Department of Medicine, National Cardiac Centre, Bashundhara, Kathmandu 44600, Nepal.
Department of Neurology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Lujiazui, Pudong, Shanghai 200120, China.
Int J Qual Health Care. 2023 Sep 13;35(3). doi: 10.1093/intqhc/mzad070.
The healthcare system in Nepal faces challenges despite the establishment of numerous medical colleges and an increasing number of doctors. The distribution of medical colleges is disproportionately concentrated in urban areas, leaving rural populations without quality health care. The mental well-being of physicians is a growing concern, with studies indicating high levels of burnout, stress, and depression among healthcare workers, worsened by the Coronavirus Disease 2019 (COVID-19) pandemic. Rising suicide rates among medical professionals highlight the severity of burnout and depression in the healthcare sector. Factors contributing to this crisis include inadequate recruitment in government hospitals, a shortage of healthcare professionals, and inefficiencies in resource distribution. Attacks on physicians have become alarmingly frequent, necessitating comprehensive studies to understand the challenges faced by different specialties and the impact of rural versus urban settings. To address these issues, prompt filling of vacant positions in government hospitals and prioritizing physicians' mental health is crucial. The government should offer competitive salaries, effective management, and supportive working environments to combat the brain drain. Initiatives inspiring professionals to stay in Nepal, along with maintaining the National Health Insurance Program and controlling healthcare privatization, are necessary. Resilience training, professional programs, and improved infrastructure in government medical colleges are vital. This crisis demands global attention and a national study to evaluate burnout, depression, and suicide among healthcare professionals. By addressing these challenges and supporting the well-being of healthcare workers, Nepal can work toward a sustainable healthcare system that provides quality care for all.
尼泊尔的医疗体系面临挑战，尽管建立了众多医学院和越来越多的医生。医学院的分布严重集中在城市地区，使农村人口无法获得高质量的医疗保健。医生的心理健康是一个日益令人关注的问题，研究表明，医疗工作者中存在高比例的倦怠、压力和抑郁，而 2019 年冠状病毒病（COVID-19）大流行使情况更加恶化。医疗专业人员自杀率上升突出表明医疗保健部门的倦怠和抑郁问题严重。导致这一危机的因素包括政府医院招聘不足、医疗专业人员短缺以及资源分配效率低下。对医生的攻击变得惊人地频繁，需要进行全面研究，以了解不同专业面临的挑战以及农村与城市环境的影响。为了解决这些问题，及时填补政府医院的空缺职位和优先考虑医生的心理健康至关重要。政府应提供有竞争力的工资、有效的管理和支持性的工作环境，以防止人才流失。激励专业人员留在尼泊尔的举措，以及维持国家健康保险计划和控制医疗保健私有化，都是必要的。在政府医学院进行弹性培训、专业课程和改善基础设施至关重要。这场危机需要全球关注和国家研究来评估医疗保健专业人员的倦怠、抑郁和自杀问题。通过应对这些挑战和支持医疗保健工作者的福祉，尼泊尔可以努力建立一个为所有人提供高质量医疗保健的可持续医疗体系。
