Health system’s readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey
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.
Figure 1
Figure 2
Figure 3
Figure 4
This is a list of supplementary files associated with this preprint. Click to download.
Posted 10 Apr, 2020
On 25 Jul, 2020
On 10 May, 2020
Received 30 Apr, 2020
Received 26 Apr, 2020
On 12 Apr, 2020
Received 08 Apr, 2020
Received 08 Apr, 2020
Invitations sent on 07 Apr, 2020
On 07 Apr, 2020
On 07 Apr, 2020
On 07 Apr, 2020
On 06 Apr, 2020
On 05 Apr, 2020
On 05 Apr, 2020
Received 30 Mar, 2020
On 30 Mar, 2020
Received 13 Mar, 2020
On 25 Feb, 2020
Received 15 Feb, 2020
On 12 Feb, 2020
Received 12 Feb, 2020
Invitations sent on 09 Feb, 2020
On 09 Feb, 2020
On 09 Feb, 2020
On 06 Feb, 2020
On 05 Feb, 2020
On 05 Feb, 2020
On 23 Jan, 2020
Health system’s readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey
Posted 10 Apr, 2020
On 25 Jul, 2020
On 10 May, 2020
Received 30 Apr, 2020
Received 26 Apr, 2020
On 12 Apr, 2020
Received 08 Apr, 2020
Received 08 Apr, 2020
Invitations sent on 07 Apr, 2020
On 07 Apr, 2020
On 07 Apr, 2020
On 07 Apr, 2020
On 06 Apr, 2020
On 05 Apr, 2020
On 05 Apr, 2020
Received 30 Mar, 2020
On 30 Mar, 2020
Received 13 Mar, 2020
On 25 Feb, 2020
Received 15 Feb, 2020
On 12 Feb, 2020
Received 12 Feb, 2020
Invitations sent on 09 Feb, 2020
On 09 Feb, 2020
On 09 Feb, 2020
On 06 Feb, 2020
On 05 Feb, 2020
On 05 Feb, 2020
On 23 Jan, 2020
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.
Figure 1
Figure 2
Figure 3
Figure 4