Cargando…

Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021

BACKGROUND: Although there has been a significant focus on improving maternal and newborn health and expanding services in Nepal, the expected positive impact on the health of mothers and newborns has not been achieved to the desired extent. Nepal not only needs to focus on improving access to and c...

Descripción completa

Detalles Bibliográficos
Autores principales: Pandey, Achyut Raj, Adhikari, Bikram, Lamichhane, Bipul, Joshi, Deepak, Regmi, Shophika, Lal, Bibek Kumar, Dahal, Sagar, Baral, Sushil Chandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10434927/
https://www.ncbi.nlm.nih.gov/pubmed/37590204
http://dx.doi.org/10.1371/journal.pone.0282410
_version_ 1785092016506404864
author Pandey, Achyut Raj
Adhikari, Bikram
Lamichhane, Bipul
Joshi, Deepak
Regmi, Shophika
Lal, Bibek Kumar
Dahal, Sagar
Baral, Sushil Chandra
author_facet Pandey, Achyut Raj
Adhikari, Bikram
Lamichhane, Bipul
Joshi, Deepak
Regmi, Shophika
Lal, Bibek Kumar
Dahal, Sagar
Baral, Sushil Chandra
author_sort Pandey, Achyut Raj
collection PubMed
description BACKGROUND: Although there has been a significant focus on improving maternal and newborn health and expanding services in Nepal, the expected positive impact on the health of mothers and newborns has not been achieved to the desired extent. Nepal not only needs to focus on improving access to and coverage of services but also the quality to achieve Sustainable Development Goals (SDG) by 2030. In this context, we aimed to analyze Basic Emergency Obstetric and Neonatal Care (BEmONC) service availability and readiness in Health Facilities (HFs) of Nepal. METHODS: We analyzed data from nationally representative Nepal Health Facility Survey (NHFS), 2021. BEmONC service availability and readiness in HFs was measured based on the “Service Availability and Readiness” manual of World Health Organization (WHO). We measured service availability by seven BEmONC signal functions. The readiness score was calculated for three domains- guidelines and staff training, essential equipment/supplies, and essential medicines on a scale of 100, and the average score for the three domains was the overall readiness score. We performed weighted descriptive and inferential analysis to account complex survey design of NHFS 2021. We summarized continuous variables with descriptive statistics like mean, standard deviation, median and interquartile range whereas categorical variables with percent and 95% confidence interval (CI). We applied simple, and multivariate linear regression to determine factors associated with the readiness of HFs for BEmONC services, and results were presented as beta (β) coefficients and 95% CI. RESULTS: Of total 804 HFs offering normal vaginal delivery services, 3.1%, 89.2%, 7.7% were federal/provincial hospitals, local HFs, and private hospitals respectively. A total of 45.0% (95% CI: 34.9, 55.6) federal/provincial hospitals, 0.3% (95% CI: 0.2, 0.6), local HFs (district hospital, primary health care centers, health posts, urban health centers) and 10.5% (95% CI: 6.6, 16.4) private hospitals, had all seven BEmONC signal functions. The overall readiness of federal/provincial hospitals, local HFs, and private hospitals were 72.9±13.6, 54.2±12.8, 53.1±15.1 respectively. In multivariate linear regression, local HFs (β = -12.64, 95% CI: -18.31, -6.96) and private hospitals had lower readiness score (β = -18.08, 95% CI: -24.08, -12.08) compared to federal/provincial level hospitals. HFs in rural settings (β = 2.60, 95% CI: 0.62, 4.58), mountain belts (β = 4.18, 95% CI: 1.65, 6.71), and HFs with external supervision (β = 2.99, 95% CI:1.08, 4.89), and quality assurance activities (β = 3.59, 95% CI:1.64, 5.54) had better readiness scores. CONCLUSION: The availability of all seven BEmONC signal functions and readiness of HFs for BEmONC services are relatively low in local HFs and private hospitals. Accelerating capacity development through training centers at the federal/provincial level, onsite coaching, and mentoring, improving procurement and supply of medicines through federal/provincial logistic management centers, and regular supportive supervision could improve the BEmONC service availability and readiness in facilities across the country.
format Online
Article
Text
id pubmed-10434927
