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 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 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 A Study on Service Availability and Readiness Assessment of Non-Communicable Diseases Using the WHO Tool for Gazipur District in Bangladesh

2016 ◽  
Vol 7 (2) ◽  
pp. 1-13 ◽  
Author(s):  
Mohammad Rashemdul Islam ◽  
Shamima Parvin Laskar ◽  
Darryl Macer
Keyword(s):  
Respiratory Disease ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Service Availability ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Service Readiness

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets.  A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.

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 The Role of Health Facilities in Supporting Adherence to Iron-folic Acid in Haiti and Malawi: A Study Linking Health Facility Survey and Population Survey Data

2020 ◽  
Author(s):  
Wenjuan Wang ◽  
Rukundo Benedict ◽  
Lindsay Mallick
Keyword(s):  
Folic Acid ◽  
Health Facility ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Facilities ◽  
Demographic And Health Surveys ◽  
Related Services ◽  
Iron Folic Acid ◽  
Facility Survey ◽  
High Level

Abstract Background: Iron-folic acid (IFA) supplementation during pregnancy is key to prevent maternal anemia. In Malawi and Haiti, consumption of IFA supplements remains suboptimal. This study examined the IFA-related services provided in health facilities and their association with women’s adherence to IFA supplementation during pregnancy.Methods: This study used data from the Demographic and Health surveys (DHS) and the Service Provision Assessment (SPA) in Haiti and Malawi. Using GPS data collected in both surveys, each DHS cluster was linked to health facilities surveyed in the SPA within a specified buffer distance (5 km for urban areas and 10 km for rural areas). IFA-related services were examined for health facilities within the buffer, including the availability of IFA supplements, prescription of IFA, and client counseling on IFA. Adherence to IFA supplementation was examined for women who received antenatal care (ANC) for their most recent live birth in the 2 years preceding the DHS survey. Multilevel logistic regressions stratified by urban and rural locale were used to model associations between women’s consumption of IFA supplements and the health facility service environment, controlling for relevant covariates.Results: More than two-thirds of facilities with ANC services in Haiti and almost all ANC facilities in Malawi had IFA supplements available. Over 60% of ANC clients in Haiti and over 80% in Malawi received IFA supplements or an IFA prescription. Counseling on IFA was less common and focused on how to use IFA; few women were counseled on side effects. Only 42% of women in Haiti and 35% of women in Malawi took IFA supplements for at least 90 days. Multivariable models indicated that in both countries, adherence to IFA supplementation in rural areas was significantly associated with a high level of availability of ANC facilities offering IFA. IFA counseling was also positively associated with the IFA supplement adherence in rural Malawi but not in Haiti. IFA supplement adherence was consistently associated with the completion of four or more ANC visits in both countries.Conclusions: Continued efforts are required to address access to IFA supplements through improving both the use of ANC services and their quality, particularly in provider counseling.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Kwikiriza Magambo ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda. Methods We conducted a cross sectional study using a mixed methods approach. The main study unit was a health center and we also interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p < 0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations. Conclusions Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

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