Table 1 - uploaded by Sailesh Bhattarai
Content may be subject to copyright.
Source publication
noBackground & Objectives: Preventive, promotive, curative, and rehabilitative health care services depend not only in availability & accessibility of it but also on awareness and attitude of the people and various inter-woven social structure that determines in making choice. The objective of this study was to explore health seeking behavior and u...
Context in source publication
Context 1
... 92 percent of the head of households were employed corresponding with the Eastern regions' high economic activities. Half of the respondent's families were original settler (Table 1). Table 2 shows the morbidity pattern among the respondents where around 37 percent were found to have chronic disease and almost 14 percent had acute illness. ...
Citations
... In Nepal, people typically wait to seek medical attention until their condition has considerably worsened. This could be due to increased adaptation to living with a disease or its symptoms, distrust of health facilities, a preference for traditional healing methods, reliance on home remedies, and perception that modern health care is costly [7]. Although substantial progress has been made in service expansion, generating demand in the community and increasing service utilization may continue to be a challenge in the upcoming days. ...
... 7 A descriptive cross sectional study conducted in 2013 in Illam district of Eastern Nepal, study reveals that 80% seek the private medical service whereas almost 19 % utilizes the service of traditional healer. 8 Similar descriptive cross sectional study conducted in senior citizen of Dharan based on household survey was conducted among 400 senior citizens. Among them, (11.3%) do self-treatment during illness, (26.3%) visit to private practitioners\ Nursing home, (21%) used over the counter drug from nearest pharmacy, (36.3%) visit to BPKIHS hospital, (3.2%) visited health post \sub health post and (2%) visited to alternative medicine. ...
... 11 Government of Nepal is committed to improve the health status of rural and urban people by delivering quality health services throughout the country through skilled human resources and various health facilities such preventive, promotive, curative and rehabilitative health care services depend not only in availability & accessibility of it but also on awareness and attitude of the people. 8 There are many communities group of people who are still far away from access of health services in remote as well as urban areas. There is variation in disease prevalence and health seeking behavior of different groups of the peoples depending on the society. 2 There are many studies revealing health seeking behavior in developed and developing countries where as in context of Nepal there are very limited study conducted in this area. ...
Background: Health seeking behavior is any action taken by an individual who perceive themselves to have any health problems or to be ill, for an appropriate remedy. It can be determined by physical, socioeconomic, cultural or political, environmental, socio-demographic, knowledge, gender issues, political environment and health care system. Individual have different opinion regarding willingness to seek health from health care services. The general objective is to assess the health seeking behavior of community people in Lalitpur district of Nepal. Methodology: A descriptive cross-sectional study was conducted on community people of Mahalaxmi municipality in Lalitpur district of Nepal with the sample size 221. Probability proportionate method was used to select the ward and household, and respondents were selected purposively. Self-developed structure questionnaire was used to collect data using interview technique. Data management, analysis and interpretation were done using both descriptive and inferential statistics in SPSS version 16 software. Results: Among 221 respondents, 84.6% of respondents seek health care services whereas 15.4 % did not seek health last time they were ill. The most frequently reported places to seek health care services were modern health facility (modern medication) (82.4%) followed by Self-medication (11.4%), alternative medication (4.6%) and traditional healer (1.6%) respectively. There was statistically significance association between health seeking behavior of community people with marital status (p=0.002), occupation (p=0.001), level of education (p=0.030), source of income (p<0.001), monthly income (p<0.006), duration of illness (p=0.008) and availability of nearest health care services (P<0.001). Conclusion: Study concluded that most of the respondents used modern medication while last time they were ill, such as hospital, clinic and health post as a first choice to treat health problem. The reasons for not seeking health care services were due to far distance, lack of money, lack of family support, lack of knowledge. Thus, awareness programmes are essential in community people for appropriate used of available health care services. Key words: Community people, Health seeking behavior, Utilization of health care services.
... The likelihood that a person would use healthcare services is reflected in predisposing factors, while enabling factors are resources that may make it easier for a person to access healthcare. Furthermore, positive health-seeking behavior in patients can lead to better utilization of health services, including patients with mental health problems (Bhattarai et al., 2015). Certain barriers contribute to poor utilization of mental health services, such as fear of stigma and embarrassment; negative attitude towards treatment or mental health services; lack of perceived need for seeking help; long waiting hours at the health center; cost of treatment; lack of information about available services; preference for self-management over seeking help; and low health professional-to-patient ratio (Menon et al., 2015;Al Ali et al., 2017;Hasan and Musleh, 2017;Musakwa et al., 2021;Salaheddin and Mason, 2016). ...
Under-utilization of mental health services among university students is a major public health concern. This study assessed the factors affecting the utilization of mental health services among undergraduate students.
