Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study

Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none hav...
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Autor*in:	Nicholas Peoples [verfasserIn] Enying Gong [verfasserIn] Kamal Gautam [verfasserIn] Shree N. Khanal [verfasserIn] Brandon A. Kohrt [verfasserIn] Suraj Koirala [verfasserIn] Archana Amatya [verfasserIn] Shangzhi Xiong [verfasserIn] Truls Østbye [verfasserIn] Jeffrey Moe [verfasserIn] Qian Long [verfasserIn] Lijing L. Yan [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	primary healthcare (PHC) cardiovascular disease hypertension stroke diabetes Nepal

Übergeordnetes Werk:	In: Frontiers in Public Health - Frontiers Media S.A., 2013, 9(2021)
Übergeordnetes Werk:	volume:9 ; year:2021

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fpubh.2021.698030

Katalog-ID:	DOAJ00504667X

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allfields	10.3389/fpubh.2021.698030 doi (DE-627)DOAJ00504667X (DE-599)DOAJ1fe78877129a4bac9fe440d89aae0b0f DE-627 ger DE-627 rakwb eng RA1-1270 Nicholas Peoples verfasserin aut Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none have specifically explored PHC use among people with CMDs. Therefore, this mixed-methods study aimed to assess the use and perception of PHC services in Nepal among people living with CMDs for primary and secondary prevention of cardiovascular disease. We used a quantitative survey followed-up by semi-structured qualitative interviews. The sampling frame comprised five PHC facilities in Sindhuli district (rural; eastern Nepal) and five in Kailali district (urban; western Nepal), with participants selected from each facility via convenience sampling. 114 people (mean age: 54.5 ± 14.7, sex ratio 1.04) with CMDs participated in the survey. Survey data showed general dissatisfaction with PHC services. Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. Interview data showed that perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. Lack of resources and excessive barriers to care was mentioned by every interviewee. In conclusion, PHC use was high but overall satisfaction relatively low. Our results suggest that bedside manner is a practical target for future research. Additionally, we identified several barriers to care, and, based on existing literature, we suggest electronic-health interventions may have potential to mitigate these challenges. primary healthcare (PHC) cardiovascular disease hypertension stroke diabetes Nepal Public aspects of medicine Nicholas Peoples verfasserin aut Enying Gong verfasserin aut Enying Gong verfasserin aut Kamal Gautam verfasserin aut Shree N. Khanal verfasserin aut Brandon A. Kohrt verfasserin aut Brandon A. Kohrt verfasserin aut Suraj Koirala verfasserin aut Archana Amatya verfasserin aut Shangzhi Xiong verfasserin aut Truls Østbye verfasserin aut Truls Østbye verfasserin aut Jeffrey Moe verfasserin aut Qian Long verfasserin aut Lijing L. Yan verfasserin aut Lijing L. Yan verfasserin aut In Frontiers in Public Health Frontiers Media S.A., 2013 9(2021) (DE-627)742224589 (DE-600)2711781-9 22962565 nnns volume:9 year:2021 https://doi.org/10.3389/fpubh.2021.698030 kostenfrei https://doaj.org/article/1fe78877129a4bac9fe440d89aae0b0f kostenfrei https://www.frontiersin.org/articles/10.3389/fpubh.2021.698030/full kostenfrei https://doaj.org/toc/2296-2565 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021
spelling	10.3389/fpubh.2021.698030 doi (DE-627)DOAJ00504667X (DE-599)DOAJ1fe78877129a4bac9fe440d89aae0b0f DE-627 ger DE-627 rakwb eng RA1-1270 Nicholas Peoples verfasserin aut Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none have specifically explored PHC use among people with CMDs. Therefore, this mixed-methods study aimed to assess the use and perception of PHC services in Nepal among people living with CMDs for primary and secondary prevention of cardiovascular disease. We used a quantitative survey followed-up by semi-structured qualitative interviews. The sampling frame comprised five PHC facilities in Sindhuli district (rural; eastern Nepal) and five in Kailali district (urban; western Nepal), with participants selected from each facility via convenience sampling. 114 people (mean age: 54.5 ± 14.7, sex ratio 1.04) with CMDs participated in the survey. Survey data showed general dissatisfaction with PHC services. Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. Interview data showed that perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. Lack of resources and excessive barriers to care was mentioned by every interviewee. In conclusion, PHC use was high but overall satisfaction relatively low. Our results suggest that bedside manner is a practical target for future research. Additionally, we identified several barriers to care, and, based on existing literature, we suggest electronic-health interventions may have potential to mitigate these challenges. primary healthcare (PHC) cardiovascular disease hypertension stroke diabetes Nepal Public aspects of medicine Nicholas Peoples verfasserin aut Enying Gong verfasserin aut Enying Gong verfasserin aut Kamal Gautam verfasserin aut Shree N. Khanal verfasserin aut Brandon A. Kohrt verfasserin aut Brandon A. Kohrt verfasserin aut Suraj Koirala verfasserin aut Archana Amatya verfasserin aut Shangzhi Xiong verfasserin aut Truls Østbye verfasserin aut Truls Østbye verfasserin aut Jeffrey Moe verfasserin aut Qian Long verfasserin aut Lijing L. Yan verfasserin aut Lijing L. Yan verfasserin aut In Frontiers in Public Health Frontiers Media S.A., 2013 9(2021) (DE-627)742224589 (DE-600)2711781-9 22962565 nnns volume:9 year:2021 https://doi.org/10.3389/fpubh.2021.698030 kostenfrei https://doaj.org/article/1fe78877129a4bac9fe440d89aae0b0f kostenfrei https://www.frontiersin.org/articles/10.3389/fpubh.2021.698030/full kostenfrei https://doaj.org/toc/2296-2565 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021
allfields_unstemmed	10.3389/fpubh.2021.698030 doi (DE-627)DOAJ00504667X (DE-599)DOAJ1fe78877129a4bac9fe440d89aae0b0f DE-627 ger DE-627 rakwb eng RA1-1270 Nicholas Peoples verfasserin aut Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none have specifically explored PHC use among people with CMDs. Therefore, this mixed-methods study aimed to assess the use and perception of PHC services in Nepal among people living with CMDs for primary and secondary prevention of cardiovascular disease. We used a quantitative survey followed-up by semi-structured qualitative interviews. The sampling frame comprised five PHC facilities in Sindhuli district (rural; eastern Nepal) and five in Kailali district (urban; western Nepal), with participants selected from each facility via convenience sampling. 114 people (mean age: 54.5 ± 14.7, sex ratio 1.04) with CMDs participated in the survey. Survey data showed general dissatisfaction with PHC services. Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. Interview data showed that perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. Lack of resources and excessive barriers to care was mentioned by every interviewee. In conclusion, PHC use was high but overall satisfaction relatively low. Our results suggest that bedside manner is a practical target for future research. Additionally, we identified several barriers to care, and, based on existing literature, we suggest electronic-health interventions may have potential to mitigate these challenges. primary healthcare (PHC) cardiovascular disease hypertension stroke diabetes Nepal Public aspects of medicine Nicholas Peoples verfasserin aut Enying Gong verfasserin aut Enying Gong verfasserin aut Kamal Gautam verfasserin aut Shree N. Khanal verfasserin aut Brandon A. Kohrt verfasserin aut Brandon A. Kohrt verfasserin aut Suraj Koirala verfasserin aut Archana Amatya verfasserin aut Shangzhi Xiong verfasserin aut Truls Østbye verfasserin aut Truls Østbye verfasserin aut Jeffrey Moe verfasserin aut Qian Long verfasserin aut Lijing L. Yan verfasserin aut Lijing L. Yan verfasserin aut In Frontiers in Public Health Frontiers Media S.A., 2013 9(2021) (DE-627)742224589 (DE-600)2711781-9 22962565 nnns volume:9 year:2021 https://doi.org/10.3389/fpubh.2021.698030 kostenfrei https://doaj.org/article/1fe78877129a4bac9fe440d89aae0b0f kostenfrei https://www.frontiersin.org/articles/10.3389/fpubh.2021.698030/full kostenfrei https://doaj.org/toc/2296-2565 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021
allfieldsGer	10.3389/fpubh.2021.698030 doi (DE-627)DOAJ00504667X (DE-599)DOAJ1fe78877129a4bac9fe440d89aae0b0f DE-627 ger DE-627 rakwb eng RA1-1270 Nicholas Peoples verfasserin aut Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none have specifically explored PHC use among people with CMDs. Therefore, this mixed-methods study aimed to assess the use and perception of PHC services in Nepal among people living with CMDs for primary and secondary prevention of cardiovascular disease. We used a quantitative survey followed-up by semi-structured qualitative interviews. The sampling frame comprised five PHC facilities in Sindhuli district (rural; eastern Nepal) and five in Kailali district (urban; western Nepal), with participants selected from each facility via convenience sampling. 114 people (mean age: 54.5 ± 14.7, sex ratio 1.04) with CMDs participated in the survey. Survey data showed general dissatisfaction with PHC services. Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. Interview data showed that perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. Lack of resources and excessive barriers to care was mentioned by every interviewee. In conclusion, PHC use was high but overall satisfaction relatively low. Our results suggest that bedside manner is a practical target for future research. Additionally, we identified several barriers to care, and, based on existing literature, we suggest electronic-health interventions may have potential to mitigate these challenges. primary healthcare (PHC) cardiovascular disease hypertension stroke diabetes Nepal Public aspects of medicine Nicholas Peoples verfasserin aut Enying Gong verfasserin aut Enying Gong verfasserin aut Kamal Gautam verfasserin aut Shree N. Khanal verfasserin aut Brandon A. Kohrt verfasserin aut Brandon A. Kohrt verfasserin aut Suraj Koirala verfasserin aut Archana Amatya verfasserin aut Shangzhi Xiong verfasserin aut Truls Østbye verfasserin aut Truls Østbye verfasserin aut Jeffrey Moe verfasserin aut Qian Long verfasserin aut Lijing L. Yan verfasserin aut Lijing L. Yan verfasserin aut In Frontiers in Public Health Frontiers Media S.A., 2013 9(2021) (DE-627)742224589 (DE-600)2711781-9 22962565 nnns volume:9 year:2021 https://doi.org/10.3389/fpubh.2021.698030 kostenfrei https://doaj.org/article/1fe78877129a4bac9fe440d89aae0b0f kostenfrei https://www.frontiersin.org/articles/10.3389/fpubh.2021.698030/full kostenfrei https://doaj.org/toc/2296-2565 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021
