02, 95%CI: 2.03-4.49) and CRDs (β=15.95, 95%CI: 4.61-55.13) at private facilities were higher than the public hospitals. Health facilities located in hills had higher readiness index for CVDs (β=1.99, 95%CI: 1.02 - 1.39). Service readiness for CVDs (β=1.13, 95%CI: 1.04-1.23) and diabetes (β=1.78, 95%CI: 1.23-2.59) were higher in the urban municipalities than in rural municipalities. Finally, disease related services readiness index was sub-optimal with some degree of variation at the province level in Nepal. Compared to province 1, Province 2 (β=0.83, 95%CI: 0.73-0.95), and province 4 (β =1.24, 95%CI: 1.07-1.43) and province 5 (β =1.17, 95%CI: 1.02-1.34) had higher readiness index for CVDs.Conclusions: This study found sub-optimal readiness of services related to three NCDs at the public facilities in Nepal. Compared to public facilities, private facilities showed higher readiness score for CVDs, diabetes and CRDs. To cope up with the growing burden of NCDs, urgent improvement in health services, particularly in public facilities are critical to manage common NCDs.

scholarly journals Health system's readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey

2020 ◽  
Author(s):  
Umesh Ghimire ◽  
Nipun Shrestha ◽  
Bipin Adhikari ◽  
Suresh Meheta ◽  
Yashashwi Pokharel ◽  
...  
Keyword(s):  
Health Facility ◽  
Respiratory Disease ◽  
Chronic Respiratory Disease ◽  
Health Facilities ◽  
World Health ◽  
Related Services ◽  
Public Facilities ◽  
Health Facility Survey ◽  
Service Readiness ◽  
Facility Survey

Abstract Background: The burgeoning rise of non-communicable diseases is posing a serious challenge in resource constrained health facilities of Nepal. The main objective of this study was to assess the readiness of health facilities for cardiovascular, diabetes and chronic respiratory disease services in Nepal. Methods: This study utilized data from the Nepal Health Facility Survey 2015. General readiness of 940 health facilities along with disease specific readiness for cardiovascular diseases (CVDs), diabetes and cardiorespiratory diseases (CRDs) were assessed using service availability and readiness assessment manual of the World Health Organization (WHO). Health facilities were categorized into public and private facilities.Results: Out of a total of 940 health facilities assessed, private facilities showed higher availability of items of general service readiness, except for standard precautions for infection prevention, compared to public facilities. The multivariable adjusted regression coefficients for CVDs (β=2.87, 95%CI: 2.42-3.39), diabetes (β =3.02, 95%CI: 2.03-4.49) and CRDs (β=15.95, 95%CI: 4.61-55.13) at private facilities were higher than public hospitals. Health facilities located in hills had higher readiness index for CVDs (β=1.99, 95%CI: 1.02 - 1.39). Service readiness for CVDs (β=1.13, 95%CI: 1.04-1.23) and diabetes (β=1.78, 95%CI: 1.23-2.59) were higher in the urban municipalities than in rural municipalities. Finally, disease related services readiness index was sub-optimal with some degree of variation at the province level in Nepal. Province 2 for CVDs (β=0.83, 95%CI: 0.73-0.95), and province 4 (β =1.24, 95%CI: 1.07-1.43) and province 5 (β =1.17, 95%CI: 1.02-1.34) had higher readiness index compared to province 1.Conclusions: This study found a sub-optimal readiness of services related to three NCDs at the public facilities in Nepal. Compared to public facilities, private facilities showed higher readiness score for CVDs, diabetes and CRDs. To cope up with the growing burden of NCDs, urgent improvement in health services, particularly in public facilities are critical to manage common NCDs.

scholarly journals Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254561
Author(s):  
Kiran Acharya ◽  
Raj Kumar Subedi ◽  
Sushma Dahal ◽  
Rajendra Karkee
Keyword(s):  
Newborn Care ◽  
Health Facilities ◽  
Public Hospitals ◽  
Service Availability ◽  
Periodic Review ◽  
Private Hospitals ◽  
Health Facility Survey ◽  
Service Readiness ◽  
Facility Survey ◽  
Maternal And Newborn