This research was a cross-sectional survey carried out among students of Afe Babalola University, Ado-Ekiti, Nigeria. A semi-structured self-administered questionnaire was used for data collection and multi-stage sampling technique was used in sampling the participants. Utilization, attitude, and health seeking behavior were categorized into good (≥50% score), and poor (<50% score), while social support was categorized into poor (8–18), moderate (19–25), and strong (26–32). Chi-square test and Logistic regression were used to assess the relationship between the categorical variables.
450 students enrolled in this study of which 52.4% were females and mean age of 19.40 ± 1.65 years. Most students showed a good attitude (87.5%), health seeking behavior (67.8%), and poor social support (69.4%) towards mental health services. There was an association between source of information (p = 0.005), health seeking behavior (p = 0.001) and utilization of mental health services. There was also a higher likelihood for students of female gender (OR: 1.621 (1.072–2.452)) and being aged above 20 years (OR: 1.331 (0.822–2.153)) to have good utilization of mental health services.
Majority of the students showed good attitude and health seeking behavior towards mental health services but there was poor utilization as well as poor to moderate social support towards mental health services. Gender, age, attitude, source of information as well as health seeking behavior are important factors that can affect the utilization of mental health services among undergraduate students. Interventions targeted towards these factors should be done to ultimately improve utilization of mental health services among undergraduate students.
... In addition, our study showed that the physical accessibility of medical services, which indicates the capability of a population to obtain health care services [43,44], was significantly associated COVID-19 mortality: areas with a lower percentage of health facilities within 30 min walking distance were likely to have a higher mortality rate. Previous research reported that limited or poor access to healthcare was associated with increased COVID-19 deaths [45]. ...
The recent global pandemic of the novel coronavirus disease 2019 (COVID-19) is affecting the entire population of Nepal, and the outcome of the epidemic varies from place to place. A district-level analysis was conducted to identify socio-demographic risk factors that drive the large variations in COVID-19 mortality and related health outcomes, as of 22 January 2021. Data on COVID-19 extracted from relevant reports and websites of the Ministry of Health and Population of Nepal, and the National Population and Housing Census and the Nepal Demographic and Health Survey were the main data sources for the district-level socio-demographic characteristics. We calculated the COVID-19 incidence, recovered cases, and deaths per 100,000 population, then estimated the associations with the risk factors using regression models. COVID-19 outcomes were positively associated with population density. A higher incidence of COVID-19 was associated with districts with a higher percentage of overcrowded households and without access to handwashing facilities. Adult literacy rate was negatively associated with the COVID-19 incidence. Increased mortality was significantly associated with a higher obesity prevalence in women and a higher smoking prevalence in men. Access to health care facilities reduced mortality. Population density was the most important driver behind the large variations in COVID-19 outcomes. This study identifies critical risk factors of COVID-19 outcomes, including population density, crowding, education, and hand hygiene, and these factors should be considered to address inequities in the burden of COVID-19 across districts.
... By reason of the foregoing, this study seeks to assess health care seeking behaviour and perception of health care services among SD Dombo University students.Our study adopted Andersen's behavioral model of health-care utilization approach[20] [21]. Specifically, we employed versions of Andersen's model, which have been adopted by most studies in resource scarce settings[20] [21][22].Figure 1 provides information on our adapted model employed in our study to examine student's health care seeking behaviour during the last illness. Andersen's model suggests that health-seeking behaviour of individuals is a function of three cluster of factors: predisposing, enabling and need. ...
... It may be due to we consider only diabetic patients so participants went to public health facilities for diabetes management. A similar finding in a study done in Ilam district of Eastern Nepal where 79.3% participants used the private health facilities [21]. One of the study done in Mumbai India among urban slums found 81% participants seek treatment from private health sector [22]. ...
... Nearest health facilities and waiting time was significantly associated with the health care utilizations in bivariate analysis. A study was done in Ilam district of Eastern Nepal where Nearest health facilities are also associated with the health care utilizations [21]. Gender, marital status, occupation and poverty index was not associated with health facilities. ...
INTRODUCTION: Diabetes was considered the disease of affluent and imposes a significant burden on the health services. The modalities of diabetes therapies are different in different parts of the world. However, studies regarding public or private healthcare utilization are lacking in Nepal. Therefore, this study was designed to assess public private health care facility utilization among diabetic people in an urban area of Ithari, Nepal. MATERIALS AND METHODS: A community based cross-sectional study was conducted in Itahari, Submetropolitan of Sunsari district in the Koshi zone of Nepal from September 2017 - September 2018. The study population included 221 participants of age 25 years and above, diagnosed with type 2 Diabetes. Multi-stage proportionate random sampling method was adopted to select the participants. Chi square test was applied to find out the association and p<0.05 is considered significant. RESULTS: Out of the total (221) participants, 55.7% were aged 45-64 years with male of 50.2%. Higher proportion of participants above poverty line (79.7%) were used private healthcare facilities. Among the participants those reported less or equal to two hours waiting time, majority (90.8%) had gone to private healthcare facilities, whereas those reported more than two hours waiting time, majority (70.8%) had gone to public healthcare facilities for the treatment which was found statistically significant (p=0.0002). CONCLUSIONS: Maximum participants prefer private health care services as compared to government health services for their treatment. Therefore, additional community based studies are needed to include larger study populations in order to help healthcare providers develop proper health care programs for these patients.
