Evidence map›Paper›PMID 39606468›Full record

ArticleResearch square2024

Barriers and Facilitators to Patient Utilization of Non-Communicable Disease Services in Primary Healthcare Facilities in Nepal: A Qualitative Study.

Sushmita Mali, Elizabeth C Rhodes, Chandani Singh Nakarmi, Soniya Shrestha, Aarati Dhakal, Alina Bharati, Anupama Bishwokarma, Asmita Adhikari, Bikram Poudel, Binuka Kulung Rai and 10 more

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Article in Research square, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

20 authors.

Sushmita MaliDhulikhel Hospital-Kathmandu University Hospital.
Elizabeth C RhodesEmory University.
Chandani Singh NakarmiDhulikhel Hospital-Kathmandu University Hospital.
Soniya ShresthaDhulikhel Hospital-Kathmandu University Hospital.
Aarati DhakalDhulikhel Hospital-Kathmandu University Hospital.
Alina BharatiDhulikhel Hospital-Kathmandu University Hospital.
Anupama BishwokarmaDhulikhel Hospital-Kathmandu University Hospital.
Asmita AdhikariDhulikhel Hospital-Kathmandu University Hospital.
Bikram PoudelDhulikhel Hospital-Kathmandu University Hospital.
Binuka Kulung RaiDhulikhel Hospital-Kathmandu University Hospital.
Sangita ManandharDhulikhel Hospital-Kathmandu University Hospital.
Surakshya KcDhulikhel Hospital-Kathmandu University Hospital.
Dinesh TimalsenaDhulikhel Hospital-Kathmandu University Hospital.
Sashi SilwalNepal Health Research Council.
Meghnath DhimalNepal Health Research Council.
Phanindra Prasad BaralMinistry of Health and Population.
Felix TeufelEmory University.
Sanju BhattaraiNorwegian University of Science and Technology.
Donna SpiegelmanYale School of Public Health.
Archana ShresthaKathmandu University School of Medical Sciences.

Funding

Building Capacity to Evaluate Package of Essential Non-Communicable Disease Interventions (PEN) in Nepal - An Implementation StudyR21TW011718 · FIC · DHULIKHEL HOSPITAL KATHMANDU UNIVERSITY HOSPITAL · PI SHRESTHA, ARCHANA · 2020 to 2021
$287k
FIC NIH HHS R21 TW011718
6 · The paper itself

Abstract

Background: The Nepalese government endorsed and implemented the Package of Essential Non-Communicable Disease Interventions (PEN) by the World Health Organization (WHO) to prevent and manage four major non-communicable diseases (NCDs): cardiovascular disease (CVD), diabetes, cancers, and chronic respiratory diseases. This study explored barriers and facilitators to patient utilization of NCD services at primary healthcare facilities in Nepal. Methodology: We conducted a qualitative study with a 35 purposive sample of patients living with one or more NCDs (hypertension, diabetes, chronic obstructive pulmonary disease (COPD/ asthma) who sought healthcare at primary healthcare facilities in 14 randomly selected districts in seven provinces in Nepal that implemented PEN. Trained qualitative researchers conducted in-depth interviews in-person in a private setting using a semi-structured interview guide developed based on the Health Belief Model in the local language. The interviews were audio-recorded, transcribed verbatim, coded inductively and deductively, and analyzed by a framework approach using Dedoose software. Results: From the perspectives of patients, key facilitators of service utilization encompassed free medicines, low-cost services, geographical and financial accessibility, less waiting time, positive interactions with health service providers, experiencing improvements in their health conditions, and support from family and peers. Barriers to utilizing services included inadequate health services (e.g., lack of medications and equipment), inaccessibility and affordability, inadequate health-related information from health service providers, low knowledge of NCD care, and lack of reminders or follow ups. Conclusion: Enhancing NCD service utilization is potentially attainable through interventions that address patients' knowledge, self-motivation, and misconceptions. Furthermore, strengthening the availability and accessibility of crucial services such as laboratory investigations, medications, equipment, and the patient-provider relationship is crucial for sustainable implementation of PEN.

Indexed as

Health Belief Model (HBM)Non-communicable diseasesPackage of Essential Non-Communicable Diseases (PEN)Patient’s perspectivePerceived BarriersPerceived Facilitators

Identifiers

PMID39606468
PMCPMC11601846

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.