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Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders

BACKGROUND: The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aimed to explore community perceptions of COVID-19 and their exp...

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Autores principales: Singh, Devendra Raj, Sunuwar, Dev Ram, Shah, Sunil Kumar, Karki, Kshitij, Sah, Lalita Kumari, Adhikari, Bipin, Sah, Rajeeb Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903406/
https://www.ncbi.nlm.nih.gov/pubmed/33627115
http://dx.doi.org/10.1186/s12913-021-06176-y
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author Singh, Devendra Raj
Sunuwar, Dev Ram
Shah, Sunil Kumar
Karki, Kshitij
Sah, Lalita Kumari
Adhikari, Bipin
Sah, Rajeeb Kumar
author_facet Singh, Devendra Raj
Sunuwar, Dev Ram
Shah, Sunil Kumar
Karki, Kshitij
Sah, Lalita Kumari
Adhikari, Bipin
Sah, Rajeeb Kumar
author_sort Singh, Devendra Raj
collection PubMed
description BACKGROUND: The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aimed to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. METHODS: The semi-structured qualitative interviews were conducted among purposively selected participants (n = 41) from a mix of rural and urban settings in all districts (n = 8) of the Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. RESULTS: The findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and anxious about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions in health services were mostly due to the closure of health services at local health care facilities, limited affordability, and involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health care workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from the government at all levels towards health services continuation/management during the COVID-19 pandemic. CONCLUSIONS: This study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is critical to expand and continue the service coverage, and its quality (even more during pandemics), as well as increase public-private sector engagement to ensure the essential health services are available for the population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06176-y.
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spelling pubmed-79034062021-02-24 Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders Singh, Devendra Raj Sunuwar, Dev Ram Shah, Sunil Kumar Karki, Kshitij Sah, Lalita Kumari Adhikari, Bipin Sah, Rajeeb Kumar BMC Health Serv Res Research Article BACKGROUND: The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aimed to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. METHODS: The semi-structured qualitative interviews were conducted among purposively selected participants (n = 41) from a mix of rural and urban settings in all districts (n = 8) of the Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. RESULTS: The findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and anxious about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions in health services were mostly due to the closure of health services at local health care facilities, limited affordability, and involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health care workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from the government at all levels towards health services continuation/management during the COVID-19 pandemic. CONCLUSIONS: This study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is critical to expand and continue the service coverage, and its quality (even more during pandemics), as well as increase public-private sector engagement to ensure the essential health services are available for the population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06176-y. BioMed Central 2021-02-24 /pmc/articles/PMC7903406/ /pubmed/33627115 http://dx.doi.org/10.1186/s12913-021-06176-y Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Singh, Devendra Raj
Sunuwar, Dev Ram
Shah, Sunil Kumar
Karki, Kshitij
Sah, Lalita Kumari
Adhikari, Bipin
Sah, Rajeeb Kumar
Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders
title Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders
title_full Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders
title_fullStr Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders
title_full_unstemmed Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders
title_short Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders
title_sort impact of covid-19 on health services utilization in province-2 of nepal: a qualitative study among community members and stakeholders
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903406/
https://www.ncbi.nlm.nih.gov/pubmed/33627115
http://dx.doi.org/10.1186/s12913-021-06176-y
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