Health System Capacity and Access Barriers to Diagnosis and Treatment of CVD and Diabetes in Nepal

BackgroundUniversal access to essential medicines and routine diagnostics is required to combat the growing burden of cardiovascular disease (CVD) and diabetes. Evaluating health systems and various access dimensions availability, affordability, accessibility, acceptability, and quality is crucial y...

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Bibliographic Details
Published in:Global heart 2021-05, Vol.16 (1), p.38-38
Main Authors: Sharma, Abhishek, Kaplan, Warren A., Satheesh, Gautam, Poudyal, Indra Prasad, Gyawali, Pawan, Neupane, Dinesh, Bhandari, Parash Mani, Malla, Milan, Sapkota, Surendra, Mishra, Shiva Raj
Format: Article
Language:English
Subjects:
cardiovascular disease
diagnostics
essential medicines
healthcare delivery
nepal
Original Research
sustainable development goals
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Summary:BackgroundUniversal access to essential medicines and routine diagnostics is required to combat the growing burden of cardiovascular disease (CVD) and diabetes. Evaluating health systems and various access dimensions availability, affordability, accessibility, acceptability, and quality is crucial yet rarely performed, especially in low- and middle-income countries. ObjectiveTo evaluate health system capacity and barriers in accessing diagnostics and essential medicines for CVD and diabetes in Nepal. MethodsWe conducted a WHO/HAI nationally-representative survey in 45 health-facilities (public-sector: 11; private-sector: 34) in Nepal to collect availability and price data for 21 essential medicines for treating CVD and diabetes, during MayJuly 2017. Data for 13 routine diagnostics was obtained in 12 health facilities. Medicines were considered unaffordable if the lowest paid worker spends >1 days wage to purchase a monthly supply. To evaluate accessibility, we conducted facility exit interviews among 636 CVD patients. Accessibility (e.g., private-public health facility mix, travel to hospital/pharmacy) and acceptability (i.e. Nepals adoption of WHO Essential Medicine List, and patient medication adherence) were summarized using descriptive statistics, and we conducted a systematic review of relevant literature. We did not evaluate medicine quality. ResultsWe found that mean availability of generic medicines is low (
ISSN:2211-8160
2211-8179
DOI:10.5334/gh.927