Background Achieving maternal and newborn related Sustainable Development Goals targets is challenging for Nepal, mainly due to poor quality of maternity services. In this context, we aim to assess the Basic Emergency Obstetric and Newborn Care (BEmONC) service availability and readiness in health facilities in Nepal by analyzing data from Nepal Health Facility Survey (NHFS), 2015. Methods We utilized cross-sectional data from the nationally representative NHFS, 2015. Service availability was measured by seven signal functions of BEmONC, and service readiness by the availability and functioning of supportive items categorized into three domains: staff and guidelines, diagnostic equipment, and basic medicine and commodities. We used the World Health Organization’s service availability and readiness indicators to estimate the readiness scores. We performed a multiple linear regression to identify important factors in the readiness of the health facilities to provide BEmONC services. Results The BEmONC service readiness score was significantly higher in public hospitals compared with private hospitals and peripheral public health facilities. Significant factors associated with service readiness score were the facility type (14.69 points higher in public hospitals, P<0.001), number of service delivery staff (2.49 points increase per each additional delivery staff, P<0.001), the service hours (4.89 points higher in facilities offering 24-hour services, P = 0.01) and status of periodic review of maternal and newborn deaths (4.88 points higher in facilities that conducted periodic review, P = 0.043). Conclusions These findings suggest that BEmONC services in Nepal could be improved by increasing the number of service delivery staff, expanding service hours to 24-hours a day, and conducting periodic review of maternal and newborn deaths at health facilities, mainly in the peripheral public health facilities. The private hospitals need to be encouraged for BEmONC service readiness.

scholarly journals Readiness of Health Facilities to Provide Child Curative Care Services: Evidence Based on Bangladesh Health Facility Survey, 2014

2020 ◽  
Vol 68 (1) ◽  
pp. 29-35
Author(s):  
Kanchan Kumar Sen ◽  
Shahnaz Nilima ◽  
Mahfuzur Rahman Khokan
Keyword(s):  
Health Facility ◽  
Health Facilities ◽  
Health Provider ◽  
Major Purpose ◽  
Care Services ◽  
Health Facility Survey ◽  
Curative Care ◽  
Proportional Odds Assumption ◽  
Facility Survey ◽  
Study Type

Bangladesh is far away to achieve the target of sustainable development goal 3 (SDG 3). To reduce the child mortality, all sectors related to child health should be improved by taking appropriate actions. In this study, readiness of child curative care health facility services is explored. The readiness was not directly measured, it is measured based on the four domains of ten indicators following WHO guidelines. To create readiness index, equal weights are given to each domains of indicators and also to each indicators at each weighted domains for providing child curative care services. The major purpose of the study is to find out the determinants of readiness of health facilities to provide the child curative care services. The 2014 Bangladesh Health Facility Survey (BHFS) data have been used to serve the purpose. The ordinal logistic regression model with proportional odds assumption has been applied in the study. Type of facility, health provider status, division, qualification of health provider and basic amenities in facility are found to have significant effects on readiness index. Dhaka Univ. J. Sci. 68(1): 29-35, 2020 (January)

scholarly journals Measuring facility readiness to provide childbirth care: a comparison of indices using data from a health facility survey in Ethiopia

2021 ◽  
Vol 6 (10) ◽  
pp. e006698
Author(s):  
Elizabeth K Stierman ◽  
Saifuddin Ahmed ◽  
Solomon Shiferaw ◽  
Linnea A Zimmerman ◽  
Andreea A Creanga
Keyword(s):  
Quality Improvement ◽  
Health Facility ◽  
Performance Monitoring ◽  
Newborn Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Who Standards ◽  
Service Readiness ◽  
Facility Readiness ◽  
Childbirth Care