... Understandably, the scenario of the proportion of symptomatic to asymptomatic cases remains to vary between countries and care facilities. Few possible reasons for low symptomatic cases reported in the Nepalese population may be poor health-seeking behavior and utilization of tertiary health care services (11) for mild symptomatic cases, home isolation without a diagnosis, and a high rate of self-medication practices (12). Among the provinces, Bagmati province (n = 144,278) has the highest number of confirmed cases in Nepal, followed by province no. 1 (n = 30,422) and Lumbini (n = 30,308) ( Figure 1A). ...
... Initially, the government had set health desks and allocated spaces for quarantine purposes at the international airport and at the borders, crossing points of entry (PoE) with India and China 10 , to withstand the influx of many possible infected individuals from India and other countries. The open border and the politico-religious relationship with India and migrant workers returning from the Middle East, and other countries were a source of rapid transmission to Nepal 10 , 11 . The Nepal-China official border crossing points have remained closed since January 21, 2020. ...
... Available online at: https://southasianvoices.org/covid-19-and-nepals-migrationcrisis/ (accessed January 15, 2021). 11 GRADA WORLD Nepal: Government announces nationwide lockdown from March 24-31/update. Available online at: https://www.garda.com/crisis24/ ...
Unprecedented and unforeseen highly infectious Coronavirus Disease 2019 (COVID-19) has become a significant public health concern for most of the countries worldwide, including Nepal, and it is spreading rapidly. Undoubtedly, every nation has taken maximum initiative measures to break the transmission chain of the virus. This review presents a retrospective analysis of the COVID-19 pandemic in Nepal, analyzing the actions taken by the Government of Nepal (GoN) to inform future decisions. Data used in this article were extracted from relevant reports and websites of the Ministry of Health and Population (MoHP) of Nepal and the WHO. As of January 22, 2021, the highest numbers of cases were reported in the megacity of the hilly region, Kathmandu district (population = 1,744,240), and Bagmati province. The cured and death rates of the disease among the tested population are ~98.00 and ~0.74%, respectively. Higher numbers of infected cases were observed in the age group 21–30, with an overall male to female death ratio of 2.33. With suggestions and recommendations from high-level coordination committees and experts, GoN has enacted several measures: promoting universal personal protection, physical distancing, localized lockdowns, travel restrictions, isolation, and selective quarantine. In addition, GoN formulated and distributed several guidelines/protocols for managing COVID-19 patients and vaccination programs. Despite robust preventive efforts by GoN, pandemic scenario in Nepal is, yet, to be controlled completely. This review could be helpful for the current and future effective outbreak preparedness, responses, and management of the pandemic situations and prepare necessary strategies, especially in countries with similar socio-cultural and economic status.
... However similar findings as my study were showed in studies done in Eastern Hilly Region of Nepal and Northwest Ethopia. 3,7 This indicates that majority of the people prefer modern health services. The reason behind this may be innovation and advancement in the modern medicine. ...
... Similar study done in Eastern Hilly Regionand in Bhimtar, Sindhupalchowk Districts found that basic demographic factors did not show any association in bivariate analysis in choosing between traditional and modern methods. 3,6 But in this study, only education, duration of stay at this locality and type of disease showed association at 95% level of confidence (p<0.05). ...
... But similar study done in Eastern Hilly Region demonstrated that no association was found between distance of health facility and means of transportation and choice of treatment systems (modern and traditional). 3 All above discussion showed that distance to the health facility and modes of transportation are one of the factors affecting the utilization of health services. ...
Introduction: In Nepal, preference of health service for treatment is different for different people, which is affected by their level of knowledge , socio-demographic factors and so on. The objective of this study was to find the first preference of health services of the people for the treatment of their illness andfactors affecting their preference. Methods: A descriptive cross-sectional study was conducted among 260 respondents of Maneswora Ward, Sindhupalchowk district which was selected through systematic random sampling. Data collection was done after taking ethical approval. Face-to-face interview was done to collect the data through semi- structured questionnaire. Data was entered and analyzed in SPSS v16. Results: One-third (36.9%) of the respondents were found to be visiting the traditional health services and more than half (63.1%) of the respondents visited modern health services. Education (0.016), duration of stay (0.014), type of disease (<0.001), distance to the health services (<0.001), modes of transportation (<0.001), affordability (0.013), waiting time (<0.001) and availability of health care provider (<0.001) demonstrated association with utilization of health services at 95% level of confidence (p<0.05). Conclusions: Despite of modern health facilities available within walking distance, still people prefer to go to the traditional healers for almost all the health problems at first hand with firm belief that they cure it. Hence, government still lacks effective programs to attract people towards modern health services to some extent. Hence, the awareness campaign regarding the benefits of modern health services should be initiated.
