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Research article
Health system’s readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey
Bipin Adhikari
University of Oxford
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8981-3910
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
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.
Keywords
Service availability, Services readiness, Non-communicable diseases, Cardiovascular diseases, Diabetes, Chronic respiratory disease
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On 25 Jul, 2020
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Received 26 Apr, 2020
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On 12 Apr, 2020
Review #2 received
Received 08 Apr, 2020
Review #1 received
Received 08 Apr, 2020
Reviewers invited
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Reviewer #1 agreed
On 07 Apr, 2020
Reviewer #2 agreed
On 07 Apr, 2020
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On 07 Apr, 2020
Editor assigned
On 06 Apr, 2020
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Received 30 Mar, 2020
Editorial decision: Major revision
On 30 Mar, 2020
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Reviewer #4 agreed
On 25 Feb, 2020
Review #2 received
Received 15 Feb, 2020
Reviewer #3 agreed
On 12 Feb, 2020
Review #1 received
Received 12 Feb, 2020
Reviewers invited
Invitations sent on 09 Feb, 2020
Reviewer #1 agreed
On 09 Feb, 2020
Reviewer #2 agreed
On 09 Feb, 2020
Editor assigned
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Submission checks complete
On 05 Feb, 2020
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On 05 Feb, 2020
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Health system’s readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey
Bipin Adhikari
University of Oxford
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8981-3910
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 10 Apr, 2020
Published
On 25 Jul, 2020
No community comments so far
Editorial decision: Minor revision
On 10 May, 2020
Review #4 received
Received 30 Apr, 2020
Review #3 received
Received 26 Apr, 2020
Reviewer #4 agreed
On 12 Apr, 2020
Review #2 received
Received 08 Apr, 2020
Review #1 received
Received 08 Apr, 2020
Reviewers invited
Invitations sent on 07 Apr, 2020
Reviewer #1 agreed
On 07 Apr, 2020
Reviewer #2 agreed
On 07 Apr, 2020
Reviewer #3 agreed
On 07 Apr, 2020
Editor assigned
On 06 Apr, 2020
Submission checks complete
On 05 Apr, 2020
Editor invited
On 05 Apr, 2020
No comments provided
Review #3 received
Received 30 Mar, 2020
Editorial decision: Major revision
On 30 Mar, 2020
Review #4 received
Received 13 Mar, 2020
Reviewer #4 agreed
On 25 Feb, 2020
Review #2 received
Received 15 Feb, 2020
Reviewer #3 agreed
On 12 Feb, 2020
Review #1 received
Received 12 Feb, 2020
Reviewers invited
Invitations sent on 09 Feb, 2020
Reviewer #1 agreed
On 09 Feb, 2020
Reviewer #2 agreed
On 09 Feb, 2020
Editor assigned
On 06 Feb, 2020
Submission checks complete
On 05 Feb, 2020
Editor invited
On 05 Feb, 2020
First submitted
On 23 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
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