Healthcare accessibility in the rural plains (terai) of Nepal: physical factors and associated attitudes of the local population

Abstract

Background While access to healthcare has been a focus of international development, populations around the world continue to lack proper access to care. Identifying at-risk demographic groups can help advance efforts both regionally and internationally. There are only a small number of studies that previously have assessed physical barriers and attitudes in Nepal. Methods This study assessed the factors and attitudes associated with healthcare accessibility in a rural population outside of Lumbini, Nepal. This descriptive cross-sectional study used a volunteer-sampling approach to collect 585 questionnaire responses from the area formerly known as the Madhuwani Village Development Committee. Results The study found that the population was more likely to access private care than public, and reported longer times to access a hospital than the national average. Across almost all findings, those with lower than a secondary education had significantly larger barriers, lower satisfaction and higher reported difficulty in accessing healthcare. Females were shown to have significantly larger transportation barriers in accessing care and lower satisfaction compared with males. Conclusions Results identify women and the less-educated as having larger barriers to accessing healthcare. Further research should focus on how inequities in access affect health outcomes among these identified vulnerable groups.

Equity of geographical access to public health facilities in Nepal

“… 2 Although the country has made notable progress in health outcomes over the past two decades, 5 inequity in access to healthcare is still significant. 6 7 Particularly, one of the major barriers were poor geographical accessibility of many people, according to the Nepal Health Sector Strategy 2015–2020. 8 Indeed, studies have shown that the utilisation of healthcare is closely related to the physical accessibility to medical services.…”

“…To our knowledge, studies on accessibility to health resources in Nepal are few, most of which are based on cross-sectional surveys on sampled residents. 6 11 According to the Nepal Living Standards Survey 2010–2011, only 61.8% of households in Nepal can reach the nearest health posts within 30 min, with significant urban and rural differences. 11 However, these studies did not provide enough information on geographical accessibility of each residential settlement to public health facility across the country.…”

Drivers of zoonotic disease risk in the Indian subcontinent: A scoping review

“…This lack of behaviour change could be related to cultural practices, or may relate primarily to structural issues such as community poverty and lack of access to healthcare providers and veterinarians. For example, much of the population of Nepal, one of the countries covered in this review, has little to no access to qualified healthcare providers, particularly in remote and rural regions: 41% of rural communities have no access to a health post, and 80% do not have access to a public hospital within 30 min of their home by public transport [ 106 ]. Many families are unable to afford veterinary care, even when it is available, and must treat their livestock themselves.…”

Ranking the Healthcare Resource Factors for Public Satisfaction with Health System in China—Based on the Grey Relational Analysis Models

“…Explanatory variables include the total health expenditure as a percentage of GDP [3], the governments' percentage of the total health expenditure on healthcare [3][4][5], out-ofpocket percentage of individuals [6,13,37], representing general supply and affordability of healthcare service [15][16][17][18][19][20]69].…”

“…Apart from dimensions of safety, effectiveness, responsiveness, affordability, accessibility, and patient-centeredness [15][16][17][18][19][20], public satisfaction is also a very important comprehensive indicator of the health system [1,6,14], because it includes not only users (the patients) but also non-users (the healthy population) in the system [7]. Hence, it can provide meaningful information (such as key factors of public satisfaction improvement) for health policy reform [21,22] and government's decisions making (such as fiscal expenditure allocation and healthcare service supplies) [23][24][25][26].…”