जारी अनुसन्धानहरु

जारी अनुसन्धानहरु


Factors Affecting the Success and Failure of Maternity Waiting Homes in Nepal

Maternity Waiting Homes (MWHs) are structures built at or near a health facility for pregnant women to stay at the end of their pregnancy so they can be transported easily to the health facility for delivery. MWHs were introduced in 1970s in order to create access to institutional delivery services. They were primarily utilized by the high-risk pregnant women who live far away from the health facilities. It can be an intervention aimed at eliminating the phase II delay by bringing women closer to facilities to deliver. It goes by many different names, but in general are accommodations at or nearby a health facility where pregnant women and accompanying family member can stay in the final weeks leading up to delivery.Nepal is an illustrative example of how MWHs can succeed and fail, and understanding the reasons for success or failure is imperative to informing the design and implementation of future MWHs in Nepal and elsewhere. The first 27 MWHs in Nepal were constructed by the Ministry of Health and Population (MoHP) with the support from UNFPA, none of which were found to be functional in a 2007 MWH feasibility study. Today, at least few MWHs are still operating in Nepal. In the FY 2075/76, the provincial government of Karnali (Province 6) of Nepal planned and implemented a program to operate maternity hostels (waiting homes) in all primary and tertiary hospitals with in the province by allocating some budget to offer a residential facility for the pregnant women in order to provide quality maternity care. There are few in...

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Effects of the Follow-Up and Enhancement program (FEP) on the retention of knowledge and skills of Skilled Birth Attendants (SBAs) and on the improvement of their working environments in rural Nepal.

The Nick Simons Institute (NSI) and Nepal Health Training center (NHTC) devised the Follow Up and Enhancement Program (FEP) – a pioneer program of supportive supervision where the clinical knowledge and skills of health workers who have received in-service training (e.g. SBA) are assessed directly at their working sites – in 2011. FEP allows on-site coaching and feedback so that trainees may continue to improve upon any gaps in their skills and knowledge. FEP also allows an assessment of the trainees’ working environment in terms of essential equipment, drugs supply, and team support which is collectively called the Enabling Environment Score. The assessments from the FEP can then be fed back to the Health Facility Management Committees at the district and central levels so that gaps in the working environment can be fulfilled.This study aims to assess the effect of the Follow-Up and Enhancement Program (FEP) on the retention of clinical knowledge and skills of Skilled Birth Attendants and on the improvement of their working environments and outcomes in rural Nepal. We will also explore the facilitating and hindering factors to provide maternal health services in rural settings....

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Deployment of Bio Medical Equipment Technician and the utilization of medical devices in the district hospitals of rural Nepal.

A large number of medical equipment in Nepal's government system is not fully functioning and awaits maintenance. Biomedical Equipment Technicians are severely needed in Nepal to provide the technical help that is necessary for effective medical equipment maintenance.This study will describe the types of medical equipment existing in rural district hospitals and their working status. Improvement in condition of medical devices can be achieved through deploying BMET, however studies have shown that Biomedical Equipment is out of service due to lack of trained professionals who are able to execute the needed repair or maintenance. Only few districts hospitals have deployed BMETs in rural Nepal. No studies have been conducted to explore the effectiveness of deploying BMETs in the rural context. This study will evaluate if the deployment of BMETs has led to improvement in condition of medical devices in district hospitals....

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Minimum Service Standards scores versus health outcomes and perceptions in Nepal Government District Hospitals.

With health as a fundamental right, people in rural Nepal are becoming increasingly aware of their healthcare needs. Recent health policies and strategies in Nepal place a central emphasis on the importance of improving quality at the point of care. The National Health Policy commits Nepal to ensure access to quality health services: (1) Quality Health Services are identified as one of the strategic directions for achieving Universal Health Coverage (UHC) in the Nepal Health Sector Strategy 2015 – 2020. (2) Improving quality of care at the point-of-delivery is an outcome of the Strategy.This study will generate evidence towards the applicability of MSS as a measure of quality in district hospitals of Nepal. This will be accomplished by comparing the MSS scores in aggregate and domain-wise between the different hospitals with health outcomes data obtained from HMIS (Health Management Information System) as well as perceptions from patients, hospital development committees, and the community. This is the first study to describe MSS and its role in government district hospitals of Nepal.The primary objective of the study is to compare the MSS scores with health outcomes and to explore the user’s perceptions towards Government hospitals and quality of services. We hypothesize that the higher MSS scores in general are associated with better healthcare outcomes and better patient/community/hospital management perceptions. ...

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