Choice of health-care facility after introduction of free essential health services in Nepal
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Background: Choice of health‑care services depends on patients’ characteristicsand the features of health‑care facilities available. In Nepal, a significant proportionof health care is provided through the private sector, despite the introduction of freeessential health care for all citizens in 2008. We sought to determine whether peoplechose private or public facilities in the first instance for acute health problems. Wealso assessed the reasons for their choice.Materials and Methods: Across‑sectional survey was done by use of a questionnaireadministered to 400 household heads in Jhapa district, Nepal.Results: 272 (68%) respondents sought treatment from public health‑care facilitiesin the first instance. On adjusted analysis, illiterate people were more likely tochoose public facilities than people with higher secondary education (OR 5.47,P = 0.002). Similarly, lower‑caste and religious‑minority respondents were morelikely to choose public facilities than disadvantaged janajati (OR 2.33, P = 0.01).Among respondents who used public facilities, 174 (64.0%) and 109 (40.0%) statedthat that their choice was based on financial accessibility and physical accessibility,respectively. Among respondents who used private facilities, 65 (50.7%) and54 (42.1%) said their choice was based on adequacy of resources/services andhealth‑care delivery, respectively.Conclusion: A substantial portion of respondents used public health‑care facilitiesin the first instance, mainly because of financial and physical accessibility ratherthan adequacy of resources or better health‑care delivery. These results mayindicate a positive impact of removal of user fees for public health‑care facilitiesin Nepal, especially for impoverished people.Описание
Rajendra Karkee & Jhalka Kadariya. (2013). Choice of health-care facility after introduction of free essential health services in Nepal. WHO South-East Asia Journal of Public Health, 2 (2), 96 - 100. World Health Organization. Regional Office for South-East Asia. https://iris.who.int/handle/10665/329781
Журнал
WHO South-East Asia Journal of Public Health, 2 (2): 96 - 100ISSN
2224-3151 (Print)2304-5272 (Electronic)