KUMJ | VOL. 19 | NO. 3 | ISSUE 75 Special | JULY - SEPT. 2021
Assessment of Health Service Delivery to Address Cardiovascular Diseases in Nepal
Suwal PS, Prajapati D, Bajracharya S, Shrestha A, Maharjan R, Shrestha S, Jha N, Koju RP, Vaidya A
Abstract: Background
A health care delivery system is the organization of people, institutions, and resources
designed to deliver health services. A comprehensive study to explore cardiovascular
health service delivery in Nepal is lacking.
Objective
This study attempted to assess Nepal’s health system gap on organization and
delivery of cardiovascular disease prevention and management services.
Method
This mixed-method study used the six building blocks of the World Health Organization
health system framework: organization; access; coverage, utilization and demand;
equity; quality of services; and outcomes. We conducted the desk reviews of national
and international documents, performed several key informant interviews, calculated
the relevant indicators, and assessed the Strengths, Weaknesses, Opportunities, and
Threats of the cardiovascular health service delivery.
Result
We found that most of the cardiovascular services are concentrated in urban areas,
and suffer from poor access, quality, utilization, and coverage in most of the areas
resulting in poor health outcomes. Though the services have recently improved
due to increased primary care interventions, there is scope for the development
of competent human resources, advancement of technologies, development of
national protocols, and improved monitoring and supervision. Improved disease
system including the medical recording and reporting mechanism to incorporate and
reflect the true burden of CVD in Nepal is lacking.
Conclusion
Despite having health facilities from grassroots to the central level, availability, access,
and quality of cardiovascular health services are poor. Further improvement and
equitable expansion of promotive, preventive, diagnostic, referral, and rehabilitative
cardiovascular services are needed to ensure universal health coverage.
Keyword : Cardiovascular Diseases, Health-service delivery, Infrastructure, Needs-assessment, Nepal