... of Nepal at central, provincial and at local levels to create awareness regarding CVDs. Although the constitution of Nepal 2072, addresses health as the basic right of all Nepalese population, people in the rural part of the country still shy away from reaching out to basic health facility for medicines and appropriate management of CVDs, stating that health care providers and infrastructures in their area are not good enough or that it was too costly.18 Further study needs to be conducted considering the recently formed federal structure of Nepal including rural, urban and semi-urban regions of Nepal to find out exact KAP regarding CVDs to apply appropriate intervention considering the local context.Knowledge, Attitude and Practices regarding Cardiovascular Diseases among people of Pakhribas municipality of Eastern Nepal. ...
Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally with 17.9 million deaths in 2016. Nepal is facing a high burden of non-communicable diseases (NCDs) with 66% of people dying from NCDs in 2018. In this study, we aim to assess the knowledge, attitudeand practice regarding CVDs among people of Pakhribas Municipality in Eastern Nepal. Methods: Observational cross-sectional study was conducted among residents of Pakhribas Municipality in eastern Nepal from 9th December to 22nd December 2018. We recruited a convenient sample of 458 permanent residents of Pakhribas municipality. A semi-structured questionnaire based on the CARRF-KL scale survey for knowledge, attitude and practice (after thorough literature review) was used to elicit the information. Descriptive and thematic analysis was done. Result: Fifty-five percent of the respondents belonged to the age group of 30-60 years. Half of the respondents were females. Janjati community was the most dominant ethnicity. One-fourth of the participants were illiterate. The knowledge was found to be average with only 51.5% realizing that family history of CVDs increases the risk of CVDs. Similarly, 46% didn’t know that coronary heart disease could be prevented. The attitude was found to be good with 90.4%, 93.6% and 90.6% respectively stating that they will exercise more, change eating habits and quit smoking if they had CVDs. Regarding practices, people visit traditional healers when they are ill and drink alcohol to fight cold despite knowing it as a risk factor for CVDs. Conclusion: The knowledge of people of Pakhribas Municipality regarding CVD was average. However, the attitude was good. Regarding the practice, people have mixed practices.
... However similar findings as my study were showed in studies done in Eastern Hilly Region of Nepal and Northwest Ethopia. 3,7 This indicates that majority of the people prefer modern health services. The reason behind this may be innovation and advancement in the modern medicine. ...
... Similar study done in Eastern Hilly Regionand in Bhimtar, Sindhupalchowk Districts found that basic demographic factors did not show any association in bivariate analysis in choosing between traditional and modern methods. 3,6 But in this study, only education, duration of stay at this locality and type of disease showed association at 95% level of confidence (p<0.05). ...
... But similar study done in Eastern Hilly Region demonstrated that no association was found between distance of health facility and means of transportation and choice of treatment systems (modern and traditional). 3 All above discussion showed that distance to the health facility and modes of transportation are one of the factors affecting the utilization of health services. ...
Introduction: Subarachnoid block is commonly employed technique for lower abdominal and lower limb procedures. Bupivacaine and ropivacaine are commonly used local anesthetics for subarachnoid block. The aim of this study is to compare the efficacy and safety of isobaric Ropivacaine over hyperbaric Bupivacaine. Methods: This was a prospective comparative study for a duration of six months. 60 ASA grade I-II adult patients between 16-60 years undergoing lower limb surgery under spinal anesthesia were randomized into two groups. Group I including patients who received 15 mg of hyperbaric bupivacaine 0.5% and group II including patients who received 22.5 mg of isobaric ropivacaine 0.75%. The onset and duration of sensory and motor block and hemodynamics including heart rate (HR), non invasive mean arterial blood pressure (MAP) and respiratory depression were recorded. Data were entered in Microsoft excel and statistical analysis was done by chi square test and T test using SPSS (version 23.0). Results: Both the groups were demographically statistically insignificant. Successful block was attained in all patients in both groups. The sensory onset and motor onset were significantly delayed in the Ropivacaine Group compared to the Bupivacaine Group P<0.001. There was no significant difference in the hemodynamics (heart rate and mean arterial pressure ). Conclusions: Though isobaric ropivacaine provided lesser degree of sensory and motor block with delayed onset compared to hyperbaric bupivacaine, it can effectively and safely used in subarachnoid block in lower limb surgeries without any major hemodynamic changes and adverse effects.