allfieldsSound	10.3389/fpubh.2021.698030 doi (DE-627)DOAJ00504667X (DE-599)DOAJ1fe78877129a4bac9fe440d89aae0b0f DE-627 ger DE-627 rakwb eng RA1-1270 Nicholas Peoples verfasserin aut Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none have specifically explored PHC use among people with CMDs. Therefore, this mixed-methods study aimed to assess the use and perception of PHC services in Nepal among people living with CMDs for primary and secondary prevention of cardiovascular disease. We used a quantitative survey followed-up by semi-structured qualitative interviews. The sampling frame comprised five PHC facilities in Sindhuli district (rural; eastern Nepal) and five in Kailali district (urban; western Nepal), with participants selected from each facility via convenience sampling. 114 people (mean age: 54.5 ± 14.7, sex ratio 1.04) with CMDs participated in the survey. Survey data showed general dissatisfaction with PHC services. Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. Interview data showed that perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. Lack of resources and excessive barriers to care was mentioned by every interviewee. In conclusion, PHC use was high but overall satisfaction relatively low. Our results suggest that bedside manner is a practical target for future research. Additionally, we identified several barriers to care, and, based on existing literature, we suggest electronic-health interventions may have potential to mitigate these challenges. primary healthcare (PHC) cardiovascular disease hypertension stroke diabetes Nepal Public aspects of medicine Nicholas Peoples verfasserin aut Enying Gong verfasserin aut Enying Gong verfasserin aut Kamal Gautam verfasserin aut Shree N. Khanal verfasserin aut Brandon A. Kohrt verfasserin aut Brandon A. Kohrt verfasserin aut Suraj Koirala verfasserin aut Archana Amatya verfasserin aut Shangzhi Xiong verfasserin aut Truls Østbye verfasserin aut Truls Østbye verfasserin aut Jeffrey Moe verfasserin aut Qian Long verfasserin aut Lijing L. Yan verfasserin aut Lijing L. Yan verfasserin aut In Frontiers in Public Health Frontiers Media S.A., 2013 9(2021) (DE-627)742224589 (DE-600)2711781-9 22962565 nnns volume:9 year:2021 https://doi.org/10.3389/fpubh.2021.698030 kostenfrei https://doaj.org/article/1fe78877129a4bac9fe440d89aae0b0f kostenfrei https://www.frontiersin.org/articles/10.3389/fpubh.2021.698030/full kostenfrei https://doaj.org/toc/2296-2565 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021
language	English
source	In Frontiers in Public Health 9(2021) volume:9 year:2021
sourceStr	In Frontiers in Public Health 9(2021) volume:9 year:2021
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institution	findex.gbv.de
topic_facet	primary healthcare (PHC) cardiovascular disease hypertension stroke diabetes Nepal Public aspects of medicine
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container_title	Frontiers in Public Health
authorswithroles_txt_mv	Nicholas Peoples @@aut@@ Enying Gong @@aut@@ Kamal Gautam @@aut@@ Shree N. Khanal @@aut@@ Brandon A. Kohrt @@aut@@ Suraj Koirala @@aut@@ Archana Amatya @@aut@@ Shangzhi Xiong @@aut@@ Truls Østbye @@aut@@ Jeffrey Moe @@aut@@ Qian Long @@aut@@ Lijing L. Yan @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
hierarchy_top_id	742224589
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callnumber-first	R - Medicine
author	Nicholas Peoples
spellingShingle	Nicholas Peoples misc RA1-1270 misc primary healthcare (PHC) misc cardiovascular disease misc hypertension misc stroke misc diabetes misc Nepal misc Public aspects of medicine Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study
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topic_title	RA1-1270 Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study primary healthcare (PHC) cardiovascular disease hypertension stroke diabetes Nepal
topic	misc RA1-1270 misc primary healthcare (PHC) misc cardiovascular disease misc hypertension misc stroke misc diabetes misc Nepal misc Public aspects of medicine
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title	Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study
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title_full	Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study
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author_browse	Nicholas Peoples Enying Gong Kamal Gautam Shree N. Khanal Brandon A. Kohrt Suraj Koirala Archana Amatya Shangzhi Xiong Truls Østbye Jeffrey Moe Qian Long Lijing L. Yan
