Thapa A K, Ghimire N, Adhikari S R
Faculty of Humanities and Social Sciences, Pokhara University, Dhungepatan, Kaski, Nepal.
Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal.
J Nepal Health Res Counc. 2016 Sep;14(34):139-142.
The Government of Nepal promulgated health as a human right via Interim constitution and implemented Free Health Service Program in 2008 as a commitment to universalize basic health care services. So, the aim of this study was to understand reported access to medicine and health care services received by outpatients in public primary facilities.
The study followed cross sectional study design. Two hundred and thirty-four For data 234 out patients were interviewed on the day of the field visit in March and October 2014 across 28 primary health facilities of seven purposively selected districts representing three ecological belts and five development regions of the country.
Our study revealed that the average number of medicines prescribed per patient was 2.65 per case in primary public health facilities, of which 91.2% were dispensed. Around 86.6% dispensed medicines were appropriately labeled and 84% of outpatients had proper knowledge of dosage and timing of medicine use. Around 55.6% of outpatients purchased some or all prescribed medicines from nearby private facilities which were not available in public facilities. Around 40% of them travelled more than half an hour to reach the facility.
The gap in medicines prescribed and dispensed, Out of Pocket expenditure coupled with opportunity cost of travelling, appear as hurdles in access to basic health care services. So increasing free medicines list in public primary facilities with all round the year availability might answer major part of the problem.
尼泊尔政府通过临时宪法将健康宣示为一项人权，并于2008年实施了免费医疗服务计划，以致力于普及基本医疗服务。因此，本研究的目的是了解公立基层医疗机构门诊患者所报告的药品获取情况及接受的医疗服务。
本研究采用横断面研究设计。2014年3月和10月实地考察当天，在代表该国三个生态带和五个发展区域的七个特意选定的地区的28个基层医疗机构，对234名门诊患者进行了访谈。
我们的研究显示，公立基层医疗机构中每位患者的平均处方药品数量为每例2.65种，其中91.2%的药品得到了配给。约86.6%的配给药品有适当的标签，84%的门诊患者对药品使用的剂量和时间有正确的认识。约55.6%的门诊患者从附近私立医疗机构购买了部分或全部处方药品，这些药品在公立医疗机构中没有。其中约40%的人前往医疗机构的行程超过半小时。
处方药品与配给药品之间的差距、自付费用以及出行的机会成本，似乎成为了获取基本医疗服务的障碍。因此，增加公立基层医疗机构全年可用的免费药品清单可能会解决大部分问题。