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-104349272023-08-18 Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021 Pandey, Achyut Raj Adhikari, Bikram Lamichhane, Bipul Joshi, Deepak Regmi, Shophika Lal, Bibek Kumar Dahal, Sagar Baral, Sushil Chandra PLoS One Research Article BACKGROUND: Although there has been a significant focus on improving maternal and newborn health and expanding services in Nepal, the expected positive impact on the health of mothers and newborns has not been achieved to the desired extent. Nepal not only needs to focus on improving access to and coverage of services but also the quality to achieve Sustainable Development Goals (SDG) by 2030. In this context, we aimed to analyze Basic Emergency Obstetric and Neonatal Care (BEmONC) service availability and readiness in Health Facilities (HFs) of Nepal. METHODS: We analyzed data from nationally representative Nepal Health Facility Survey (NHFS), 2021. BEmONC service availability and readiness in HFs was measured based on the “Service Availability and Readiness” manual of World Health Organization (WHO). We measured service availability by seven BEmONC signal functions. The readiness score was calculated for three domains- guidelines and staff training, essential equipment/supplies, and essential medicines on a scale of 100, and the average score for the three domains was the overall readiness score. We performed weighted descriptive and inferential analysis to account complex survey design of NHFS 2021. We summarized continuous variables with descriptive statistics like mean, standard deviation, median and interquartile range whereas categorical variables with percent and 95% confidence interval (CI). We applied simple, and multivariate linear regression to determine factors associated with the readiness of HFs for BEmONC services, and results were presented as beta (β) coefficients and 95% CI. RESULTS: Of total 804 HFs offering normal vaginal delivery services, 3.1%, 89.2%, 7.7% were federal/provincial hospitals, local HFs, and private hospitals respectively. A total of 45.0% (95% CI: 34.9, 55.6) federal/provincial hospitals, 0.3% (95% CI: 0.2, 0.6), local HFs (district hospital, primary health care centers, health posts, urban health centers) and 10.5% (95% CI: 6.6, 16.4) private hospitals, had all seven BEmONC signal functions. The overall readiness of federal/provincial hospitals, local HFs, and private hospitals were 72.9±13.6, 54.2±12.8, 53.1±15.1 respectively. In multivariate linear regression, local HFs (β = -12.64, 95% CI: -18.31, -6.96) and private hospitals had lower readiness score (β = -18.08, 95% CI: -24.08, -12.08) compared to federal/provincial level hospitals. HFs in rural settings (β = 2.60, 95% CI: 0.62, 4.58), mountain belts (β = 4.18, 95% CI: 1.65, 6.71), and HFs with external supervision (β = 2.99, 95% CI:1.08, 4.89), and quality assurance activities (β = 3.59, 95% CI:1.64, 5.54) had better readiness scores. CONCLUSION: The availability of all seven BEmONC signal functions and readiness of HFs for BEmONC services are relatively low in local HFs and private hospitals. Accelerating capacity development through training centers at the federal/provincial level, onsite coaching, and mentoring, improving procurement and supply of medicines through federal/provincial logistic management centers, and regular supportive supervision could improve the BEmONC service availability and readiness in facilities across the country. Public Library of Science 2023-08-17 /pmc/articles/PMC10434927/ /pubmed/37590204 http://dx.doi.org/10.1371/journal.pone.0282410 Text en © 2023 Pandey et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Pandey, Achyut Raj
Adhikari, Bikram
Lamichhane, Bipul
Joshi, Deepak
Regmi, Shophika
Lal, Bibek Kumar
Dahal, Sagar
Baral, Sushil Chandra
Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021
title Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021
title_full Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021
title_fullStr Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021
title_full_unstemmed Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021
title_short Service availability and readiness for basic emergency obstetric and newborn care: Analysis from Nepal Health Facility Survey 2021
title_sort service availability and readiness for basic emergency obstetric and newborn care: analysis from nepal health facility survey 2021
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10434927/
https://www.ncbi.nlm.nih.gov/pubmed/37590204
http://dx.doi.org/10.1371/journal.pone.0282410
work_keys_str_mv AT pandeyachyutraj serviceavailabilityandreadinessforbasicemergencyobstetricandnewborncareanalysisfromnepalhealthfacilitysurvey2021
AT adhikaribikram serviceavailabilityandreadinessforbasicemergencyobstetricandnewborncareanalysisfromnepalhealthfacilitysurvey2021
AT lamichhanebipul serviceavailabilityandreadinessforbasicemergencyobstetricandnewborncareanalysisfromnepalhealthfacilitysurvey2021
AT joshideepak serviceavailabilityandreadinessforbasicemergencyobstetricandnewborncareanalysisfromnepalhealthfacilitysurvey2021
AT regmishophika serviceavailabilityandreadinessforbasicemergencyobstetricandnewborncareanalysisfromnepalhealthfacilitysurvey2021
AT lalbibekkumar serviceavailabilityandreadinessforbasicemergencyobstetricandnewborncareanalysisfromnepalhealthfacilitysurvey2021
AT dahalsagar serviceavailabilityandreadinessforbasicemergencyobstetricandnewborncareanalysisfromnepalhealthfacilitysurvey2021
AT baralsushilchandra serviceavailabilityandreadinessforbasicemergencyobstetricandnewborncareanalysisfromnepalhealthfacilitysurvey2021