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title_sort	perception and use of primary healthcare services among people with cardiometabolic diseases in two resource-limited areas in nepal: a mixed methods study
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title_auth	Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study
abstract	Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none have specifically explored PHC use among people with CMDs. Therefore, this mixed-methods study aimed to assess the use and perception of PHC services in Nepal among people living with CMDs for primary and secondary prevention of cardiovascular disease. We used a quantitative survey followed-up by semi-structured qualitative interviews. The sampling frame comprised five PHC facilities in Sindhuli district (rural; eastern Nepal) and five in Kailali district (urban; western Nepal), with participants selected from each facility via convenience sampling. 114 people (mean age: 54.5 ± 14.7, sex ratio 1.04) with CMDs participated in the survey. Survey data showed general dissatisfaction with PHC services. Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. Interview data showed that perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. Lack of resources and excessive barriers to care was mentioned by every interviewee. In conclusion, PHC use was high but overall satisfaction relatively low. Our results suggest that bedside manner is a practical target for future research. Additionally, we identified several barriers to care, and, based on existing literature, we suggest electronic-health interventions may have potential to mitigate these challenges.
abstractGer	Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none have specifically explored PHC use among people with CMDs. Therefore, this mixed-methods study aimed to assess the use and perception of PHC services in Nepal among people living with CMDs for primary and secondary prevention of cardiovascular disease. We used a quantitative survey followed-up by semi-structured qualitative interviews. The sampling frame comprised five PHC facilities in Sindhuli district (rural; eastern Nepal) and five in Kailali district (urban; western Nepal), with participants selected from each facility via convenience sampling. 114 people (mean age: 54.5 ± 14.7, sex ratio 1.04) with CMDs participated in the survey. Survey data showed general dissatisfaction with PHC services. Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. Interview data showed that perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. Lack of resources and excessive barriers to care was mentioned by every interviewee. In conclusion, PHC use was high but overall satisfaction relatively low. Our results suggest that bedside manner is a practical target for future research. Additionally, we identified several barriers to care, and, based on existing literature, we suggest electronic-health interventions may have potential to mitigate these challenges.
abstract_unstemmed	Nepal is a country in south Asia with a high burden of cardiometabolic diseases (CMDs). Strengthening primary healthcare (PHC) is a key strategy to mitigate this increasing burden and achieve universal health coverage. While previous studies in Nepal have assessed PHC use among the elderly, none have specifically explored PHC use among people with CMDs. Therefore, this mixed-methods study aimed to assess the use and perception of PHC services in Nepal among people living with CMDs for primary and secondary prevention of cardiovascular disease. We used a quantitative survey followed-up by semi-structured qualitative interviews. The sampling frame comprised five PHC facilities in Sindhuli district (rural; eastern Nepal) and five in Kailali district (urban; western Nepal), with participants selected from each facility via convenience sampling. 114 people (mean age: 54.5 ± 14.7, sex ratio 1.04) with CMDs participated in the survey. Survey data showed general dissatisfaction with PHC services. Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. Interview data showed that perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. Lack of resources and excessive barriers to care was mentioned by every interviewee. In conclusion, PHC use was high but overall satisfaction relatively low. Our results suggest that bedside manner is a practical target for future research. Additionally, we identified several barriers to care, and, based on existing literature, we suggest electronic-health interventions may have potential to mitigate these challenges.
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title_short	Perception and Use of Primary Healthcare Services Among People With Cardiometabolic Diseases in Two Resource-Limited Areas in Nepal: A Mixed Methods Study
url	https://doi.org/10.3389/fpubh.2021.698030 https://doaj.org/article/1fe78877129a4bac9fe440d89aae0b0f https://www.frontiersin.org/articles/10.3389/fpubh.2021.698030/full https://doaj.org/toc/2296-2565
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