Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal.
Health Action and Research, Kathmandu, Nepal.
PLoS One. 2021 Dec 30;16(12):e0261524. doi: 10.1371/journal.pone.0261524. eCollection 2021.
The COVID-19 pandemic has affected the health systems in many ways. It has put unprecedented strain on health systems worldwide and exposed gaps in public health infrastructure. A health system comprises all institutions and resources working towards improving and maintaining health. Among the different aspects of health system strengthening, a patient's experiences and expectations play a crucial role in determining how well the health facilities function. This study aims to explore health system strengthening's implications based on experiences and feedback provided by COVID-19 patients admitted to a government tropical and infectious disease hospital in Nepal.
In this qualitative study, we collected the voluntary handwritten feedback by the admitted COVID-19 patients to document the feedback and experiences from a book, maintained by the hospital. We performed thematic content analysis using the World Health Organization's six building blocks of health system as a theoretical framework which included service delivery, health workforce, information, leadership and governance, financing, and access to medicines.
Most patients in this study had positive experiences on service delivery and health workforce. Some also highlighted the gaps in infrastructure, cleanliness, and hygiene. Many suggested positive experiences on other dimensions of the health system such as financing, governance and leadership, and access to medicines reflected upon by the patients' thankfulness to the hospital and the government for the treatment they received. The responses also reflected the inter-connectedness between the different building blocks of health system.
This study approached a unique way to strengthen the health system by exploring patients' feedback, which suggested an overall positive impression on most building blocks of health system. However, it also highlighted certain gaps in infrastructure, cleanliness, and hygiene. It reinforces the hospital management and government's role to continue its efforts to strengthen the health system.
COVID-19 大流行以多种方式影响了卫生系统。它给全球卫生系统带来了前所未有的压力，暴露出公共卫生基础设施的差距。卫生系统由所有旨在改善和维护健康的机构和资源组成。在加强卫生系统的不同方面中，患者的体验和期望在确定卫生设施的运行情况方面起着至关重要的作用。本研究旨在探讨基于尼泊尔一家政府热带和传染病医院收治的 COVID-19 患者提供的经验和反馈，加强卫生系统的影响。
在这项定性研究中，我们收集了住院 COVID-19 患者自愿手写的反馈意见，以记录医院保存的意见和经验。我们使用世界卫生组织的卫生系统六个组成部分作为理论框架进行了主题内容分析，这六个组成部分包括服务提供、卫生人力、信息、领导力和治理、筹资以及药品获取。
本研究中的大多数患者对服务提供和卫生人力有积极的体验。一些人还强调了基础设施、清洁度和卫生方面的差距。许多人对卫生系统的其他方面提出了积极的体验，例如患者对医院和政府提供的治疗表示感谢，这反映了他们对筹资、治理和领导力以及药品获取的看法。这些回应还反映了卫生系统不同组成部分之间的相互联系。
本研究通过探索患者的反馈意见，以一种独特的方式来加强卫生系统，这表明对卫生系统的大多数组成部分都有整体积极的印象。然而，它也突出了基础设施、清洁度和卫生方面的某些差距。它强调了医院管理和政府继续努力加强卫生系统的作用。
