Paudel R, Upadhyaya T, Pahari D P
Department of Community Medicine and Public Health, Tribhuvan University, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2012 Jan-Mar;52(185):20-4.
Over the past several decades, Nepal has attempted to increase the access of health care services, however progress toward achieving high coverage of health care services in rural communities is still low. Therefore this study attempts to provide a perspective on access to basic health care services in government health facility.
Descriptive cross-sectional study with quantitative and qualitative methods was designed and applied to identify the access to health care services. The study population were people who were sick within three months prior to the study where basic sampling unit was household. Total sample size was 96 through the application of simple random sampling method. Bivariate analysis with 95% confidence interval was used to identify the association of variables with access to health care services.
Among the total population, 28% of households in the study area received health care services at government health facility. The reasons for not accessing health care were insufficient drugs (61%), distance (22%), staff unavailability (19%), sickness (9%), money (7%), and facility hours (4%). Sex, ethnicity and distance were found significantly associated with access to health care services.
Less than one third of households had access to health care services in government health facility. Addressing the important factors such as drug problems, staff unavailability, long distance to health institutions and inconvenient health facility hours may help to increase access to health care services at government health facility.
在过去几十年里,尼泊尔一直试图增加医疗服务的可及性,然而在农村社区实现高覆盖率医疗服务的进展仍然缓慢。因此,本研究试图提供关于政府医疗机构基本医疗服务可及性的观点。
设计并应用了采用定量和定性方法的描述性横断面研究,以确定医疗服务的可及性。研究人群为在研究前三个月内生病的人,基本抽样单位是家庭。通过简单随机抽样方法,总样本量为96。采用95%置信区间的双变量分析来确定变量与医疗服务可及性之间的关联。
在总人口中,研究区域内28%的家庭在政府医疗机构接受了医疗服务。未获得医疗服务的原因包括药品不足(61%)、距离(22%)、工作人员不在岗(19%)、生病(9%)、资金(7%)和机构营业时间(4%)。发现性别、种族和距离与医疗服务可及性显著相关。
不到三分之一的家庭能够在政府医疗机构获得医疗服务。解决药品问题、工作人员不在岗、距离医疗机构远以及机构营业时间不便等重要因素,可能有助于增加政府医疗机构的医疗服务可及性。