BackgroundActionable information about the readiness of health facilities is needed to inform quality improvement efforts in maternity care, but there is no consensus on the best approach to measure readiness. Many countries use the WHO’s Service Availability and Readiness Assessment (SARA) or the Demographic and Health Survey (DHS) Programme’s Service Provision Assessment to measure facility readiness. This study compares measures of childbirth service readiness based on SARA and DHS guidance to an index based on WHO’s quality of maternal and newborn care standards.MethodsWe used cross-sectional data from Performance Monitoring for Action Ethiopia’s 2019 survey of 406 health facilities providing childbirth services. We calculated childbirth service readiness scores using items based on SARA, DHS and WHO standards. For each, we used three aggregation methods for generating indices: simple addition, domain-weighted addition and principal components analysis. We compared central tendency, spread and item variation between the readiness indices; concordance between health facility scores and rankings; and correlations between readiness scores and delivery volume.ResultsIndices showed moderate agreement with one another, and all had a small but significant positive correlation with monthly delivery volume. Ties were more frequent for indices with fewer items. More than two-thirds of items in the relatively shorter SARA and DHS indices were widely (>90%) available in hospitals, and half of the SARA items were widely (>90%) available in health centres/clinics. Items based on the WHO standards showed greater variation and captured unique aspects of readiness (eg, quality improvement processes, actionable information systems) not included in either the SARA or DHS indices.ConclusionSARA and DHS indices rely on a small set of widely available items to assess facility readiness to provide childbirth care. Expanded selection of items based on the WHO standards can better differentiate between levels of service readiness.

scholarly journals Newborn Service Readiness of Primary Level Health Facilities of Eastern Mountain Region of Nepal

2020 ◽  
Vol 17 (4) ◽  
pp. 431-436
Author(s):  
Ambika Thapa Pachya ◽  
Uttam Pachya ◽  
Mona Giri ◽  
Sujata Shakya ◽  
Anita Mahotra ◽  
...  
Keyword(s):  
Health Facility ◽  
Room Temperature ◽  
Descriptive Analysis ◽  
Skilled Birth Attendance ◽  
Health Facilities ◽  
Mountain Region ◽  
Birth Attendance ◽  
Service Readiness ◽  
Facility Readiness ◽  
Health Facility Readiness

Background: Newborn service readiness is facility’s observed capacity to provide newborn services and a pre-requisite for quality. Newborn services are priority program of government and efforts are focused on infrastructure and supplies at peripheral health facilities. Study describes health facility readiness for newborn services in four domains of general requirements, equipment, medicines and commodities, and staffing and guidelines.Methods: Convergent parallel mixed method using concurrent triangulation was done in public health facilities providing institutional deliveries of two randomly selected districts- Taplejung and Solukhumbu of Eastern Mountain Region of Nepal. Face to face interview and observation of facilities were done using structured questionnaire and checklist; in-depth interviews were done using interview guideline from November 2016 to January 2017. Ethical clearance was taken. Descriptive analysis and deductive thematic analysis were done.Results: Mean score of newborn service readiness was 68.7±7.1 with range from 53.3 to 81.4 out of 100. Domains of general requirement, equipment, medicine and commodity, supervision, staffing and guideline were assessed. The gaps identified in general requirements were availability of uninterrupted power supply, means of communication and referral vehicle. Clean wrappers and heater for room temperature maintenance were identified during interviews to be part of the readiness. All health facilities had trained staff while retention of skill was of concern. There was felt need of enforcing adequate training coverage to suffice the need of human resources in remote. Conclusions: Efforts of improving transportation, heater for room temperature maintenance, trainings with skill retention strategy, utilization of guidelines, availability of skilled birth attendance could result increased and improved newborn service readiness.Keywords: Eastern mountain region of Nepal; health facility readiness; newborn service readiness.

scholarly journals Awareness of RTI/STI and HIV/AIDS among women in Kerala: a district level analysis based on DLHS-4

