Service readiness of primary healthcare facilities for dengue management in Bagmati Province, Nepal: a mixed method study.

Sagar Parajuli, Hari P Kaphle, Nand R Gahatraj, Sunita Poudel, Arjun Poudel, Kusumsheela Bhatta, Gokarna Dahal
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Abstract

Background: In Nepal, frequent dengue outbreaks have been reported in the past decades leading abrupt and substantial burden to healthcare system. Thus, this study aimed to assess dengue service readiness and factors influencing readiness at health facilities level.

Methods: A convergent parallel mixed method study was conducted in 131 primary healthcare facilities of the Bagmati Province. Key informant interviews were carried out for exploring facilitators and barriers for dengue service readiness.

Results: The majority of primary healthcare facilities were found with sub-optimal readiness for dengue i.e. 63.4% of facilities and readiness was found varied by health facility type, settings, ecological region, and districts. In the study, health facility type [Primary healthcare centers Adjusted Odds Ratio (AOR): 6.1, CI: 1.5-23.9], review and trend analysis practice [AOR: 3.6, CI: 1.1-11.6], and facilities meetings [AOR: 5.8, CI: 1.2-26.7] were identified as key predictors for service readiness. External supervision, quality assurance practice and stakeholder sensitization were explored as facilitators for the readiness.

Conclusions: Improving and expanding dengue services in all primary healthcare facilities, and ecological regions, having regular facilities meeting, review and trend analysis practice and stakeholder sensitization can enhance dengue service readiness at facility level.

尼泊尔Bagmati省初级卫生保健设施对登革热管理的服务准备情况:一项混合方法研究。
背景:在尼泊尔,据报道,在过去的几十年里,登革热疫情频繁爆发,给卫生保健系统带来了突然和巨大的负担。因此,本研究旨在评估登革热服务准备情况和影响卫生机构准备情况的因素。方法:在巴格马提省的131个初级卫生保健机构中进行了一项趋同平行混合方法研究。为探索登革热服务准备的促进因素和障碍,进行了关键信息提供者访谈。结果:大多数初级卫生保健机构对登革热的准备程度为次优,即63.4%的设施,并且发现准备程度因卫生设施类型、环境、生态区域和地区而异。在研究中,卫生设施类型[初级卫生保健中心调整优势比(AOR): 6.1, CI: 1.5-23.9]、回顾和趋势分析实践[AOR: 3.6, CI: 1.1-11.6]和设施会议[AOR: 5.8, CI: 1.2-26.7]被确定为服务准备的关键预测因素。探讨了外部监督、质量保证实践和利益相关者敏感化作为准备工作的促进因素。结论:在所有初级卫生保健机构和生态区域改善和扩大登革热服务,定期举行设施会议,审查和趋势分析实践以及利益相关者敏感化可以提高设施层面的登革热服务准备程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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