Use of Healthcare Services by Patients with Non-Communicable Diseases in Nepal: A Qualitative Study with Healthcare Providers
Published: June 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/25021.9970
Saval Khanal, Lennert Veerman, Lisa Nissen, Samantha Hollingworth
1. Consultant and International Relation Officer, Global Health Initiative, Sankalpa Foundation, Kaski, Pokhara, Nepal;
PhD Student, School of Pharmacy, The University of Queensland, Wooloongabba, Australia.
2. Senior Research Fellow, The Cancer Council NSW, Sydney, Australia: Honorary Senior Fellow, School of Public Health, The University of Queensland, Herston,
Australia.
3. Professor and Head, School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
4. Senior Lecturer, School of Pharmacy, The University of Queensland, Woolloongabba, Australia.
Correspondence
Mr. Saval Khanal,
Sankalpa Foundation (Pvt) Ltd, Ratna Chowk, Pokhara, Kaski, Nepal.
E-mail: khanalsaval@gmail.com
Introduction: The healthcare systems in many Low-and Middle-Income Countries (LMICs) like Nepal have long focused on preventing and treating infectious diseases. Little is known about their preparedness to address the increasing prevalence of Non-Communicable Diseases (NCDs).
Aim: This study aimed to investigate the use of healthcare services by patients with NCDs in Nepal.
Materials and Methods: Nine healthcare providers (including health assistants, pharmacy assistants, nurse, specialised nurse, practicing pharmacists, chief hospital pharmacist, doctors and specialised doctor) from Pokhara, Nepal, were recruited using purposive sampling. In depth interviews about the magnitude of NCDs, first point of care, screening and diagnosis, prevention and management, follow-up, and healthcare system responses to NCD burden were conducted. Data were thematically analysed with a deductive approach.
Results: Although the healthcare system in Nepal is still primarily focused on communicable infectious diseases, healthcare providers are aware of the increasing burden of NCDs and NCD risk factors. The first points of care for patients with NCDs are government primary healthcare facilities and private pharmacies. NCDs are often diagnosed late and opportunistically. NCD prevention and treatment is unaffordable for many people. There are no government sponsored NCD screening programs.
Conclusion: There are problems associated with screening, diagnosis, treatment and follow-up of patients with NCDs in Nepal. Healthcare providers believe that the current healthcare system in Nepal is inadequate to address the growing problem of NCDs. The health system of Nepal will face challenges to incorporate programs to prevent and treat NCDs in addition to the pre-existing communicable diseases.
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