2017 ◽  
Vol 4 (6) ◽  
pp. 2124
Author(s):  
T. Radhakrishnan ◽  
A. Saravana ◽  
P. K. Babu
Keyword(s):  
Sexually Transmitted Infections ◽  
Urban Areas ◽  
Reproductive Tract ◽  
Health Workers ◽  
Household Survey ◽  
District Level ◽  
Sexually Transmitted ◽  
Facility Survey ◽  
Tract Infections ◽  
Hiv Aids

Background: Many of the reproductive tract infections and sexually transmitted infections (RTI/STIs) are preventable and curable. Kerala is one of the highest literate states in India, but women in Kerala had very low knowledge in sexually transmitted infections and HIV/AIDS. The objective of the present study was to assess the level of awareness on RTI/STI and HIV/AIDS among women in Kerala with inter district variations on awareness among women in RTI/STI and HIV/AIDS. Another objective of the study was to find out the association between socio economic characteristics and awareness on RTI/STI and HIV/AIDS.Methods: Data for the present analysis comes from the district level household and facility survey-3 2007-08 (DLHS-3) and district level household and facility survey-4 (DLHS-4), 2015–16. DLHS is a nationally representative household survey, primarily conducted to monitor and evaluate the implementation of reproductive and child health program across the districts of India. To assess the level of awareness on RTI/STI and HIV/AIDS among women in Kerala with inter district variations on awareness among women in RTI/STI and HIV/AIDS data of DLHS-3 and DLHS-4 were used for analysis and to find out the association between socio economic characteristics and awareness on RTI/STI and HIV/AIDS, data of DLHS were used.Results: Only 48% of women in Kerala had heard of RTI/STI in Kerala, but 75.8% of the women had heard about HIV/AIDS. Knowledge on RTI/STI and HIV/AIDS among women in all the districts in Kerala had fallen from the DLHS-3 to DLHS-4.Conclusions: Decentralized field level interaction of health workers with IEC programs in both rural and urban areas regarding STIs/RTIs and HIV/AIDS should be strengthened along with effective mass media activities.

scholarly journals KNOWLEDGE OF NURSES ON SYNDROMIC MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS IN PUBLIC FACILITIES

2020 ◽  
Vol 5 (5) ◽  
pp. 1
Author(s):  
Maina Eva Mumbi ◽  
Mwangi John Hiuhu ◽  
Njuguna Felix Tharao ◽  
Maingi Nancy Nyambura
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Sexually Transmitted Infections ◽  
Health Facilities ◽  
Unique Contribution ◽  
Data Collection Tool ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Public Health Facilities ◽  
Syndromic Approach

Purpose: The main purpose of this study is to assess the knowledge of nurses on syndromic management of STIs in public health facilities within Kirinyaga west Sub County. Methodology: The study utilized descriptive cross-sectional study design, with a target population of 70 nurses working in 16 Kirinyaga west public health facilities. The dependent variable was applying syndromic approach management of sexually transmitted infections, independent variables as knowledge and practices. The study utilized purposive sampling technique to determine the sample size of 49 nurses. The study employed the use of a questionnaire as a data collection tool and check list. A pretest of the data collection tool was conducted at Karatina sub county hospital MCH/FP Findings The study findings showed that 90% of the respondents had general knowledge of what syndromic approach is though 38% were not able to identify the common STIs syndromes and 39% couldn’t correctly identify the STIs that present a genital ulcer. 45% depended on laboratory investigations to diagnose and manage STIs, while 74% had not undergone any training or CME in the last 2 years on syndromic management of STIs and 96%reported that the health facilities they were stationed did not have readily available WHO/NASCOP 2015 guidelines. The respondents did not apply the syndromic approach in managing STIs and that, knowledge and practice on syndromic management of STIs among nurses in Kirinyaga west Sub County is low at 41%. Unique contribution to theory, practice and policy: There is need for more awareness through capacity building among health workers managing sexually transmitted infections in the communities and therefore the study recommends county Governments to organize for trainings and CMEs on STIs/syndromic approach and identify an STIs management focal person in public health facilities.

Sign in / Sign up

Export Citation Format

Share Document